FOLLOWING MAINE’S LEAD

A welcome new plan to expand health-insurance access from the main lobby of the industry describes the direction in which the health care debate is headed – directly toward Maine, with its higher levels of Medicaid coverage. But to persuade taxpayers to spend hundreds of billions more to subsidize insurance, the industry must be prepared to provide a level of transparency it has long resisted. Without that, containing costs so that this necessary expansion can be funded would be impossible.

The lobby, America’s Health Insurance Plans, proposes that states should cover all adults up to 100 percent of poverty ($9,800 annually in income for an individual) and cover all kids up to 200 percent of poverty through the State Children’s Health Insurance Program (SCHIP). Maine already has done this, and is one of the few states to see its rates of the uninsured fall in the last couple of years.

The plan also would expand tax incentives and credits for families to cover their children (up to 300 percent of poverty) and for families to create health savings accounts. Total cost would be $300 billion over 10 years. The plan relies heavily on action by the states, an indication of what the industry thinks is possible in Washington.

Meanwhile, the need for increased government intervention can be seen in the rising number of uninsured, now nearly 47 million Americans, up 17 percent since 2000. The number has increased as businesses have cancelled their health plans: According to the Kaiser Family Foundation, employer coverage in 2004-05 accounted for 53 percent of all coverage; just two years earlier, it accounted for more than 60 percent. This abandonment of workers to the high-priced individual market demands intervention to leverage buying power for participants.

If insurers are serious about the government buying $300 billion in new health care coverage for Americans and persuading states to pick up high-risk residents while subsidizing others, it must be serious about providing the government with information that demonstrates taxpayer money is going to good use. That means the public should know how the high health care costs are generated, what kind of care is provided and whether similar outcomes could be had for far less money.

For the last few years, Maine has been moving in the direction of expanded coverage and greater transparency so that health care savings can be identified. It’s nice to be joined by a national insurers’ group in this pursuit, but finding those savings is the key to sustaining the kind of reforms the insurers envision.