The Y.I. Want Change Coalition applauds the President’s efforts to move forward on health care reform at today’s summit with Congressional leaders. We believe that now, more than ever, is the time to pass real, comprehensive health care reform. The failures of the current state of health care in America have never been clearer, as evidenced in the recent report released by the National Center for Health Statistics, showing that one-third of our generation is uninsured.
As Congress edges closer to crafting a reconciliation bill, we call for a renewed sense of urgency about enhancing the catastrophic plans in the health reform bill. While providing an affordable option for young adults is essential, the current catastrophic plan provided in the Senate bill is inadequate and will have a negative impact on reform. Because the legislative fixes we have proposed these last few months will add no cost to the bill and will not conflict with other reform goals, there is no reason why 4 million young Americans should not get the insurance they deserve. As the President and several Democratic leaders voiced today, catastrophic coverage is simply inadequate.
Indeed, President Obama stated that catastrophic plans are “basically not health insurance, [they’re] house insurance,” and that there would be a “riot” in Congress if members had to be on them. As the President said, on a catastrophic plan, “I don’t go to the doctor. I don’t get preventive care. There are a whole bunch of things I just do without.”
Young Americans, the largest group of uninsured in the country, should not have to go without. We are united in asking for the following modest fixes to the catastrophic plan. Based on our analysis, it is possible to add these benefits while keeping the plans affordable for our demographic and not negatively impacting the cost of the bill:
1. Require coverage for three primary care visits and trips to the ER with reasonable pre-deductible co-pays ($25 and $100, respectively), as well as an option to purchase pre-deductible prescription drug coverage. The current Senate bill allows for pre-deductible coverage of three primary care visits but does not require it, nor does it provide that consumers will only have to pay a reasonable co-pay. Primary care should be defined broadly to include visits to a general practitioner and OB-GYN.
2. Incorporate language allowing people with certain qualifying life events – like pregnancy – to move easily to more comprehensive insurance. Senator Menendez offered an amendment along these lines during debate of the Senate bill.
3. Require that plans targeted at young adults only be offered through a qualifying exchange, not the off-exchange private market
4. Enhance the transparency language in the Senate bill to require plans to state the essential benefits not covered before the deductible.
5. Mandate a target actuarial value set by the HHS Secretary as opposed to the minimum deductible. Specifically, rather than setting the deductible at the HSA out-of-pocket maximum (as it currently does), the bill should allow catastrophic plan deductibles to vary between the HSA minimum and maximum. We think the target AV should be no less than 85 percent of the next lowest plan.
It is time for us to provide meaningful health care for all Americans. We cannot wait any longer. But nor should we leave anyone behind. We urge leadership in Congress to adopt these modest changes. There is no reason not to do so.