Priorities for Reform from the Legislative Letter

• “Choice of a quality public health insurance plan that is available to businesses, individuals, and families.” This will provide Americans with more choice, which the public overwhelmingly supports (73%), and create competition in the highly consolidated health insurance industry.
  • In 36 states, three or fewer health insurers dominate the market, reports the Economic Policy Institute.i According to Federal Trade Commission guidelines, as The Urban Institute reports, 34 states have health insurance “markets highly concentrated and therefore of anti-trust concern.” These conditions enable insurance companies to not only “pass on health care costs to purchasers but to increase profitability at the same time” even while health care costs increase markedly faster than inflation.ⁱⁱ
  • 73% of "voters overwhelmingly want everyone to have a choice of private health insurance or a public health insurance plan," according to a January 2009 Lake Research Partners public opinion poll.ⁱⁱⁱ
  • Private insurance spends two-and-a-half times more on administrative expenses than public programs, according to the Commonwealth Fund.^iv
• “Strengthening and expanding the Medicaid program with the help of enhanced federal support so that it can serve all low-income Americans.”
  • Almost 59 million Americans who can’t afford insurance are covered by Medicaid.^v It is the bedrock of the health care safety net.
  • Medicaid is one of the best and most cost-effective ways for states to broaden access to health care coverage. It brings in valuable federal dollars that have an economic multiplier effect on state economies.^vi
• “Guaranteeing affordability for individuals and businesses.”
  • Medical bills are blamed for 60% of personal bankruptcies in the US, according to a Robert Wood Johnson Funded study. Having insurance does not necessarily protect families from the threat of bankruptcy, as 75% of these families had health insurance.vii
  • A 2008 Kaiser Family Foundation poll found that almost half of Americans reported delaying or foregoing needed medical care because of its cost.^viii
  • Faced with rising premiums, employers are shifting costs to workers by increasing deductibles and worker premiums. Premiums for family coverage have doubled in ten years and 35% of workers in small businesses (3 to 199 employees) face a $1,000 deductible, up from 21% in 2008. Less than half of small firms with 3 to 9 workers now offer coverage.^ix
• “Eliminating racial, ethnic, gender, and rural health disparities.”
  • People of color in the US are less likely than whites to receive routine medical care as well as quality health care services.^x
  • People of color are more likely than whites to be uninsured – 33.5% of Hispanics, 20.9% of African-Americans, and 12.2% of Whites lack health insurance.^xi
  • Disparities in access to quality health care result in poorer health and a shorter lifespan. African-Americans are more likely than whites to die from complications caused by diabetes, 47 per 100,000 people to 22 per 100,000 people for whites.xii And, the life expectancy for African-Americans is five years shorter than it is for whites.^xiii
• “Ensuring shared responsibility among employers, individuals and government in financing health care.”
  • All Americans and sectors of the economy have a stake in health care, and in ensuring we achieve a sustainable, affordable and quality health care system. An accessible and quality health care system will ensure the continued economic competitiveness of Americans businesses and workers in the international community, and support the entrepreneurial spirit of the American economy.
• “Cost containment strategies that eliminate waste and inefficiency and improve quality, especially for people with chronic illnesses.”
  • Quality and costs are inextricably linked. 78% of all health care costs are spent on people with chronic health care conditions. 20% of Medicare beneficiaries account for 2/3rds of Medicare spending.^xiv Improving preventive care and treatment for chronic illnesses can reduce the escalating growth of health care costs.
  • The Institute of Medicine estimates that medical errors cost $17 billion to $29 billion each year.^xv
  • According to the Commonwealth Fund, US administrative costs - as a share of total health care spending - are 30% to 70% higher than peer countries, including those with mixed public/private systems, which have universal coverage, better access to care, and better health outcomes.^xvi

i Economic Policy Institute, April 2009, Why a public insurance plan is essential for health reform, http://bit.ly/Yv18a
ii Urban Institute, 2008, Can a Public Insurance Plan Increase Competition
and Lower the Costs of Health Reform?, http://bit.ly/gPWIi
iii Lake Research Partners, January 2009, Voter support for a public health insurance plan, http://bit.ly/3mFeco
iv Commonwealth Fund, 2003, American Health Care: Why So Costly? http://bit.ly/199uQD
v Kaiser Family Foundation, Total Medicaid Enrollment, FY2006, http://bit.ly/BWkrk
vi Families USA, Medicaid: An Important Part of an Economic Stimulus Package, http://bit.ly/10guGD
vii Reuters, June 2009, Medical bills underlie 60 percent of U.S. bankrupts: study, http://bit.ly/136VF7
viii Kaiser Family Foundation, 2008, Americans Rank Health Care Near the Top of Their Economic Woes, http://bit.ly/K4wgJ
ix Kaiser Family Foundation, 2008, 2008 Employer Health Benefits Survey, http://bit.ly/16aUjj
x Institute of Medicine, 2002, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, www.iom.edu/?id=16740
xi Kaiser Family Foundation, 2007, Uninsured Rates for the Noneldery by Race/Ethnicity, http://bit.ly/c68dz
xii Kaiser Family Foundation, 2005, Number of Diabetes Deaths per 100,000 Population by Race/Ethnicity, http://bit.ly/P7jXQ
xiii Arizona Daily Star, August 2007, US now trails 41 other nations in life expectancy, http://bit.ly/18nKt5
xiv National Chronic Care Consortium, 2003, Check List for Chronic Care Reform, http://bit.ly/kTabe
xv The Commonwealth Fund, 2008, Who Pays for Medical Errors?, http://bit.ly/h6e2N
xvi The Commonwealth Fund, 2008, Why Note the Best? Results from the National Scorecard on US Health System Performance, http://bit.ly/noHAH

State Legislators for Progressive Health Care Reform: Press Releases and Media

• 1000+ State Legislators Support Health Reform, Far Outnumber Marginal Opposition by ALEC Legislators [61] (12/7/09)
• Obama, Pelosi, Harkin to Meet with State Legislator Delegation Representing 1000+ Legislators for Real Health Reform [62] (10/14/09)
• Mission Statement: State Leader Lobby Day [63] (Word Document, 10/13/09)
• Body Representing Every State Legislature in Country Backs Public Health Insurance Option [64] (7/23/09)
• Body Representing Every State Legislature in Country Backs Public Health Insurance Option [64] (7/23/09)
• Delegation Representing 700 State Legislators Meets With White House, Congress To Urge Public Health Insurance Option [65] (6/17/09)
• Media Roundup: PSN Makes State Voices Heard in DC Health Care Debate [66] (6/18/09)