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October 19, 2004 | 2:23 p.m.(EDT)

Q: Bob from Tampa:
What are you doing to improve health care?

Doug Badger A: Doug Badger, Senior Health Policy Advisor:

Millions of Americans lack health insurance coverage today. For them, the anxiety of not knowing how they will find the resources to pay their medical bills is a daily concern. Millions more worry that they might lose coverage if they lose their jobs or change jobs. And while most seniors have prescription drug coverage, millions do not and many are needlessly being forced to choose between their medicines and other life necessities because they don.t about the help that is available to them today through Medicare-approved prescription drug discount cards.

The President.s proposals to make health care more affordable address all of these concerns, from the uninsured child in a low-income household to the senior struggling to make ends meet on a social security check.

In addition to strengthening and improving Medicare and adding prescription drug coverage to the program, the President has:

  • Created health savings accounts, which will make affordable coverage and portable accounts available to millions of Americans.

  • Increased the number of children enrolled in the State Children’s Health Insurance Program (SCHIP) by 75% -- from 3.3 million to 5.8 million.

  • Moved toward doubling the numbers of community health centers, which provide primary care to low-income people who live in medically underserved areas.

  • Provided Medicare prescription drug discount cards to more than 4.5 million seniors, who are now saving hundreds, and in some cases thousands, of dollars on their medicines. In addition to these sizable discounts, some 1.3 million seniors are receiving $1,200 through the end of 2005 to help them buy their medicines, and more than 1 million cards will be mailed to low-income beneficiaries during the month of October.

  • Approved waivers and state plan amendments that have made an additional 2.6 million low-income adults and children eligible for Medicaid and SCHIP.

  • Provided $1 billion in additional assistance to hospitals that provide uncompensated medical care to undocumented aliens.

  • Closed loopholes that pharmaceutical companies had used to keep generic competitors off the market.

  • Doubled funding for NIH.

  • Increased funding for bioterrorism preparedness.

  • Established the Global AIDS initiative.

Despite this progress, there is more to be done. The percentage of Americans who lack coverage is the same as it was in 1996, although fewer children are uninsured than in any year since 1989 and the percentage of children who lack coverage has never been lower. The President has a common sense plan to extend coverage to millions more Americans.

  • Cover the Kids campaign. To ensure coverage for uninsured low-income children, the President will launch an aggressive, billion-dollar effort to enroll eligible kids for quality health care coverage. The Cover the Kids campaign will combine the resources of the Federal government, states, and community organizations, including faith-based organizations, with the goal of covering millions more SCHIP and Medicaid-eligible children within the next two years.

  • Affordable Health Care for Low-Income Families and Individuals. President Bush signed legislation creating Health Savings Accounts (HSAs), which are a new, affordable option in health care coverage. HSAs are tax-free savings accounts that people can set up when they purchase a low-premium, high-deductible policy to cover major medical expenses. Money from the HSA can be used to pay for routine medical expenses or saved for future health needs, while the major medical policy helps cover big expenses, like hospital stays.

    To extend the benefits of HSAs to low-income families and individuals, the President proposes giving low-income families a $1,000 contribution made directly to their HSA, along with a $2,000 refundable tax credit to help purchase a policy to cover major medical expenses. Employers and states also can supplement this assistance.

  • Affordable Health Care for Small Business Employees and the Self-Employed. More than half of the uninsured are small business employees and their families. Small businesses face obstacles in providing health benefits including high costs, complicated regulations, and a lack of bargaining power with insurance companies. The President’s plan helps them in several ways. President Bush has supported Association Health Plans (AHPs), which allow small businesses to band together to negotiate lower-priced health insurance for their employees. He also is proposing to help individuals and families who work for small businesses fund their HSAs by giving small business owners a tax credit on HSA contributions for the first $500 per worker with family coverage and the first $200 per worker with individual coverage.

  • Affordable Health Care for all Americans. High health care costs are the underlying reason why many Americans are uninsured. President Bush has proposed Medical Liability Reform and new investments in Health Information Technology to help lower costs. In addition, he is proposing the following new initiatives:

    • Extend Association Health Plans to civic groups and other community organizations. Community, civic, and religious groups may want to offer health plans to their members. President Bush proposes to allow local groups to band together through their regional or national organizations to negotiate low-priced coverage for their members.

    • Allow individuals to buy the best coverage they can find anywhere in the country. Today, it is easy to use the Internet or 800 numbers to shop anywhere for anything. But different rules apply to health insurance. Individual consumers can only purchase health insurance in the state in which they live and can’t shop around for a better deal in another state. The President believes that creating a competitive marketplace across state lines can increase the availability of health care coverage and help drive down the costs for everyone. He proposes to give people this freedom to shop for the best buy on the health coverage that best meets their individual needs. This proposal will help individuals save on health insurance, and includes provisions to prevent fraud and abuse.

    • Establish a health center or clinic in every poor county in America. The President believes that access to primary and preventive health care services is critical, especially in poor communities that are medically underserved. For example, many rural communities with higher levels of poverty have little access to basic health care services. The President’s current initiative has successfully increased the number of people served in health centers by almost 30 percent. However, there are still poor counties throughout the country that have no community health center at all. The goal of the President’s new initiative is to ensure that every poor county in America has a community or rural health center.