Private Health Insurance--As a Right, Not a Mandate

 

The Problem: Private insurance spending has skyrocketed from $69 billion in 1980 to today's $970 billion, a staggering 1300 percent increase over a period in which GDP grew by just 510 percent. Notwithstanding the Affordable Care Act, there are still tens of millions who find coverage un-affordable. At the same time, there are huge inequities, like the tax exclusion (or subsidy) for employer-paid coverage that gives a substantial tax break to some but not others.

The BETTER WAY: As for Medicare, private health insurance will be transformed into a premium support system, with all eligible Americans receiving a "voucher" to be used in purchasing basic healthcare coverage, sufficient to cover almost all healthcare costs for those with the lowest incomes and sufficient to protect against medical catastrophe for the well-to-do.

How much coverage? The average value of the premium support voucher (in 2015 dollars) will be approximately $2,700 per person (more than $10,000 for a family of four) with specific values dependent on age, income, and family make-up.

Who will be eligible? All under-65s except disabled Medicaid enrollees will be eligible. Thus all those previously with or without private insurance will be covered, along with those currently enrolled in CHIP or Medicaid (except the aged and disabled groups), approximately 240 million in all.

Where will funding come from? Premium support costs will be financed by redirecting current tax expenditures and subsidies from three sources: employer sponsored insurance and related federal taxes, ACA exchange subsidies, and Medicaid and CHIP, for a total of approximately $650 billion.

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"Every American will be protected against the threat of bankruptcy resulting from catastrophic medical expenses... Every individual will be able to select insurance based on their needs... Employers will no longer have to bear the complexities and costs of insurance administration..." -- from the Campaign study report

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How will it work? Premium support levels will be based on prior year's income, with an adjustment for age. Each individual or family will be able to select coverage from an array of available plans. As for Medicare, they may choose a plan costing no more than their voucher value at no additional cost, or may apply their premium support as part-payment for a more generous plan.

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