CAHI Issues & Advocacy
Legislation and regulation, both from Congress and state legislatures,
can have either a positive or negative impact on Americans' access
to affordable health insurance. For this reason, since its founding
in 1992 the Council for Affordable Health Insurance (CAHI) has played
an active lobbying role in Washington, D.C. and in state capitals.
Our mission is to develop and promote free market solutions to America's
health care challenges, so that all Americans have access to affordable
What needs to be done to achieve that goal?
tax credits for the uninsured - Workers with employer-provided
health insurance don't pay taxes on the money their employers spend
on premiums. And the self-employed get a 100 percent tax deduction.
But workers without employer-provided coverage get no help at all.
The Fair Care for the Uninsured Act (H.R.765),
which is very similar to President
Bush's tax credit proposal, would provide a $1,000 refundable
tax credit per adult, and up to $3,000 per family, to use toward
the purchase of a health insurance policy. As a result, millions
of uninsured Americans could afford to buy their own health coverage.
Health Savings Accounts - Health Savings Accounts (HSAs)
combine a high-deductible health insurance policy with a tax-deferred
savings account. The high-deductible policy protects the insured
from the cost of a catastrophic illness, prolonged hospitalization
or a particularly unhealthy year. The savings account is controlled
by the insured and is intended to pay small and routine health care
expenses. HSAs encourage people to be value-conscious health care
shoppers. Legislation proposed by the Bush administration (H.R.37)
would expand HSAs by making the insurance policy tax deductible,
making them even more attractive as an alternative to traditional
high-risk pools - Roughly 2 percent of the population can't
get health coverage because of a pre-existing medical condition.
To address their problem, more than 30 states have established high-risk
pools for their uninsurable populations. However, Congress needs
to provide states with additional funding so that high-risk pools
can serve as a safety net for all of the uninsurable (S.288).
long-term care premiums - Long-term care (LTC) refers to
the medical and/or personal assistance that people require when
they are unable to manage common activities of daily living on their
own because of frailty, chronic illness or mental incapacity. Unfortunately,
because of lax eligibility standards the federal-state Medicaid
program has become the primary payer for long-term care, even for
middle and upper-middle income families. If the government allowed
individuals to use tax-deferred funds from their IRAs or 401(k)s
to pay for long-term care premiums, millions of working Americans
would protect themselves by purchasing insurance against that risk
state mandates - Mandates are laws that require health insurers
to provide coverage, or offer to provide coverage, for specific
providers or procedures - driving up the cost of a policy and increasing
the number of uninsured. The Council for Affordable Health Insurance
has identified more than 1,800 state mandates nationwide. What's
reasonable underwriting - Underwriting is the process whereby
an insurance company assesses how much risk an applicant brings
to the health insurance pool. Several states effectively eliminated
underwriting by imposing "guaranteed issue" (anyone can get coverage
regardless of health status) and "community rating" (everyone pays
the same price) laws. In every case, these laws have destroyed the
state's individual health insurance market.
health insurance options - Health insurance in some states is outrageously
expensive - in large part because of the laws and regulations imposed by those
states. As a result, uninsured people can't find affordable coverage. There
is an easy solution: let people buy health insurance that is approved and available
to people in other states. Rep. John Shadegg (R-AZ) has introduced just such
a bill (H.R. 2355).
Reform medical liability - There
is widespread agreement that the U.S. tort system is broken. Several
states have passed tort reform, and President Bush has made it one
of his top legislative proposals.
access to prices - Consumers need access to price information if they
are going to make good decisions. Yet the health care system historically has
been very reluctant to provide that information. No where is this more evident
than when the uninsured go to the hospital and get hit with a bill that is often
three or four times what an insured person would pay, or more. This has to change.
Reinsurance - Reinsurance can simply be defined as a type of insurance
for insurance companies. It is a way for a primary insurer to protect its business
against unforeseen or extraordinary losses. Federal legislators, both Republicans
and Democrats, are considering various policy options creating a national government
subsidized health reinsurance program.
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