Bill Would Establish Catastrophic Coverage Pilot Projects
Sens. Gordon Smith (R-Ore.) and Ron Wyden (D-Ore.) on Thursday introduced a bill (S 3701) that would create several pilot projects to allow states to offer uninsured residents health plans that provide basic coverage paired with catastrophic coverage for individuals with high out-of-pocket health costs, CQ HealthBeat reports.
The bill would establish six pilot projects, for which states could apply through HHS. At least two projects would create a "hybrid" health insurance plan that would combine primary and preventive care coverage with high-deductible catastrophic coverage. Private health insurers could market this plan to both uninsured individuals and small businesses.
At least two other projects would help privately insured individuals who have out-of-pocket costs that exceed $10,500 annually. The bill also would provide for gradual subsidization of plan premiums for workers with annual incomes below 200 percent of the federal poverty level. The bill would allow catastrophic coverage through high-risk pools, reinsurance mechanisms for small businesses and other public-private agreements.
According to Smith, the coverage could help small businesses extend their health care benefit offerings. Wyden said, "[N]o one should go to bed at night wondering if they are going to lose their home ... because they or someone in their family had a health care tragedy" (Teitelbaum, CQ HealthBeat, 7/21).