May 10, 2006 — A bipartisan bill designed to expand health care coverage to millions of uninsured Americans while improving quality and efficiency was introduced in the U.S. Senate on May 9, 2006.
Arthur Garson Jr., M.D., Vice President and Dean of the School of Medicine of the University of Virginia and other health policy experts worked closely with senators George Voinovich (R-OH) and Jeff Bingaman (D-NM) on its development.
The bill was unveiled at a press conference in Washington D.C. Under the Health Partnership Act, Congress would authorize grants to individual states, groups of states and Indian tribes to carry out any of a broad range of strategies to increase health care coverage; ensure patients receive high quality appropriate care; improve the efficiency of health spending; and use information technology to improve infrastructure.
“States have shown themselves to be the innovators in health care systems; what has been lacking is a mechanism by which states could learn from each other and then implement best practices. This bill creates a framework for action,” said Garson. “We need to take action, as the number of uninsured in our country has now topped 46 million, nearly one-in-seven Americans—on its way to one-in-five in the next few years.”
To put this in perspective, 46 million people without insurance is more than the combined populations of Canada and Australia; more than the aggregate population of 24 states. And more than the number of people in the U.S. who are covered by Medicare.
Nearly half of small businesses with between three and nine workers do not provide health insurance for their employees. The skyrocketing cost of health insurance premiums forces many businesses (some of them not small) into the decision of offering health care insurance or staying in business.
For those Americans living near or below the poverty line, after paying for food, housing, transportation and child care needs, roughly 3 to 5 percent of their income is left for health care insurance. When a family insurance premium ranges from $2,300 to $10,000 annually, health insurance quickly becomes a luxury that many people cannot afford.
“The uninsured are the people we meet every day: waiters, clerks in the local cleaners, people that help us at some large discount stores. These are not faceless people. One of my first patients had successful heart surgery at the age of 5 only to die suddenly at 19; she had not refilled a vital prescription after her Medicaid ran out. ” said Garson.
Garson worked with an Institutes of Medicine panel that first developed the state model concept. He then worked with others involved in healthcare policy to turn these ideas into a bill that will expand coverage to millions of Americans as well as improve efficiency by getting rid of paperwork burdens and introducing electronic systems. In addition, the bill will incorporate quality measures to provide the best care possible in the most cost-effective way possible.
“I want to commend Senators Voinovich and Bingaman for taking the first real national steps in a long time to improving our entire health care system, said Garson.”
Health Partnership Act Summary:
Each state’s grant application would be required to:
a) Describe the manner in which the state would ensure that an increased number of individuals gain access to health care coverage with a specific five-year target;
b) Provide a plan to improve overall health delivery quality, including safety and medical errors;
c) Reduce administrative costs (including paperwork burdens) and
d) Provide methodology for the use of health IT to improve infrastructure.
State Plans: States desiring to implement a state health care expansion and improvement program would submit an application to a federal “State Health Innovation Commission” housed at the Department of Health and Human Services (HHS). The Commission would be comprised of the Secretary of HHS, four state governors (appointed by NGA), two members of state legislators (to be appointed by the NCSL), two county officials (to be appointed by National Association of Counties), four members of the United States House of Representatives, and four Senators.
State Health Innovation Commission: The Commission would approve a variety of reform options (“toolbox”), including tax credit approaches; expansion of Medicaid or SCHIIP; creation of pooling arrangements like the FEHBP; single payer systems; health savings accounts; or a combination of these or other options.
Plan Approval: After reviewing the state proposals, the Commission would submit to Congress a list of recommended state applications. The Commission would also recommend the amount of federal grant money each state should receive to carry out the actions described in their plan.
Reports: At the end of the five year period, the Commission would be required to report to Congress whether the states are meeting the goals of the Act and recommend future action Congress should take concerning overall reform, including whether or not to extend the program.