HELP FOR THE UNINSURED: H.R. 2185 -- HON. FORTNEY PETE STARK (Extensions of Remarks - June 17, 1999)

[Page: E1304]
---

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 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.

END