The California Common Sense Healthcare Revolution.
by Linda Halderman, M.D., FACS
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ELIMINATE INSURANCE MANDATES. Allow insurers to sell plans that provide basic and catastrophic coverage, using competition and freedom from expensive regulations to drive down premiums.
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CONFORM CALIFORNIA TAX LAWS ON Health Savings Accounts (HSAs) TO FEDERAL TAX LAWS. This allows individuals to use pre-tax dollars for HSA contributions.
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INCREASE THE AGE OF DEPENDENCY FOR UNMARRIED ADULTS FROM 19 TO 26 regardless of school enrollment. This allows healthy young adults to remain covered through their parents’ plans, reducing the ranks of the uninsured by up to 25%.
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REDUCE OVERSIGHT REQUIREMENTS TO ALLOW NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS TO FUNCTION INDEPENDENTLY IN LOW COST OUTPATIENT CLINICS. This decompresses emergency rooms and alleviates access issues in underserved areas.
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UNCOUPLE EMPLOYMENT FROM HEALTH INSURANCE. Allow a standard tax deduction for healthcare plans whether purchased by the employer or the individual, avoiding costly employer mandates and rewarding individual responsibility. Also, provide an immediate conversion plan for people leaving employment instead of forcing them into costly COBRA or CAL-COBRA plans. This reduces the ranks of the uninsured by up to 11%.
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ELIMINATE THE MEDI-CAL TREATMENT AUTHORIZATION REFERRAL (“T.A.R.”) SYSTEM. Use computer-generated oversight and audits to identify fraud and overuse.
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TAX FOREIGN REMITTANCES TO REIMBURSE HOSPITALS AND PROVIDERS FOR PROVIDING FEDERALLY MANDATED UNCOMPENSATED CARE. These payments—untaxed disposable income sent from the U.S. by foreign nationals to their native countries—totaled $9.6 Billion to Mexico in 2004 alone. This is expected to reach $25 Billion by 2010, and represents an opportunity for undocumented immigrants to help reimburse California for part of the uncompensated medical care provided to them.
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ESTABLISH TAX CREDITS FOR PROVIDERS TO OFFSET THE FINANCIAL BURDEN OF PROVIDING UNCOMPENSATED AND UNDERCOMPENSATED CARE. Issue a sliding scale tax credit for California providers who care for a percentage of Medi-Cal patients in excess of the statewide average.
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ALLOW HOSPITALS AND PROVIDERS TO ISSUE 1099 (MEDICAL) FORMS TO PATIENTS INELIGIBLE FOR STATE OR FEDERAL ASSISTANCE WHO LEAVE MEDICAL BILLS UNPAID.
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CHANGE THE DEFINITION OF “SMALL GROUP” TO 100 AND ALLOW INSURERS TO RATE UP OR DOWN BY 25% (NOT ONLY 10% AS CURRENTLY ALLOWED). This will drive down premiums by decreasing community-rated risk.
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ENCOURAGE INSURANCE AGENTS STATEWIDE TO IDENTIFY AND ASSIST LOW-INCOME UNINSURED CALIFORNIANS IN AFFORDABLE HEALTH PLAN ENROLLMENT TAILORED TO THEIR NEEDS. Use vouchers for individuals without resources to allow the purchase of basic health care coverage in an individual policy. Currently, Medi-Cal spends $7,490 to cover each enrollee, while private insurance can be purchased for $3,088 per person. This will reduce California’s Medi-Cal costs by 58%.