By Jocelyn Guyer
Yesterday, the Senate Finance Committee released a set of health reform coverage options, offering some important insight into the direction this crucial committee may take as it tackles the goal of covering all Americans.
It’s hard to sum up the 61-page document — not only does it cover a lot of terrain but there are options within the options. But having made our way through it at least a few times, we think that, with some key exceptions, the news is mostly very positive for children and families. (See our health care reform Web page for a quick summary of some of the key provisions.) The proposed options include:
- A strong and affordable benefit package would be available to children and parents through Medicaid, potentially up to 150 percent of the federal poverty line.
- Families above that income level would be covered through what seems to be a coordinated package consisting of CHIP (for kids) and coverage on the exchange with a tax credit (for parents).
- CHIP would be brought up to 275 percent of the federal poverty line, and CHIP benefits would be strengthened to cover all recommended preventive care and the full range of medical services a child might need.
- In addition to the coverage improvements, the Finance Committee document advances the notion that it should be much easier for people to enroll in coverage. It recommends a simplified, unified system for figuring out whether people should be enrolled in Medicaid, CHIP, or the Exchange that relies on a web-based portal, among other approaches.
At the same time, some of the options still under consideration fall short of the goal of guaranteeing access to high quality care for everyone. For example:
- There is no limit on out-of-pocket costs for people covered through the exchange, which means many Americans will still face the prospect that a serious health crisis can also quickly become a financial crisis.
- There could be a waiting period — a state option — before immigrants lawfully residing in the country can be covered under Medicaid or CHIP.
- Benefits on the Exchange don’t require a pediatric care package, and
- States could be required to rely on commercial insurance products to serve Medicaid beneficiaries, disrupting other successful models of care that are often better suited to the needs of low-income people, such as the medical home model now in use in North Carolina and other states.
What’s clear from looking at these options — not to mention the options within the options — is that there is still much to be figured out. Members of the Finance Committee will “walk through” these options on Thursday morning but the door doesn’t close then. People can share their thoughts with their senators and staff even after Thursday, and the Committee itself has a formal comment period that extends through May 22nd.
