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ACP-ASIM Releases Plan to Ensure All Americans Have Health Insurance by 2009

April 12, 2002

(Philadelphia, PA): The American College of Physicians- American Society of Internal Medicine (ACP-ASIM) has released a comprehensive plan to ensure that all Americans have health insurance within seven years.

"This plan does not seek to replace the current health care system with a model based on the experience of a foreign nation," said incoming ACP-ASIM President Sara Walker, MD, MACP. "We propose to preserve what is best about the American approach to health care and to expand programs that are already in place and functioning."

Under the College plan, the following changes would occur in the American health care system.

  • a subsidized health insurance program would be available to all who lack another form of coverage;

  • all insurance plans would be required to offer a standard basic package of benefits including preventive services;

  • health plans would be required to agree to uniform new federal rules on risk rating and renewability as a condition of participating in the program;

  • and purchasing groups would give individuals the collective buying power that is now available only to large groups.

To reach the goal of insurance for all Americans, the College believes that Congress should enact legislation to establish a framework of a step-by-step plan to make affordable coverage available to all Americans.

"We want to challenge the conventional wisdom that it would take decades to achieve health insurance coverage for all," said Dr. Walker.

The College's plan calls for the following steps.

  1. Congress adopts a resolution establishing the goal of making health insurance coverage available to all citizens within seven years.

  2. Congress creates an advisory commission to report annually on the effectiveness of measures to expand health insurance coverage. The Commission will also develop a basic benefits package that will be required of health plans.

  3. Congress enacts legislation to make affordable coverage available to all people with incomes up to 200 percent of the Federal poverty level. The legislation creates national income eligibility for Medicaid (up to 100 percent of the federal poverty level). This step would make health insurance coverage available to more than one-third of the total uninsured population.

    S-CHIP will be converted to a federal-state entitlement program. The federal contribution to Medicaid will be increased to fully cover the costs of the expanded enrollment. A premium subsidy program for individuals with incomes from 100-200 percent of the federal poverty level would be applied to Medicaid or S-CHIP "buy ins" or toward the purchase of individual or employer coverage.

  4. Congress expands the premium subsidy program to all uninsured individuals with incomes above 200 percent of the federal poverty level. Legislation also authorizes the creation of purchasing groups. The legislation will establish basic benefits requirements and market reforms for health plans.

  5. Congress enacts legislation to authorize states to request a waiver to opt-out of the national framework for coverage. States that meet federal guidelines will be able to use federal funding for state programs.

  6. The National Commission on Expanded Access submits a recommendation to Congress on mechanisms to discourage individuals from voluntarily opting out of insurance coverage. Options to be considered include: automatic enrollment in Medicaid, S-CHIP, or Medicare, with a tax imposed on the individual to cover a portion of the costs of enrollment.

"Even if Congress does not agree to everything we are proposing, we hope to succeed in challenging the conventional wisdom that nothing can or will be done to make health insurance coverage available to everyone before the close of the decade," said Dr. Walker. "We intend to show that it is possible to make coverage available to all within seven years by building upon the current health care system."

The American College of Physicians-American Society of Internal Medicine is the nation's largest medical specialty organization and the second largest physician group. Membership encompasses more than 115,000 internal medicine physicians and medical students.

Jack Pope, ACP-ASIM Washington Office, (202) 261-4556
Jennifer Whalen, ACP-ASIM Washington Office, (202) 261-4575

Page updated: 11-04-03

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