THE UNINSURED: AMA Drafts Coverage Recommendations
The American Medical Association has approved several recommendations to expand coverage to some of the nation's 43.4 million uninsured Americans, while opposing some "new health insurance benefit mandates unrelated to patient protections" on grounds that they "increase the cost of insurance and make it unaffordable for some individuals and employers." In the interest of expanding coverage, the AMA will urge HCFA to begin requiring states to use its pared-down, four-page Medicaid/CHIP application unless they can offer simpler versions. The AMA notes that nearly two-thirds of uninsured adults have no more than a high school education, and current enrollment materials may be too complex. The AMA will also encourage state medical organizations to cooperate with state agencies to "develop innovative programs to expand coverage for the uninsured." The organization will press HCFA to ensure that Medicaid and CHIP marketing efforts feature cultural sensitivity "and language diversities in states or localities that have large uninsured ethnic populations," noting that 36% of Hispanics are uninsured, as compared with 23% of blacks and 14% of whites. As far as extending current policy is concerned, the AMA continues to recommend that "the existing tax exclusion for employer expenditures on health insurance be replaced with a refundable tax credit equal to a percentage of individuals' or families' insurance expenditures." The percentage would be inversely related to income. The group also continues to support federal measures that would permit the formation of voluntary choice cooperatives, noting, "Existing employer health insurance purchasing alliances have contained premium costs, expanded individual choice of plans and extended insurance coverage in some cases." However, the AMA's plan for cooperatives differ from employer cooperatives, as the former would enable individuals to select their own health plans independently of their employers (Aston, American Medical News, 7/19 issue).
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