May 04, 2003 -- Stripped-down care for the uninsuredThanks to Don McCanne's Quote-of-the-day mailing list for the article and his comments. The article concerns how states are passing laws for "universal health coverage" providing stripped-down health plans for the uninsured. As shown below, these "covering the uninsured" laws explicitly exempt these stripped-down plans from state laws mandating a certain level of care for other health plans. The example below concerns Colorado, Texas is pursuing a similar strategy. Let us be forewarned; if states can legally establish these stripped-down plans for the uninsured, we will all be put on them before long.
Single payer, by itself, simply means a single financial funnel for reimbursement. We also need a single standard of healthcare benefits, with the same level of care available for all. I think most of us understand "single payer" to include this, but this article shows we need to explicitly demand it.
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Sixty-fourth General Assembly, State of Colorado House Bill 03-1164 A Bill for an Act Concerning the Expansion of Access to Health Insurance...
The commissioner shall promulgate rules to implement a basic health benefit plan and a standard health benefit plan to be offered by each small employer carrier as a condition of transacting business in this state.
The commissioner shall implement a basic plan that approximates the lowest level of coverage offered in small group health benefit plans and shall implement a standard plan that approximates the average level of coverage offered in small group health benefit plans.
(a) The standard health benefit plan shall reflect the benefit design of common plan offerings in the small group market...
(b) The basic health benefit plan shall NOT INCLUDE COVERAGE PURSUANT TO THE MANDATORY COVERAGE PROVISIONS OF SECTION 10-16-104 (4), (5), AND (8) TO (12).
Don McCanne's Comment: This bill was passed by the Colorado State House, and then was amended (capital letters, above) and approved by the Colorado Senate. It now returns to the House for approval of the Senate amendments.
With this benign-sounding amendment, the bill creates state-sanctioned, bare- bones insurance plans which are stripped of "mandated" benefits. In the name of "affordability," Colorado would be authorizing plans that will provide neither health security nor financial security.
This is a national issue. Legislation has been proposed to create association health plans (AHPs), which would be designed to allow small businesses to offer similar bare-bones coverage that would be exempt from state-mandated benefits. Affordability of health care coverage for small businesses and for the uninsured is a crucial issue. But creating affordability by destroying the security that should be offered by private plans is not the answer. And other current reform proposals to fund private plans through tax credits will only increase pressures to strip plans of their benefits.
We need affordable, comprehensive coverage for everyone. The only model of reform that promises that is a single, publicly-administered program of social insurance.
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