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Blue Cross Blue Shield Proposes New Plan to Cover Uninsured

By Reed Cooley, CQ Staff

January 23, 2008 -- The Blue Cross and Blue Shield Association, whose members provide health care coverage to nearly one in three of all Americans, unveiled a new proposal Wednesday that aims to cover a large chunk of 47 million uninsured Americans.

The Blue Cross Blue Shield Association (BCBSA) plan emphasizes private and public cooperation, incentives rather than mandates, and an improvement of the existing system rather than looking for new modes of coverage. The association hopes that the five-point proposal will extend coverage to two-thirds of America's uninsured, or about 35 million people, as well as improve the quality of care.

"We believe the best approach is to build upon the current employer-based system—a system which is working today," said Scott P. Serota, president and CEO.

The plan is a second attempt by BSBCA to tackle the problem of the uninsured. In 2007 the group, as part of a larger coalition, released a proposal to cover more Americans, but the plan never came to fruition. BCBSA acknowledged at a Wednesday news conference that a portion of its new proposal, which focuses on public and private cooperation, shares many similarities with the 2007 plan.

However, the key difference is that the new plan looks at changing the delivery system rather than just expanding access, said Mary Nell Lehnhard, senior vice president, Office of Policy and Representation at BCBSA.

Specifically, the new proposal promises to reimburse providers based on quality standards designed by third party evaluators, to help providers and consumers adopt and make use of electronic and personal health records, and to create a new nationwide database to record the claims experiences of 80 million BCBS costumers.

Each of the five points also contains recommendations on what state and federal governments should do in cooperation with the proposal. Suggestions include tax credits, health education programs and the creation of an independent entity—a Comparative Effectiveness Research Institute—to evaluate cost and clinical effectiveness of various procedures, drugs, and technologies. BCBSA also recommends expanding public programs to cover all individuals living below the Federal Poverty Line ($10,210 annually for individuals and $20,650 annually for a family of four in 2007).

Serota did not put a price tag on the proposal and said that BCBSA had not yet identified revenue sources to back the tax credits. He said that the Association was suggesting that all private and public payers fund the proposed institute.

The Association has enlisted the help of Sens. Kent Conrad, D-N.D., and Max Baucus, D-Mont, in drawing up language for a bill to support the plan, but Serota and his colleagues expressed some concern that the legislative progress would be slow in a contentious election year.

Serota said BCBSA has touched base with each viable presidential candidate for the 2008 election, in hopes of building a foundation for cooperation in the new term.

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