Nevada Community Coalition: Affordability Is Key to Health Insurance Reform

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Nevada Community Coalition: Affordability Is Key to Health Insurance Reform
Author: Progressive Leadership Alliance of Nevada
Published on Jan 12, 2010 - 9:35:44 AM

Jan. 12, 2010 - A Nevada coalition of more than 50 community groups and leaders is urging Senate Majority Leader Harry Reid to ensure that health insurance is affordable.

The coalition includes representatives from business, labor, communities of faith, and elected leaders who support the health reform effort championed by Sen. Reid and President Obama, but are concerned that middle- and lower-income families could be hurt by requirements to buy high-cost health care insurance.

"Compromise is possible and necessary," said Jon Sasser, a long-time Reno community leader and chair of Nevada Lawyers for Progressive Policy. "Sen. Reid and many others have worked for a reform bill that brings health care to nearly everyone, but we don't want to hurt those most vulnerable. It would be tragic if after all of this effort Congress passes a bill which hurts the uninsured by making them buy something that they cannot afford to purchase or use."

Concerns include the following:

* A family of four with a household income of about $33,000, about 150 percent of the poverty line, would pay a premium of about $1,000, or 3 percent of income, under the House bill and about $1,500, or 4.6 percent of income, under the Senate bill.
* A Consumers Union analysis of the Senate bill shows that an individual earning about $22,000, just over 200 percent of the poverty line, would have a likely deductible of at least $1,500. Under the House bill, however, the same individual would likely have a deductible of about $600.

The concern is that "the existing proposals contain ticking time bombs that could outrage health care consumers and voters," said Michael Ginsburg, an organizer for Nevada's Progressive Leadership Alliance and the national Health Care for America Now group.

A Las Vegas health care consumer, Leana Hildebrand, agreed.

"Requiring economically disadvantaged families to purchase insurance that they cannot afford runs counter to the goals of reform," said Hildebrand, an uninsured independent contractor. "It is crucial for the physical and economic health of this country to ensure that families are given meaningful access to health care through affordable choices."

A copy of the letter to Sen. Reid follows:

Senator Harry Reid
U. S. Senate
Lloyd D. George Building
333 Las Vegas Boulevard
South, Suite 8016
Las Vegas, NV 89101

January 11, 2010

Dear Senator Reid,

We, the undersigned Nevadans, want to thank for your leadership in passing health care reform in the Senate. You overcame obstacle after obstacle and we are on verge of the greatest expansion of healthcare since Medicare was enacted in 1965.

The work is not over yet, however. Each time you have intervened since passage of health reform by the Finance Committee, the Senate bill has gotten better. Please use your influence once more to make sure that the final bill makes coverage affordable for those who are mandated to purchase it. If Congress mandates that low to moderate-income individuals and families purchase insurance that they cannot afford to buy nor use, the backlash by consumers and voters could be overwhelming. It is vital that in conference, the final bill adopts the House's more affordable premiums for lower middle income families in the exchange. Below are examples of how the House bill is more affordable than the Senate bill.

* In the House bill, a family of four earning about $29,000 (just over 133% of the poverty line) would be eligible for Medicaid, which generally does not charge premiums. Under the Senate bill, that same family would have to pay almost $600 (2%) for insurance purchased in the exchange.

* A family of four with a household income of about $33,000 (about 150% of the poverty line) would pay a premium of about $1,000 (3% of income) under the House bill and about $1,500 (4.6% of income) under the Senate bill.

* A family of four with income of about $44,000 (or approximately 200% of the poverty line) would pay a premium of just over $2,400 (5.5% of income) under the House bill and nearly $2,800 (6.3% of income) under the Senate bill.

These figures demonstrate how much more affordable premiums for lower-income families are under the House bill. However, for individuals and families with incomes between 250 and 400% of the poverty line, the premiums are more affordable in the Senate bill.

Another provision that makes the House bill more affordable has to do with the more generous cost-sharing assistance provided to individuals and families earning up to 350% of the poverty line. A Consumers Union analysis of the Senate bill shows that an individual earning about $22,000 per year (just over 200% of the poverty line) would receive coverage that would likely carry a deductible of at least $1,500. Under the House bill, however, the same individual would likely have a deductible of about $600.

To ensure that families at the lower end of the income spectrum (those with incomes between 133% and 150% of the poverty line) do not face steep out-of-pocket expenses, the final bill could adopt the House Medicaid expansion up to 150% of the poverty line. Medicaid generally does not charge premiums and require only minimal cost-sharing, and provides more affordable coverage for families who are struggling with the basic necessities like food, heating, and rent.

