Bipartisan group of lawmakers proposes legislation that would provide Federal funding for state initiatives to expand Health Coverage to uninsured

Jan 18, 2007--A bipartisan group of lawmakers on Wednesday introduced legislation in both chambers of Congress that would provide grants to individual states, groups of states and portions of states to test various health reform strategies, CQ HealthBeat reports.

Grants could fund initiatives including tax credits, Medicaid or SCHIP expansions, and health savings accounts. Program proposals would be submitted to a bipartisan "State Health Innovation Commission," which then would present the proposals to Congress for review and funding. After five years, the commission would deliver a report to Congress on the effectiveness of the programs.

Under the bill, states also would be able to "ask for relief from federal laws that they think complicate efforts to cover the uninsured, such as tax law or the 1974 Employee Retirement Income Security Act," CQ HealthBeat reports. Sen. George Voinovich (R-Ohio), a co-sponsor of the bill, said there is no specific funding level for the bill aside from $3 million to $4 million in start-up funds.

Voinovich said that creating access to affordable, high-quality health care "is the greatest domestic challenge this nation faces," but he added that political pressures related to the 2008 presidential election make federal congressional reform "not realistic" at this time.

Sen. Jeff Bingaman (D-N.M.), the bill's primary author, said that most health care reform efforts are occurring at the state level and that Congress should "give states greater latitude and resources with which to experiment to accomplish those objectives."

Rep. Tammy Baldwin (D-Wis.), another co-sponsor, said, "Under our plan, states have a lot of freedom to think creatively and independently." Arthur Garson, dean of the University of Virginia School of Medicine and an adviser who helped Bingaman develop the bill, said, "The federal government has taken little substantive action, but the states have moved in impressive ways. This is a way to start moving, one state at a time, toward improving our health care system" (Carey, CQ HealthBeat, 1/17).

Coalition To Offer Proposal
In related news, a "diverse group of business, consumer and health care organizations" on Thursday is expected to announce a "closely guarded" plan for covering more uninsured children and adults, McClatchy/Wichita Eagle reports. The group -- called the Health Coverage Coalition for the Uninsured -- includes AARP, the American Medical Association, the American Hospital Association, America's Health Insurance Plans, Families USA, Pfizer and the U.S. Chamber of Commerce.

The first phase of the coalition's plan "reportedly dovetails on efforts to reauthorize" SCHIP this year, McClatchy/Eagle reports. The coalition also is expected to propose increases in tax credits to help the uninsured pay for coverage, as well as insurance pools to help people obtain coverage.

The coalition's plan is "notable because it represents a unified action plan by organizations with varied and often competing interests -- and because lawmakers and their staffers were excluded from negotiations," McClatchy/Eagle reports.

Families USA Executive Director Ron Pollack said, "We felt that for us to really achieve the consensus breakthrough that we were looking for that we should meet quietly and confidentially and without members of Congress participating. Now that we've concluded the process, we are very actively talking to members in both houses and on both sides of the aisle" about legislation to adopt the recommendations.

AHIP President Karen Ignagni said, "We wanted to craft something that appeals to Democrats, Republicans, conservatives and liberals, and has a balanced public-private approach. We think there's a moment in time now that various groups coming together can make a material difference." AFL-CIO, SEIU and the National Association of Manufacturers initially were part of the coalition but left "over disagreements about the final proposal," McClatchy/Eagle reports. JoAnn Volk, a health care lobbyist for AFL-CIO, said her organization wanted the coalition to call for universal health care (Pugh, McClatchy/Wichita Eagle, 1/17).

Association Health Plans
In other congressional news, Sen. Ben Nelson (D-Neb.) on Wednesday said that he and Sen. Michael Enzi (R-Wyo.) are looking for ways to win approval for a bill to allow small businesses to join together across state lines to form association health plans. Legislation was approved in the House during the last Congress but was rejected in the Senate.

The bill "faced fierce opposition from Democrats and several Republicans, who expressed concern that allowing small businesses to form insurance pools would permit them to bypass too many state regulations," CongressDaily reports.

"[P]ossibilities for compromise might still exist in terms of pooled health insurance plans within a regulated government framework," according to CongressDaily. Nelson said, "There is a middle ground being discussed," adding, "Sen. Enzi and I have talked about possible changes." Enzi last week told reporters that he is "making progress" in negotiations with colleagues.

Separately, Sens. Susan Collins (R-Maine) and Mary Landrieu (D-La.) have introduced a bill that includes health tax credits for small businesses and federal grants for states to help businesses set up group purchasing cooperatives (Johnson, CongressDaily, 1/18).