Insuring The Uninsured:
Strategies For Success

by Shelly Harrison

A National Concern

The US Census Bureau reports that 44 million Americans go without health insurance each month for a variety of reasons. In Kansas and Missouri alone, there are 940,470 uninsured people. As healthcare costs cont-inue to escalate, employers are forced to rethink what is affordable coverage for their employees; healthcare providers strain to bear the cost of providing care to uninsured patients, families struggle to pay for increasing cost-shifts and many individuals remain uninsurable in the private market due to pre-existing conditions. With the steady rise of health care costs it is more important than ever to address the dilemma of the uninsured and support innovative, thoughtful initiatives that promote reduced costs, greater flexibility and more choice for consumers.

Who are the uninsured? Many of the uninsured are hard-working Americans who simply earn too much to qualify for Medicaid, yet not enough to afford health insurance.

What if we stay status quo? For most individuals, being uninsured is a temporary situation, however for many, the problem isn't access--it's affordability. They cannot afford their share of employer-sponsored plans or bear the entire cost of individual coverage. Many of the uninsured are hard-working Americans who simply earn too much to qualify for Medicaid, yet not enough to afford health insurance. As healthcare costs rise and cost-shifting continues to swing toward the employee, will the number of uninsured increase? Likely!

Can we fix the problem? There is no silver bullet solution to answer the growing concern of such a diverse American population, but a number of proposals have been put forth that provide real solutions. Health Savings Accounts (HSAs) were enacted as part of the Medicare Modernization Act and makes health insurance more affordable by encouraging individuals to be better health care consumers and more aware of the costs of medical care. The new law allows individuals to put money, tax-free, into HSA accounts to help with health insurance costs not covered by their insurance and to save for future medical expenses. HSA funds can pay for expenses before the deductible is met as well as help pay for services Not covered by the health plan or COBRA coverage during periods of unemployment.

Advanceable, refundable health insurance tax credits for low-income individuals would be an excellent way to address the challenge of the uninsured and provide a practical answer to the most basic component of access to health care--affordability. Such a credit would provide a way for qualified individuals to pay their health care premium on a monthly basis. It would create a fair means to make current health insurance tax policy more equitable by providing tax benefit for those who do not benefit from the tax exclusion on employer paid premiums due to their income status and benefit individuals and families without access to employer based coverage. Some federal bills for tax credits proposed by Granger (TX) HR1236, Collins (ME) S100 and Bilirakis (FL) S2698, uphold these crucial components and provide tax credits for both group and individual markets, providing tangible means to pay health insurance and COBRA premiums when people change jobs. Allowing low-income employees to supplement their employer's contributions with a refundable tax credit would allow families to be insured together and would empower individuals to select their own place of purchase, rather than having it imposed on them by the government.

Lastly, I would be remiss not to mention also the need for Malpractice reform at both the federal and state levels. Providers are leaving the state of Missouri due to high malpractice costs. Such reforms should include limitations on pain and suffering awards and the timeframe litigation can be sought. Defensive medicine resulting from the threat of malpractice lawsuits accounts for a significant portion of the high cost of health care and unlimited lawsuits do not ensure accountability of either health plans or providers.

As an employer, is your healthcare plan becoming un-affordable for you and your employees? Do you offer benefits at all? Employees look to you for more than a paycheck and you know that employees that feel secure are far more productive. For more information on healthcare tax credit proposals and what the new HSA laws have to offer and other pertinent benefit information, you may visit the NAHU website at www.nahu.org.

Shelly Harrison, is a Sales Operations Supervisor with United Healthcare in Overland Park, Kansas. She can be reached by e-mail at shelly_k_harrison@uhc.com or by phone at 913.317.7226 .