In the bill that emerges from the conference committee, please do all you can to make coverage affordable by: (1) adopting the premium structure in the House bill for those whose incomes fall between 133% and 250% of the poverty line; and (2) adopting the cost-sharing assistance provisions in the House bill for those whose incomes fall between 133% and 350% of the poverty line. Thank you again for your tireless leadership. Making these changes related to affordability will go a long way toward ensuring that quality coverage is available for all Americans.

Sincerely,

Groups/Organizations

SEIU Nevada, Local 1107, Al Martinez, President

Nevada State Education Assoc., Craig Stevens, Director of Education Policy

AFSCME Local 4041, Dennis Mallory, Chief of Staff

Progressive Leadership Alliance of NV, Bob Fulkerson, Ex. Dir.

Nevada Alliance for Retired Americans (NARA), Scott Watts, President

Nevada Women's Lobby, Dinah Jordan, State Co-chair

Great Basin Primary Care Association, Patricia Durbin, Director

Planned Parenthood Mar Monte, No. NV Region, Patty Elzy, Dir. of Public Affairs

Human Services Network by Julia Ratti, Executive Director

Food Bank of No. NV, Cherie Jamason, President and CEO

Three Square Food Bank, Julie Murray, CEO

Nevada Diabetes Association, Mylan Hawkins, State Executive Director

National Assoc. of Social Workers, NV Chapter, Mark Nichols, Ex. Dir.

Nevada Lawyers for Progressive Policy, Jon Sasser, Chair

Nevada Covering Kids and Families, Nancy Whitman, Executive Director

Clark County Democratic Black Caucus, Yvette Williams, Caucus Chair,

NV Stonewall Democrats, Derrick Washington, Chair

Democracia Ahora, Marco Rauda, State Dir.

Gay and Lesbian Community Center of Southern Nevada, Candice Nichols, Director

Business Advocating Social Equity, Tim Healion, Founder

ProgressNow Nevada, Erin Neff, Executive Director

Walker River Paiute Tribal Health Clinic, Kenneth Richardson, Director

Paula Berkeley and Associates, Paula Berkeley CEO

Law Office of Alison Colvin, Alison J. Colvin, Esq

Clinica Sierra Vista, Stephen W. Schilling, CEO

Community Leaders:

Debra "Sam" King, President, League of Women Voters of Nevada

Robert Disney, State Director, Sierra Club

Denise Tanata Ashby, Executive Dir., NV Institute for Children's Research and Policy

Trudy Larson, MD, Medical Director, No. NV HIV Outpatient Program (HOPES)

Paul Gowins, Chair, NV Commission on Services for Persons with Disabilities

Tom Durante, President, National Assoc. of Social Workers, NV Chapter

Louise Helton, State Director, Communities In Schools of Nevada

Kenya Pierce, Ex. Dir., TRENDZ

Assemblywoman Sheila Leslie, Assembly Majority Whip

Assemblywoman Debbie Smith, Chair, Assembly Committee on Health Care

Assemblywoman Peggy Pierce, Vice- Chair, Legislature's Committee on Health Care

Laura Leavitt, Law & Legislative Committee Chair, AFSCME Desert Chapter Board

Marcia O'Malley, Executive Director, Family TIES of Nevada

Rota Rosaschi, Exec. Dir., Nevada Public Health Foundation

Judy Treichel, Executive Director, Nevada Nuclear Waste Task Force

Jessica Bradley, Member, Maternal Child Health Adv. Bd. Prenatal Subcommittee

David Ward, Disability Advocate

Shannon Ward, Disability Advocate

Shaun Griffin, Executive Director, Community Chest, Inc.

Sherri Rice, Executive Director, Access to Healthcare Network

Jonnie Pullmam, former Washoe Co. School Board Trustee.

May Shelton, Washoe Co. Social Services, Director (retired) and Community Activist

Dino Gonzalez, MD, Las Vegas

Erik Schoen, Executive Director, Community Chest, Inc.

Scot Rutledge, Ex. Dir., NV Conservation League

Ray Leavitt, member, United Transportation Union, Las Vegas, NV

Laurrie Bullock, UUCLV Social Action Comm.

Loren Ellery, Director, Washoe Tribal Health Center

Nancy Hart, Social Justice Council, UU Fellowship of No. NV

Website: www.planevada.org