(Adds details on Baucus plan)
By Patrick Yoest Of DOW JONES NEWSWIRES WASHINGTON -(Dow Jones)- U.S. Senate Finance Committee Chairman Max Baucus urged quick action on his plan to provide health insurance for all Americans through a new pooling arrangement intended to reduce health-care costs and expand access to Medicare and Medicaid.
Baucus, D-Mont., on Wednesday unveiled the proposal, which would create a pooling scheme called the Health Information Exchange that is intended to foster competition in the health-insurance market. Health insurers participating in the exchange would be regulated by an independent health council, according a white paper released by the Senate Finance Committee.
"The health-care system in this country is broken for individual Americans, and it's straining our economy," Baucus said.
Under Baucus' plan, individuals at or below four times the federal poverty level would qualify for subsidies to buy insurance in the exchange, while small businesses would receive tax credits based on earnings and the number of employees participating in the system. The plan, if adopted, would represent an unprecedented level of government intervention in the health-insurance market and likely would cost the federal government billions of dollars a year until long-term cost savings from an improved primary-care system are realized.
To ease the transition to the health-insurance exchange, the plan would also temporarily allow people aged 55 to 64 to buy into Medicare coverage and would allow all those at or under the federal poverty level to be eligible for Medicaid.
Baucus said he hoped the Medicare buy-in provision would take effect "right away." According to the proposal, the buy-in is intended for individuals who can't afford to pay private insurance premiums because the premiums are too high due to the participant's age and pre-existing medical conditions.
Once the exchange takes effect - which Baucus estimated would take three years - participants in the Medicare buy-in could switch to purchasing private insurance through the exchange.
For individuals employed by mid- and large-sized companies, Baucus' plan would allow them to pay for insurance premiums through pre-tax income.
Large employers who don't provide health insurance to their employees would have to pay into a fund covering employees who aren't insured, likely "based on a percentage of payroll that took into account the size and annual revenues of each firm," according to the proposal.
Baucus said he wants to see speedy passage of the health-care plan in the Senate.
"I'd like to see, frankly, the legislation acted on in the first half of the year," he said. Baucus said he had several conversations with Senate Health, Education, Labor and Pensions Chairman Edward Kennedy, D-Mass., in recent weeks. Kennedy shares jurisdiction with Baucus on health-care issues, and Kennedy's staff has pledged an aggressive approach on health-care legislation.
Baucus said he had several conversations with Senate Health, Education, Labor and Pensions Committee Chairman Edward Kennedy, D-Mass., in recent weeks. Kennedy shares jurisdiction with Baucus on health-care issues, and Kennedy's staff has pledged an aggressive approach to health-care legislation.
But while Kennedy staffer Michael Myers on Nov. 6 called for a "one-bill strategy" to craft health-care legislation next year, Baucus was more agnostic on the question of how legislation would materialize.
"There are certain provisions that are certainly within the jurisdiction of the Senate Finance Committee...and there are provisions clearly in the jurisdiction of the Health Committee," Baucus said. "Now, is that two bills? I don't know."
Still, the two appear to be taking a joint approach to crafting health-care legislation, at least for now.
"I want to work with Sen. Kennedy," Baucus said Wednesday. In a statement, Kennedy said Baucus' proposal is "a major contribution to the debate on health reform."
Baucus' plan differs in one key respect from President-elect Barack Obama's long-time policy platform on health care: Baucus, unlike Obama, would require Americans to buy health care in order to maximize the amount of participants in the new system and create a larger pool. Baucus on Wednesday sought to reinforce the notion that the plan was a public-private hybrid - a mix of tax incentives and expansions of public health-care programs.
"Some people suggest the United States should have a single-payer system," Baucus said. "I don't think a single-payer system makes sense in this country."
Another part of Baucus' proposal would expand the state children's health-insurance program, or Schip, by requiring states to insure all children at or below 250% of the federal poverty level. Schip is intended to cover mostly low-income children who don't qualify for Medicaid.
While some states already provide benefits at this level, 14 states had a funding shortfall for Schip in 2007 and some had to lower the income threshold for the program.
House Ways and Means Health Chairman Pete Stark, D-Calif., has said that he wants Congress to pass a stand-alone Schip expansion as one of its first acts in 2009. Baucus wouldn't say whether he would endorse a move to separate Schip expansion from a broader health-care overhaul.
"That's a tactical, strategic question we're going to have to work out," Baucus said.
In a statement, Stark and House Ways and Means Chairman Charles Rangel, D-N.Y., said Baucus' proposal "supports a number of principles we have pursued over time" and that they "look forward to working together with Sen. Baucus and other members of Congress, under the leadership of the Obama administration, to ensure affordable health care for all."
The cost of creating the health-insurance exchange and expanding coverage through private insurance and federal government programs would create substantial new spending in the short term, Baucus said. But he declined to put a dollar figure on the cost of this program.
Baucus policy staff said Wednesday that the costs of the program likely wouldn't be offset with new taxes - or in other words, the Baucus proposal would create new deficit spending.
"It's something we're clearly going to have to talk about," one staffer said. "[Baucus] believes there's going to be an initial investment that you can't make up."
Baucus' plan won initial praise Wednesday from a number of advocacy groups and trade organizations.
AARP, which represents older Americans, praised several parts of the plan, including the Medicare buy-in and a Schip expansion.
Karen Ignagni, president and chief executive of the insurers' trade group America's Health Insurance Plans, in a statement praised Baucus "for putting forth a comprehensive reform proposal that addresses the key health-care challenges facing the nation."
Helen Darling, president of the National Business Group on Health, said Baucus "is to be commended for rightly recognizing that health-care reform goes hand-in-hand with addressing our nation's broader economic problems." Darling's organization represents 300 large employers.
-By Patrick Yoest, Dow Jones Newswires; 202-862-3554; patrick.yoest@dowjones.com
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(END) Dow Jones Newswires
November 12, 2008 17:29 ET (22:29 GMT)

Publié le 12 novembre 2008 Copyright © 2008 Dowjones