[Congressional Record (Bound Edition), Volume 145 (1999), Part 9]
[Extensions of Remarks]
[Pages 13480-13481]
[From the U.S. Government Publishing Office, www.gpo.gov]



                   HELP FOR THE UNINSURED: H.R. 2185

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Thursday, June 17, 1999

  Mr. STARK. Mr. Speaker, on June 14, I introduced H.R. 2185, the 
Health Insurance for Americans Act, to provide refundable tax credits 
for the purchase of health insurance through a consumer co-op type of 
mechanism.
  We must act to revise America's health care system. The current 
system of employer-based coverage is dying, as the following quote from 
a May 1999 study for the Health Insurance Association of America by Dr. 
William Custer, makes clear:

       There were 31.8 million uninsured non-elderly Americans in 
     1987. In 1997, this number had risen to 43.1 million, which 
     represents a 35.5 percent increase. From 1996 to 1997 alone, 
     the number of non-elderly Americans without health insurance 
     rose by 4.1 percent. And this report forecasts that the 
     number of uninsured Americans will climb to 53 million during 
     the next ten years and could, if the nation experiences an 
     economic downturn and higher-than-predicted health-care cost 
     inflation, reach 60 million by 2007. This would mean that 
     almost one of every four non-elderly Americans would lack 
     health coverage.
       The primary reason for the increase in the number of 
     Americans without health coverage over the past 15 years has 
     been the increase of health care costs relative to family 
     income. Almost six of every ten uninsured Americans lives in 
     families with incomes of less than 200% of the federal 
     poverty level. And while public programs such as Medicaid 
     provide health coverage to about half of those in families 
     with incomes below the federal poverty level, these 
     individuals account for nearly three out of every ten 
     uninsured Americans.

  Is there hope that other proposals will noticeably reduce the number 
of uninsured? For example, various Republicans are pushing the idea of 
Health Marts and Association Health Plans as forums where small 
businessmen can buy cheaper health insurance policies for their 
workers. But we know from polling of many small businesses that they 
have no interest in being in the health insurance-providing business. 
Even if it didn't cost them a penny, a majority of small businesses 
have said they didn't want to be involved in this process!
  In addition, a May 1999 study by the National Coalition on Health 
Care entitled ``Small Employer Health Insurance Purchasing 
Arrangements: Can They Expand Coverage?'' reports:

       The central conclusion of this study is that while Health 
     Marts and Association Health Plans will offer advantages to 
     some small firms and may somewhat reduce the deterioration in 
     health insurance coverage in the U.S., they will not by 
     themselves solve the problem of the uninsured. That is 
     primarily because, on balance, neither Health Marts nor 
     Association Health Plans are likely to reduce health costs 
     enough to significantly entice most small firms not now 
     offering coverage to buy health insurance. In addition, 
     benefit packages that are significantly less comprehensive 
     than typical do not seem to have broad appeal, and may still 
     be too costly for most small businesses . . . .
       Even the most optimistic estimates of the impact of 
     eliminating state mandated benefits or implementing 
     Association Health Plans suggest that between 80% and 80% of 
     the 43 million Americans who are uninsured today would remain 
     uninsured.

  Mr. Speaker, it is clear that we need to try new approaches to a 
problem which is growing evermore serious. Following is a summary of 
the tax credit bill I have introduced. I hope my colleagues will join 
me in exploring this approach.

             Summary of Health Insurance for Americans Act


    Refundable tax credit for purchase of qualified health insurance

       Amount: $1,200/adult; $600 per dependent child, $3,600 max 
     per family. Dollar amounts

[[Page 13481]]

     adjusted by annual inflation in Federal Employee Health 
     Benefits Program (FEHBP) average premium increase.
       Eligibility: Anyone not participating in subsidized 
     employer plan or public plan, or eligible for Medicare.


                       Qualified health insurance

       Is private sector insurance sold through new HHS Office of 
     Health Insurance (OHI).
       Insurance must be guaranteed issue/no waiting period, no 
     pre-existing condition, community rated policies.
       OHI may negotiate on price, ensure quality of providers and 
     adequacy of benefit package (Like the Office of Personnel 
     Management does for FEHBP now), and hold open enrollment 
     periods to facilitate comparison pricing.
       Every insurer selling to FEHBP must offer to sell similar 
     policies to OHI, but may also offer zero premium policies.
       OHI will serve as an administrative device to move tax 
     credit from IRS to the insurer selected by the individual, 
     thus providing `advance funding' and preventing fraud.
       Effective date: 2001.
       Financing: Not spelled out in bill. Can be surplus, 
     business tax, VAT, insurer/provider surtax, savings from 
     reduced subsidies to providers to provide for the uninsured.

     

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