A broad coalition of 16 organizations "laid out a major proposal on Thursday to provide health coverage to more than half of the nation's 47 million uninsured," the New York Times reports. The plan, developed over more than two years, initially calls for increased funding for an expansion of SCHIP programs and tax credits for families to purchase private insurance for children (Pear, New York Times, 1/19). Families earning up to 300% of the federal poverty level would be eligible for the tax credits (Appleby, USA Today, 1/19). The group -- known as the Health Coverage Coalition for the Uninsured -- "envisions a 'one-stop shopping' center that would let uninsured children be automatically enrolled in [SCHIP] when they enroll in other means-tested programs such as discount school lunches and food stamps," the AP/Houston Chronicle reports. The proposals to expand coverage for children, called Kids First, would cost an estimated $45 billion over five years. Coalition members "declined to take a position on how it should be paid for, except to say they envision that the amount would be covered by the federal government," the AP/Chronicle reports (Freking, AP/Houston Chronicle, 1/18). About 98% of the nation's nine million uninsured children would be covered under the SCHIP expansion. A second phase of the coalition's plan recommends giving states the flexibility and funding to expand Medicaid to make all adults at or below the federal poverty level eligible for coverage. The coalition did not estimate the cost of the proposed Medicaid expansion (Armstrong, CQ Today, 1/18). The second phase also would offer tax credits for adults with incomes between 100% and 300% of the federal poverty level to help them purchase private insurance (HCCU release, 1/18).

Member Comments
Member organizations come "from across the political spectrum," including the U.S. Chamber of Commerce, America's Health Insurance Plans, the American Medical Association, the American Hospital Association, the Catholic Health Association, AARP, the United Health Foundation, the Blue Cross Blue Shield Association, Kaiser Permanente and Pfizer (Johnson, CongressDaily, 1/18). Other members include the American Academy of Family Physicians, the American Public Health Association, Families USA, the Federation of American Hospitals, the Healthcare Leadership Council and Johnson & Johnson (Reichard, CQ HealthBeat, 1/18). United Health Foundation Senior Vice President Reed Tuckson said, "These recommendations provide a realistic blueprint for immediate action by a bipartisan and caring Congress" (Pugh, Miami Herald, 1/19). Tuckson added, "Day after day there is debate and discussion. Day after day people die. We are sick and tired of the debate. We are focusing on what is achievable" (New York Times, 1/19). Families USA Executive Director Ron Pollack said, "We recognize we are strange bedfellows, but let this be clear, we are not interested in a one-night stand" (Miami Herald, 1/19). FAH President Chip Kahn said that it is "easy to be skeptical" of the proposal's chances in Congress (AP/Houston Chronicle, 1/19).

Labor, Business Representation Absent in Coalition
"Notably absent from the coalition were representatives from labor and business organizations that have been prominent at other recent health care coverage discussions," CQ Today reports (CQ Today, 1/18). AFL-CIO and the Service Employees International Union participated in the coalition for more than a year but did not endorse the final report. According to the Times, the "deepest divisions" between the coalition and the labor groups "came over how to pay for expanded coverage and who should foot the bill." SEIU President Andrew Stern supports moving away from employer-sponsored coverage, which he called a "collapsing" system, while the coalition supports maintaining and expanding the employer-sponsored system. AFL-CIO policy analyst JoAnn Volk said she supports the expansion of government programs but added that "tax credits would not guarantee access to comprehensive coverage and could leave consumers with high out-of-pocket costs." E. Neil Trautwein, former assistant vice president at the National Association of Manufacturers, said the plan has "little reference to fiscal realities" (New York Times, 1/19). NAM also dropped out of the coalition (CQ Today, 1/18).

Outlook for Proposals
SCHIP is up for congressional reauthorization in 2007, and the coalition "has been lobbying lawmakers to make the reauthorization the jumping-off point for their plan," CQ Today reports (CQ Today, 1/18). Drew Hammill, a spokesperson for House Speaker Nancy Pelosi (D-Calif.), said Pelosi "very much supports" the expansion of SCHIP and favors reducing the number of uninsured. Hammill added, "Fiscal responsibility will always be a priority. We'll put everything on the table and make the tough decisions" (Miami Herald, 1/19). HHS spokesperson Suzanne DeFrancis said, "We all share the goal of helping people get health insurance. The administration believes this can be done best by helping people buy their own insurance, rather than creating a new government entitlement to health care or raising taxes" (New York Times, 1/19).

Other Comments
Brandeis University professor Stuart Altman said the coalition has proposed "a great moderate bill, which I think is what it needs to be" to succeed politically. "I think it's a very positive first step, and it's a big first step," Altman said. He added that the U.S. Chamber of Commerce is "a very powerful organization" and that they "now realize this current system is really killing them. They realize they're paying a huge hidden tax" of higher health care premiums caused by an inefficient health care system. Center for Studying Health System Change President Paul Ginsburg said the plan could help small businesses compete against large employers by giving their employees tax breaks to buy insurance. Ginsburg added that the coalition could break up over disagreements about how to pay for its recommendations. Joseph Antos, an analyst for the American Enterprise Institute, said, "Everybody would like a federal bailout, but the only problem is that a federal bailout means the taxpayers pay for it. So it's just moving the money around as opposed to really getting at the hard job, which is addressing the high and rapidly rising spending on health care" (CQ HealthBeat, 1/18). National Coalition on Health Care President Henry Simmons said that the proposal's expanded coverage would be short-lived unless health care costs also are addressed. "Unless you couple reform proposals with some strong mechanism to contain rising costs, it is virtually impossible to sustain any mechanism of (expanded) coverage. It just can't be done," Simmons said (Miami Herald, 1/19).

WSJ Looks at Growing Movement for Health Reform
The Wall Street Journal on Friday examined how "the long-festering issue of providing health coverage to the one in six Americans who lack it seems to have leapt to the top of the national to-do list." According to the Journal, "political and economic forces that have been building for years" are "[t]hrusting the long-running issue to the fore" (Solomon/Wessel, Wall Street Journal, 1/19).

Broadcast Coverage
NPR's "All Things Considered" on Thursday reported on the coalition's proposal. The segment includes comments from Altman, Kahn, Pollack and Tuckson (Rovner, "All Things Considered," NPR, 1/18).

Audio of the segment is available online.

A webcast of a briefing related to the release of the coalition's plan -- featuring comments by Tuckson; Pollack; Karen Ignagni, president and CEO of AHIP; Jeremy Lazarus, vice speaker of the House of Delegates for AMA; and Kevin Lofton, chair-elect of the AHA Board of Trustees -- is available online at kaisernetwork.org.