Guarantee Access to Affordable Health Insurance Coverage

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					                  Guarantee Access to Affordable Health Insurance Coverage
Background
The number of uninsured Americans continues to rise as employers reduce or eliminate health care benefits and as costs
increase beyond the purchasing power of more and more Americans. Based on the most recent Census Bureau estimates,
46 million Americans lacked health insurance coverage for at least a portion of calendar year 2007. Without insurance,
children and adults do not have access to regular preventive and screening checks, and often delay obtaining treatment
until they are seriously ill—leading to an increase in premature deaths and unnecessary suffering. The Institute of
Medicine (IOM) estimates that lack of insurance results in an average of 18,000 deaths each year.

Achieving Affordable Health Coverage for All
ACP is committed to ensuring that all Americans have access to affordable health care coverage and has offered a
framework for Congress to achieve this goal. This proposal includes a series of recommendations for Congress to enact
that would:
 Expand Medicaid coverage to all persons with incomes up to 100 percent of the federal poverty level;
 Provide advance, refundable, and sliding scale tax credits to uninsured working Americans, starting with those with
     incomes up to at least 200 percent of the federal poverty level, to buy qualified coverage from a purchasing pool or
     health exchange;
 Require that qualified health plans cover essential benefits, including preventive services and primary care, and
     prohibit them from excluding persons based on pre-existing conditions, varying rates based on a person’s medical
     condition, or dropping coverage due to illness;
 Create a process for an expert advisory group to recommend essential benefits, including evidence based preventive
     services, that would be offered by qualified health plans;
 Create options for small business to be able to buy insurance equal to coverage offered for federal employees;
 Designate federal funding for states to develop their own alternative coverage arrangements provided that such
     coverage is at least equal (numbers of persons covered, benefits) to that which otherwise would be available under
     the federal subsidies and purchasing arrangement;
 Once coverage is affordable and available to all, everyone should participate and coverage should be guaranteed;
     Share responsibility for financing the expansion of health coverage with individuals, employers, and the federal
     government.

Without More Primary Care Physicians, Expanding Health Insurance Coverage Will Not Ensure Access to Care
Health reforms to expand coverage will fail to improve outcomes and lower costs unless actions are taken simultaneously
to reverse a growing shortage of primary care physicians. Persons who do not have access to health insurance coverage
are less likely to have a physician as a regular source of care. They are also less likely to comply with recommended
treatments, to take their medications, and receive recommended preventive services. Accordingly, as more persons
obtain health insurance coverage as a result of health care reform, they will appropriately seek to form a relationship with
an internist, family physician, or pediatrician to serve as their regular source of care.

Most established primary care physicians are currently working at full capacity and will be unable to absorb the
increased number of patient visits that will accompany coverage expansions. A rapid expansion of primary care capacity
will accordingly be needed as coverage is expanded.

Conclusion
ACP urges Congress to pass legislation this year that includes our recommendations to achieve affordable health
insurance for all Americans, while working simultaneously to address the shortage of primary care physicians. Members
of Congress are urged to cosponsor H.R 956, the HealthCARE Act of 2009, sponsored by Representatives Marcy Kaptur
(D-OH) and Steve LaTourette (R-OH). H.R. 956 would be an important step towards the ultimate goal of ensuring all
Americans have health insurance through a combination of both public and private approaches. It is based directly on
ACP’s proposal to provide affordable health insurance coverage to all, as described above.

For more information on ACP’s positions, please visit the Advocacy section on ACP Online,
http://www.acponline.org/advocacy.

				
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