Covering the Uninsured: Blue Plan Initiatives

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Covering the UninsuredBlue Plan Initiatives

• NGA Governors Health Policy Advisors Retreat
• September 4, 2003

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Overview

• Blue initiatives to keep health care affordable
• and reduce the uninsured
• Research and efforts to slow healthcare cost
  drivers
• Specialized, innovative products
• Legislative solutions

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Healthcare Costs Are Rising
Growth in health insurance premiums
Source Kaiser Family Foundation/Health Research
and Educational Trust, Employer Health Benefits
Survey, 1999 and 2001 Abelson, t., Hard
Decisions for Employers as Cost Soar in
HealthCare, The New York Times, 2002.
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Blue Research on Cost Drivers
Blue research assessed the primary healthcare
cost drivers
Contributions to Private Insurance Spending
Growth, 2002
HospitalOutpatient
Physician
27
37
Prescription Drugs
22
14
HospitalInpatient
Source Center for Studying Health System Change,
Tracking Health Care Costs, 2003
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Efforts to Slow Drivers Examples

• Encourage use of generic drugs
• Consumer education campaigns to increase
  confidence in generics
• One Plan reports 17M saved from 1 increase in
  generics use
• Provider outreach, including free samples of
  generics

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Efforts to Slow Cost Drivers Examples
National LaunchJune 26
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Specialized Blue Products

• Low cost uninsured products
• Consumer-driven products
• Special coverage for low-income children
• TAA tax credit products

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Low Cost Uninsured Products

• Many Blue Plans developing new low cost products
• Shaped by local market conditions

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Consumer-Driven Products

• Many Plans introducing consumer-driven products
  -- wide range of
• approaches

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Special Coverage for Low-Income Children

• Some Blue Plans provide subsidized coverage for
  low-income
• children ineligible for SCHIP

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TAA Tax Credit Products

• Blue Plans also developing products qualified for
  purchase with
• new TAA tax credit

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Legislative Solutions BCBSA Supports

• Tax credits for low-wage workers in small firms
• About half are uninsured in very small firms
• Several bipartisan bills include these credits
• Revisions to McCain-Schumer to speed access
• to generic drugs
• Included in Medicare reform bills
• Medical malpractice reform

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Legislative Solutions BCBSA Opposes

• Exempting AHPs from state law/oversight
• Increase premiums by 23 (Mercer)
• Increase uninsured by 1 million (Mercer)
• High-risk pool funding evaporates (Groom Law)
• Results in widespread MEWA-like fraud and abuse
• (Eleanor Hill)
• Increasing cost of health coverage with
  additional
• mandates

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Wrap-Up

• Keys to ensuring access and affordability
• Targeted, innovative products
• Partnerships with other stakeholders
• Consumer information/incentives to promote
  cost-conscious decisions
• Subsidies/incentives for key segments of
  uninsured
• Avoid problematic solutions and costly new
  mandates