Health care reform proposals outlined in the Crossing Our Lines: Working Together to Reform the U.S. Health System Report released by Bipartisian Policy Center advisors and former Senators Howard Baker (R-TN), Tom Daschle (D-IA) and Bob Dole (R-KS) appears to enjoys significant support among many members of Congress as an alternative to the comprehensive health care reform proposals contained in the “Affordable Health Choices Act” (the “Kennedy Bill”) supported by Senator Edward M. Kennedy. As the health care reform rages among members of Congress, the Senate Committee on Health, Education, Labor and Pensions (HELP) chaired by Senator Kennedy continues its mark up of the Kennedy Bill.
Senator Finance Committee Chairman Max Baucus Max Baucus (D-Mont) expressed support for the proposals, which he cast as substantially consistent with many proposals advocated by Senator Baucus, Ranking Member Senator Chuck Grassley (R-IA) and others on the Senate Finance Committee. Read more about Senate Finance Committee approach to health care reform here.
The Bipartisian Policy Center Report calls for Congress to adopt the following platform of health care reforms:
Invest in Health Care Workforce:
- Offer funding for providers in underserved areas
- Integrate delivery reforms into graduate medical education (GME)
- Provide funding for education of nurses and allied health professionals
- Revise scope of practice laws that discourage use of advanced practice nurses, pharmacists, and other allied health professionals
Address Racial/Cultural Disparities
- Guarantee that patients are treated with best practices, regardless of race or ethnicity
- Realign reimbursement in federal programs to improve patient outcomes and care coordination based on a patient’s specific circumstances
- Ensure adequate provider capacity in medically underserved areas
- Invest in workforce to increase the number of minorities entering the medical and allied health professions
- Implement standard collection of patient race and ethnicity information
Establish an Independent Health Care Council (IHCC) that would:
- Analyze and report on health care quality and cost trends in federal health programs and in the overall health care system
- Promote coordination among federal health programs
- Issue an annual report to the President with recommendations to improve quality of care and avoid unnecessary costs
Reform Medical Liability Laws
Reform Health Insurance Markets
- Guarantee access to coverage regardless of health status
- Limit variation in premiums
- Ensure a high level of participation by expecting individuals to purchase basic health coverage
- Achieve lower administrative costs via standardized electronic claims processing, public reporting of medical loss ratios, and administrative simplification
- Require state reporting on implementation progress
- Establish a federal fallback if states do not implement market reforms
Create a Network of State or Regional Regional-Level Health Insurance Exchanges
- Establish minimum operating guidelines for exchanges
- Provide startup funding for states to establish insurance exchanges
- Permit all individuals and small groups to purchase in the exchanges
- Ensure coverage is affordable and meaningful
- Make enrollee support tools and adopt strategies to improve plan choice
- Risk-adjust premiums paid to plans participating in exchanges
- Implement a federal fallback if states or regions do not create exchanges in a timely manner
- Provide for Competing State Plan Options
- Require Further Action if Coverage Affordability and Accessibility Goals Are Not Met
Ensure Meaningful Health Insurance Benefits
- Establish minimum creditable coverage standards for health insurance
- Set additional standards for options available through insurance exchanges
Guarantee Affordable Coverage for All
- Limit out-of-pocket premiums to no more than 15 percent of income for a minimum benefit package
- Offer enhanced protections for Americans under 400 percent of the federal poverty level (FPL)
- Provide additional protections for retirees
- Create new tax credits for small businesses to purchase coverage for their employees
- Ensure low-income families have coverage through the Medicaid program
Expect Individual Responsibility for Obtaining Basic Health Insurance
- Establish a personal responsibility requirement for all Americans
Empower Individuals to Make Better Health Care Choices
- Expand the Centers of Excellence program within Medicare
- Offer premium reductions for healthy behaviors
- Support the development of educational materials to improve health literacy
Create a Public Health and Wellness Fund to provide support for evidence-based wellness, prevention, and care coordination programs, including, but not limited to:
- Eliminate cost-sharing for A and B-rated services by the U.S. Preventive Services Task Force
- (USPSTF) in both Medicare and in the health insurance exchanges
- Extend new authority to the Secretary of HHS to eliminate coverage for D-rated services by the USPSTF, at her discretion
- Allow Medicare coverage for health risk assessments and personalized prevention plans within routine wellness visits
- Provide tax credits for certain worksite wellness programs
- Fund the Community Health Teams (CHT) initiative to help coordinate care for Medicare beneficiaries, including dual eligibles
- Invest in grants to schools and community-based prevention and wellness programs
Reform Delivery and Payment Systems to Achieve Higher-Value Health Care
Implement a Balanced Set of Medicare and Medicaid Payment Reforms in Support of Delivery
The Report and its proposals are likely to draw additional attention inside and outside Congress as members of Congress increasingly join in the call for health care reform but disagree widely about what reforms to adopt.
Assistance Monitoring & Responding To Health Care Reform Proposals
If you or someone else you know would like to receive updates about health care reform proposals and other related legislative, regulatory, and enforcement developments, please:
- Register for this resource at the link above;
- Join the Coalition for Responsible Health Policy group at linkedin.com to share information and input;
- Share your input by communicating with key members of Congress on committees responsible for this legislation and your elected officials directly and by actively participating in and contributing to other like-minded groups; and
- Be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here.
You can register to receive future updates on legislative and regulatory health care reform proposals and other related information by registering for this resource or access other publications by Ms. Stamer and access other helpful resources here.
Long-time health policy advocate and advisor Cynthia Marcotte Stamer has more than 22 years of experience advising and assisting clients to evaluate and respond to health care reform proposals and other proposed or adopted changes in federal or state health care, employee benefit, employment, tax and other federal and state laws. Former Chair of the American Bar Association’s Managed Care & Insurance Section, Ms. Stamer is highly regarded legal advisor, policy advocate, author and speaker recognized both nationally and internationally for her more than 20 years of work assisting U.S. public and private employers, health care providers, health insurers, and a broad range of other clients to respond to these and other health care, employee benefit and workforce public policy, regulatory and compliance and risk management concerns within the U.S. as well as internationally. Her work includes extensive involvement providing input and assistance about health care, workforce, pensions and social security and other reforms domestically and internationally. In addition to her continuous involvement in U.S. health care, pensions and savings, and workforce policy matters, Ms. Stamer has served as an advisor on these matters internationally. As part of this work, she served as a lead advisor to the Government of Bolivia on its social security reform as well as has provided input on ethics, medical tourism, workforce and other reforms internationally.
Ms. Stamer is a widely published author and popular speaker on health plan and other human resources, employee benefits and internal controls issues. Her work has been featured and published by the American Bar Association, BNA, SHRM, World At Work, Employee Benefit News and the American Health Lawyers Association. Her insights on human resources risk management matters have been quoted in The Wall Street Journal, the Dallas Business Journal, Managed Care Executive, HealthLeaders, Business Insurance, Employee Benefit News and the Dallas Morning News.
Ms. Stamer also serves in a number of professional leadership roles including the leadership council of the ABA Joint Committee on Employee Benefits, Vice Chair of the ABA Real Property, Probate & Trust Section and Employee Benefits & Compensation Group.
If your organization needs assistance with monitoring, assessing, or responding to these or other health care, employee benefit or human resources reforms, please contact Ms. Stamer via e-mail here, or by calling (214) 270-2402. For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here.
Additional Resources & Information
We hope that this information is useful to you. For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here.
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