Who Helps The 47 Million Uninsured?

Washington, D.C. President Bush is convinced that “private health insurance is the best way to meet” the health care needs of Americans. In his recent speech on the state of the Union, he proposed to reward Americans with a standard tax deduction if they purchase their health insurance from private companies. Regrettably, however, for the 47 million uninsured Americans, the insurance industry fails to provide coverage they can afford.

According to the Kaiser Family Foundation, “roughly 90 percent of applicants in what’s known as less-than-perfect-health were unable to buy individual policies at standard rates, while 37 percent were rejected outright.” To encourage the states to provide coverage to the uninsured, Mr. Bush proposed the Affordable Choices Initiative that would give participating states new federal funds for the purchase of private insurance but not for coverage through public programs.

No longer willing to wait for Congress and the President to address the national health care crisis, the governments of Maine, Massachusetts, and Vermont have been instituting their own versions of statewide universal health insurance. Most recently, California’s Republican Governor Arnold Schwarzenegger proposed to extend health care coverage to the 6.5 million (or 20 percent) uninsured among the 36 million residents of his state. Complicating his plan is the fact that more than one million of the uninsured are illegal immigrants.

Rather than financing the project’s estimated $12 billion cost with government funds only, Schwarzenegger wants the burden be shared by contributions from state and federal funds, employers, health care providers, and the uninsured themselves. Hospitals are to contribute 4 percent and physicians 2 percent of their revenues to help cover the cost of health care for the poor in the Medicaid (called Medi-Cal in California) program.

Medicare in California is presently limited to adults with children and children of families with incomes 250 percent above the federal poverty line. Schwarzenegger’s plan would extend eligibility for Medicare to children regardless of their immigration status, as well as to families with incomes up to 300 percent and adults up to 100 percent above the poverty line. Illegal adult immigrants would be excluded from Medicaid, but local health agencies would still be allowed to render them services.

Businesses with 10 or more employees that refuse to offer employees health insurance would be required to pay an amount equaling 4 percent of their total social security payments into a state fund purchasing insurance for the working uninsured. While Schwarzenegger wants the 4 percent levy to serve as an incentive for employers to provide health care coverage, a caucus of Republican state legislators denounced the levy as a “job tax.” The governor also faces opposition from the insurance companies because he opposes denying coverage to patients deemed too old or suffering from pre-existing health conditions. The insurers would also be required to contribute 85 percent of their profits directly to health care.

While Mr. Bush proposes a tax incentive to the Americans who are financially able to buy health insurance, he offers no relief for the nation’s 16 percent uninsured. The Schwarzenegger plan, however, seriously tries to help the uninsured. It calls not only on the government but also on the health care suppliers and the insurance industry to contribute an affordable share to the solution of the problem.

While it appears that a Congress controlled by Democrats is unlikely to give Mr. Bush’s proposal a favorable hearing, Mr. Schwarzenegger’s chances for the passage of his plan--albeit in revised form--appear to be fair. “Taking each part separately, there’s something for everyone to hate,” commented the chief executive of Blue Shield of California. “But taken as a whole, there’s a lot to like.”

How do you, dear reader, rate the Bush and the Schwarzenegger initiatives? Or do you have a different and better solution altogether?

Wolf D. Fuhrig	Home	02-04-07
Who Helps The 47 Million Uninsured?
*Washington, D.C.* President Bush is convinced that “private health insurance is the best way to meet” the health care needs of Americans. In his recent speech on the state of the Union, he proposed to reward Americans with a standard tax deduction if they purchase their health insurance from private companies. Regrettably, however, for the 47 million uninsured Americans, the insurance industry fails to provide coverage they can afford. According to the Kaiser Family Foundation, “roughly 90 percent of applicants in what’s known as less-than-perfect-health were unable to buy individual policies at standard rates, while 37 percent were rejected outright.” To encourage the states to provide coverage to the uninsured, Mr. Bush proposed the Affordable Choices Initiative that would give participating states new federal funds for the purchase of private insurance but not for coverage through public programs. No longer willing to wait for Congress and the President to address the national health care crisis, the governments of Maine, Massachusetts, and Vermont have been instituting their own versions of statewide universal health insurance. Most recently, California’s Republican Governor Arnold Schwarzenegger proposed to extend health care coverage to the 6.5 million (or 20 percent) uninsured among the 36 million residents of his state. Complicating his plan is the fact that more than one million of the uninsured are illegal immigrants. Rather than financing the project’s estimated $12 billion cost with government funds only, Schwarzenegger wants the burden be shared by contributions from state and federal funds, employers, health care providers, and the uninsured themselves. Hospitals are to contribute 4 percent and physicians 2 percent of their revenues to help cover the cost of health care for the poor in the Medicaid (called Medi-Cal in California) program. Medicare in California is presently limited to adults with children and children of families with incomes 250 percent above the federal poverty line. Schwarzenegger’s plan would extend eligibility for Medicare to children regardless of their immigration status, as well as to families with incomes up to 300 percent and adults up to 100 percent above the poverty line. Illegal adult immigrants would be excluded from Medicaid, but local health agencies would still be allowed to render them services. Businesses with 10 or more employees that refuse to offer employees health insurance would be required to pay an amount equaling 4 percent of their total social security payments into a state fund purchasing insurance for the working uninsured. While Schwarzenegger wants the 4 percent levy to serve as an incentive for employers to provide health care coverage, a caucus of Republican state legislators denounced the levy as a “job tax.” The governor also faces opposition from the insurance companies because he opposes denying coverage to patients deemed too old or suffering from pre-existing health conditions. The insurers would also be required to contribute 85 percent of their profits directly to health care. While Mr. Bush proposes a tax incentive to the Americans who are financially able to buy health insurance, he offers no relief for the nation’s 16 percent uninsured. The Schwarzenegger plan, however, seriously tries to help the uninsured. It calls not only on the government but also on the health care suppliers and the insurance industry to contribute an affordable share to the solution of the problem. While it appears that a Congress controlled by Democrats is unlikely to give Mr. Bush’s proposal a favorable hearing, Mr. Schwarzenegger’s chances for the passage of his plan--albeit in revised form--appear to be fair. “Taking each part separately, there’s something for everyone to hate,” commented the chief executive of Blue Shield of California. “But taken as a whole, there’s a lot to like.” How do you, dear reader, rate the Bush and the Schwarzenegger initiatives? Or do you have a different and better solution altogether?

Wolf D. Fuhrig

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02-04-07

Who Helps The 47 Million Uninsured?