Health Care for America by Jacob Hacker - January 2007

http://www.sharedprosperity.org/bp180/bp180.pdf

"...How Health Care for America would provide affordable coverage to all

Health Care for America has just three central elements:

• the new Health Care for America Plan, which would be open to any legal U.S. resident without good workplace
coverage;3
• a requirement that employers (and the self-employed) either purchase coverage comparable to Health Care for
America for all their workers or pay a relatively modest payroll contribution (6% of payroll) to fund Health Care for
America coverage for all their employees;
• a requirement that Americans who remain without insurance take responsibility for their and their families’ health
by purchasing private coverage or buying into the Health Care for America Plan.4


Non-elderly beneficiaries of Medicaid and S-CHIP (the State Children’s Health Insurance Program) would be enrolled
in the Health Care for America Plan, either through their employers if working or individually if not. Enrollment
in the plan would relieve the states of a significant share of the burden of these programs, providing states with strong
incentives to streamline enrollment. To ensure that former Medicaid and S-CHIP beneficiaries received coverage at least
as generous as that which they had enjoyed previously, the states would be required to provide wraparound benefits.
(States could also elect to pay Health Care for America to provide such wraparound coverage.) Moreover, all low-income
enrollees in the Health Care for America Plan would receive cost-sharing subsidies to ensure that co-payments or deductibles
did not deter them from seeking necessary care.

For the small share of people without direct or family ties to the workforce and ineligible for Medicaid, S-CHIP, or
Medicare, the Health Care for America Plan would be available as an attractive new coverage option. Premiums would
again be based on income, ranging from no premium in the case of those with incomes below the poverty line to the
average actuarial cost of coverage for all enrollees in Health Care for America in the case of those with incomes above
400% of the poverty level. In other words, Health Care for America would allow higher-income individuals without
workplace ties to buy into the program for a premium that did not vary with age, region, or health status (a so-called
community-rated premium)...."