National Congress on the

1

• National Congress on the
• Uninsured and Underinsured

December 10, 2007
Karen Ignagni President and CEO Americas Health
Insurance Plans
2
Outline

• Our Objectives
• What do Voters Say?
• What We Have Proposed
• Bipartisan Approach to Reform
• Addressing the Larger Puzzle
• Conclusion

3
Our Objectives

• Getting Kids Covered
• Getting Adults Covered
• Blending Public/Private Solutions
• Defining an Affirmative Role for Both Public and
  Private Sectors
• Inserting Quality Into the Debate
• Ensuring Costs Are Not Ignored

4
What Are the Voters Saying? Topics They Want to
Hear from the Candidates
Source Kaiser Family Foundation Domestic Issues
Only October, 2007
5
What Are the Voters Saying? Priorities for
Health Care Reform
Source Kaiser Family Foundation October, 2007
6
TrendsHow Rising Costs Affect Coverage
Uninsured Rate
Private Health Insurance Premiums
National Health Expenditures
Source for Premiums and Expenditures Centers for
Medicare and Medicaid Services, National Health
Expenditures by Type of Service and Source of
Funds. Source for uninsured U.S. Census Bureau.
7
TrendsIncome and Coverage
Source Income, Poverty, and Health Insurance
Coverage in the United States 2006, Census
Bureau.
8
TrendsAge and Coverage
Source Income, Poverty, and Health Insurance
Coverage in the United States 2006, Census
Bureau.
9
TrendsEmployer-Sponsored Coverage
Source Kaiser Family Foundation
10
TrendsRegion and Coverage
Source Income, Poverty, and Health Insurance
Coverage in the United States 2006, Census
Bureau.
11
The Political Challenges

• Federal vs. State
• Children vs. Adults
• Public vs. Private
• To Mandate or Not
• Basic vs. Comprehensive Coverage
• Voter Enthusiasm vs. Constituent Reluctance

12
What Have We ProposedAHIP Access Proposal

• Improve SCHIP to Cover All Uninsured Children
  From Low-income Families
• Expand Medicaid to Cover All Uninsured Adults
  Living in Poverty
• Establish a Child Health Care Tax Credit for
  Working Families
• Create a New Tax-free Health Care Account That
  Can Be Used to Pay For Any Type of Coverage
• Create a New Incentive Grant Program to Assist
  States in Expanding Access

13
What Have We ProposedAddressing Quality and Costs

• Create a New Entity for Comparative Effectiveness
• Revise Device Approval Process
• Establishing a Research Agenda to Address Gaps in
  Evidence
• Coordinate and Step Up Diffusion of Research
• Develop Consensus on Measurement and Reward High
  Performance
• Create a New Medical Dispute Resolution System to
  Resolve Disputes Fast, Fairly and Effectively

14
What Are We Trying to Accomplish

• Promoting a Public-Private, Federal-State
  Approach
• Encouraging Customized Solutions to Meet the
  Unique Needs of Each State
• Expanding Access in Phases
• Meeting Test of Fiscal Responsibility
• Being Politically Advisable

15
What Voters Say About the Proposal
Ranked by Percent Support
Rep
Ind
Dem
Giving a federal tax credit to low and moderate
income parents
85
Increasing funding for health insurance program
for children
77
Providing grants from the federal government
71
Having the federal government match contributions
69
Giving federal tax deduction for purchase of
private insurance
69
Expanding the federal governments Medicaid
program
69
Establishing a tax-free Health Account for all
Americans
65
Source Ayres, McHenry Associates November 2006
16
Conclusion

• The Challenges are Palpable to the Public
• Crisis is Reaching a Tipping Point for All
  Stakeholders
• Solutions Must Appeal to Red, Blue and Purple
  Electorate
• Must Address Costs, Quality and Access Together
  to Enact Effective Reform
• Public-Private Partnerships are Key for Building
  Workable Approach

17
Conclusion
THEN
NOW

• Proposing Policy Reforms
• Agreement On Universal Access
• Collaborating On Ops
• Prioritizing Quality
• Disease Management

• Reacting To Policy
• Lack Of Agreement On Policy
• Little Experience On Ops
• Little Experience On Quality
• Little Focus On Chronic Disease