| Plan |
Center for Health Transformation (Gingrich) 21st Century Intelligent Healthcare Solution to a 300 Million Payer System | |
| Date |
April 2008 | |
| Overall Approach |
Focus on health information technology and electronic medical records. | |
| Universal Coverage |
Yes | |
| Guaranteed Coverage |
Yes | |
| Portability |
Yes | |
| Voluntary Employer-Based System |
No | |
| New Programs |
Establish a private/public partnership that reviews rejected applications to determine if the applicant is truly uninsurable
Creation of an HSA eligible HDHP high-risk pool | |
| Expansion of Existing Public Programs/Federal Law |
No | |
| Insurance Pool |
Require states to establish an HSA/HDHP "high-risk" insurance pool that requires participation in disease management programs and provides varying benefits based upon compliance with care and health outcomes
Allow HSA/HDHP approval reciprocity across state lines | |
| State Responsibility |
Remove financial and bureaucratic barriers to new market entrants
Remove state legal and regulatory conflicts to offering flexible HSA-eligible HDHPs
Remove legal and regulatory restrictions on providing incentives and rewards for compliance with health management and disease management programs
Allow list billings through employers for individual policies
Allow state approval of limited use Health Reimbursement Arrangement Only plans so pre-tax employer contributions can be used to purchase HSA eligible HDHPs | |
| Individual Mandate |
Not specifically addressed | |
| Employer Mandate |
No | |
| Private Insurance Mandates |
Required to accept an equal number from the screening process for the high-risk uninsurable pool | |
| Individual Subsidies |
Financial incentives for participation, rewards for compliance
Provide "health scholarships" for the low-income uninsured using subsidized HSA/HDHPs
HDHP Premium Advancable Tax Credit for non-Medicaid eligible low-income families and individuals
Charity-subsidized HSAs for the low-income uninsured | |
| Individual Vouchers |
Yes (SCHIP) | |
| Employer Subsidies |
Not addressed | |
| Individual Plan/Provider Choice |
Yes | |
| National Health Board |
Not addressed | |
| Tax Changes |
Eliminate state and other municipal premium taxes on HSA-eligible high-deductible health plans
Remove federal income and employment taxes on HSA eligible HDHP insurance premiums
Equalize the state income tax deductibility of premiums for individually purchased HSA-eligible HDHPs
Incentivize newly formed small retail, service, and restaurant businesses to initiate HSA/HDHP coverage for employees by providing a lower graduated sales tax submittal rate
Tax credits to small employers offering HSA-eligible HDHPs
Tax incentives to accelerate the use of electronic medical records (EMRS) and other electronic (non-paper) systems through investment tax credits or other similarly-situated tax incentives | |
| Premium/Co-Pay/Deductible |
Allow annual HSA contributions to be the maximum out-of-pocket expense under HDHP guidelines | |
| Health Quality Improvement |
Focus on health information technology and electronic medical records
Provide quality comparisons of hospitals with simplified consumer-friendly analysis capabilities | |
| Information Technology / Electronic Medical Records |
Yes | |
| Individual Responsibility for Health and Lifestyle |
Yes | |
| Preventive care |
Focus on behavioral changes including wellness, prevention, early intervention, and compliance with proven care and treatments | |
| Transparency |
Support the development of a "Health Travelocity" model for insurance products that would allow consumers to compare services provided by selling agents, covered benefits, and premium costs of products
Require hospitals receiving state funds to release information on risk-adjusted death rates and complication rates, with a guarantee that use of the data will include a fair risk adjustment
Support the "right-to-know" initiative, requiring providers to disclose cost and quality information on all discharges as a condition of participation in the Medicaid or other state-sponsored programs
Provide quality comparisons of hospitals with simplified consumer-friendly analysis capabilities | |
| Drug Reimportation |
Not addressed | |
| Medicare Rx Drug Price Negotiation |
Not addressed | |
| Medical Personnel Education |
Not addressed | |
| Mental Health Parity |
Not addressed | |
| Other Provisions |
All government programs converted to private market insurance though "insurance scholarships," health insurance "Pell Grants," or other advanced tax credit voucher programs
Allow the use of HSA funds for the payment of health insurance premiums
Allow HSAs to be attached to any health insurance plan
Allow HSA eligible policies approved under the laws and regulations of any state to be sold in other states
Limit SCHIP coverage to children in families with incomes at or below 200 percent of poverty
Fix incentives that reward states at a higher level for enrolling higher-income SCHIP children over poorer Medicaid children
Aggressive outreach and education campaign to enroll the 8,280,000 Americans who qualify for Medicaid and the State Children's Health Insurance Program (SCHIP) and are not signed up | |
| Cost |
Not addressed | |
| Cost Containment |
Competition in an open free market is the best solution to lower prices
Controlling demand for services by engaging participants in healthy behaviors and providing rewards and incentives for cost effective purchasing of healthcare services | |
| Financing |
Current federal and state funds used to cover the uninsureds should provide direct subsidies to low income uninsureds | |
| Source |
R. E. Bachman and N. Desmond, "A 21st Century Intelligent Healthcare Solution to Creating a 300 Million Payer System," Center for Health Transformation, April 1, 2008 | |
