Chris Dodd for President

Chris Dodd understands that we cannot move forward as a nation until we fix the major problems in our health care system. These problems reduce our productivity, drain our economy, undermine our readiness for emergencies, and threaten our well-being. We need a better deal on health care. Universal coverage and universal responsibility by all parties is the only way to get a truly better deal. While we wait, we waste money, lives, and productivity. In a Chris Dodd presidency, the waiting stops and action begins. Let us move forward together to be a healthier, fairer, more productive people with a health care system that makes us stronger.

• The Dodd plan provides for universal coverage, phased-in over 4 years; by the next election, everyone will have coverage.
• Coverage will flow automatically to all Americans, assuring that it is truly universal coverage.
• People will be able to get their private insurance through their employer or individually through a health insurance marketplace like the Federal Employees Health Benefits (FEHB) Plan. This marketplace, Universal HealthMart, will give everyone the right to have the same benefits and types of plans as every Congressman and Senator. Every business and individual will contribute a premium to purchase insurance based on their ability to pay. Sliding scale subsidies will be provided to supplement premiums of those that are not able to pay the full premium amount.
• Universal HealthMart will provide comprehensive benefits and value to improve the health status of all our people and sustain an energized, efficient, and competitive market for private plans.
• The Dodd plan includes significantly improved care for people with chronic diseases, leading to better health and lower costs.
• Regardless of where people live, they have access to a wide range of choices and benefits. It creates true parity whether you live in Mississippi or Massachusetts, and your coverage is not disrupted if you move out of state.
• Employers and individuals who want to keep their existing insurance arrangements can do so; no one is forced to get their health insurance from Universal HealthMart.
• The Dodd plan is easy to accomplish – the Federal Employees Health Benefits Plan already operates in every county in the country.
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• By participating, the burden to employers of administering their own health plans will be transferred to the healthcare marketplace.
• Incentives will be created to spread interoperable health information technology among all providers and plans.
• The Dodd plan reduces administrative costs, eliminates insurance coverage discrimination based on condition, and improves chronic illness prevention and management throughout the healthcare system to improve health and lower costs.

The Dodd Health Plan

• Universal responsibility by individuals, employers, insurance companies, and government for universal coverage. This means that everybody is covered and every person and every business contributes based on their ability to pay. If a person is unable to pay for insurance, the government will help buy their insurance through subsidies on a sliding scale based on income. Like individuals, businesses will only have to make contributions based on their ability to pay. In exchange for a larger market and a lot more customers, most of whom are pretty healthy, the insurance industry will have to end price and coverage discrimination against people who need medical care.
• Action now. Universal coverage is an important priority for our productivity, our economic growth, our readiness to deal with national and local emergencies, and the lives and health of our people. Chris Dodd’s plan can be implemented easily, and he has the political will and the skill to make this happen. There is no reason why enactment should be postponed or implementation impeded. Accordingly, he proposes phasing in coverage by age group based on current levels of insurance and health need within 2 years of enactment to be completed for everyone within 4 years. This is the only plan with a defined timeline. Delay empowers opponents and wastes lives and money. We cannot afford to wait.
• The formation of a voluntary health insurance marketplace identical and parallel to the Federal Employees Health Benefits Plan (FEHBP). Any employer and any individual/family can come to Universal HealthMart to purchase high-value health insurance at an optimal price either through paying a defined contribution into the marketplace or through purchasing health insurance as an employment benefit from the marketplace. All subsidies to help individuals and businesses buy insurance will operate through Universal HealthMart.
• Automatic coverage. Coverage will occur through direct enrollment as people choose their plans or automatically when people file their tax returns, complete W-4 forms at the start of employment similar to the way they sign up for health insurance now when they start a job, or show up for health care with a provider. Through the process of automatic coverage and enrollment, universal coverage is guaranteed.
• Coverage parity. In the Universal HealthMart marketplace, everyone will have access to the same types of plans and the same benefits as members of Congress do under FEHBP.
• Voluntary participation in the Universal HealthMart marketplace. Employers and individuals can choose to keep their existing insurance arrangements or participate in Universal HealthMart. No one will be forced into this more sensible system, but over time, as people see how well it works, we expect that more and more people will choose to join.
• Plan choice. Every American would be guaranteed a number of comprehensive health coverage options within the Universal HealthMart. At the same time, market forces will be harnessed to make insurance more affordable and improve health care, rather than harm it, as is all too often the case today. If employers choose to provide coverage from Universal HealthMart as an employee benefit, their employees get to choose from all the plans in the marketplace, making a wide array of choices automatic. It frees employers from having to make actual healthcare choices for their employees, a particular burden to smaller employers who interact closely with employees and lack the administrative capacity to oversee insurance plans. People can keep their insurance plan even if they change jobs.
• Better choices. As more people choose to participate in Universal HealthMart, more and more Americans will gain a choice of diverse private health plans at lower prices – the kind of choice today that is limited to employees of the federal government and large corporations. Americans will gain the ability to choose for themselves and their families the kind of health plan they want, rather than leaving that choice in the hands of employers who may be more interested in controlling costs than in meeting each family’s needs. In addition, people who make personal choices to improve their health such as smoking cessation, weight loss, and exercise programs will have access to plan rewards and incentives.
• Portability and fairness. Health coverage will become increasingly portable. If people like their health plan, they can keep it regardless of job changes (unless they happen to work for an employer who insists on staying outside this new and much better system). What kind of health care and benefits you get will no longer depend on what state you’re from – you can count on your health care as an American whether you’re from Mississippi or Massachusetts.
• Improved quality and chronic disease management. Chronic illness now accounts for 74 percent of private health insurance medical spending, 96 percent of Medicare spending, and 83 percent of Medicaid spending. We need to make significant changes in how we prevent and treat chronic illness. A better approach can lead to better health as a nation and savings. An integrated system of chronic disease management modeled after the system used by the Veterans Administration will be established within Universal HealthMart to deliver better health outcomes and wiser use of resources. That system will employ the most innovative methods of care coordination including interoperable health information technology and management between providers and levels of care. Universal HealthMart will promote widespread use of information technology among all providers and plans and will provide the mechanisms for monitoring and improving quality.
• Existing public insurance. Medicare remains intact; all people under 100% of poverty are eligible for Medicaid with adjustments in the federal match to hold states harmless.

The Dodd Health Plan in Action

The Dodd Plan envisions a health care system characterized by shared responsibility and universal coverage. Americans will be able to choose their private insurance plan from an insurance marketplace that operates parallel to the Federal Employees Health Benefits Plan (FEHBP) and has all the same benefits and types of plans as those available to members of Congress. The Universal HealthMart marketplace administrator will be able to negotiate the best prices for consumers just as plan prices are currently negotiated for FEHBP.

If an individual prefers to continue existing coverage or if an employer prefers to continue to offer coverage to its employees through its own carrier outside of Universal HealthMart, the individual or employer may do so. However, in Universal HealthMart, employers will have a large array of plans from which to choose available at large group rather than small business prices. This approach provides affordable private coverage for the best benefits, allows employers to provide insurance directly if they want to while letting the Universal HealthMart administrator take care of all administrative costs and functions, and gives individuals the most flexibility, all of which are highly attractive features to employers who wish to provide coverage. If an employer chooses not to offer coverage, an employer defined contribution will be made into Universal HealthMart to help workers pay for insurance. In order to be able to direct the subsidies and provide affordable, high-value insurance, all subsidies to individuals and businesses must come through plans in the marketplace.

Universal HealthMart will be financed primarily by a combination of employer and individual/family premiums or contributions to buy the insurance policies. Other revenue streams will be identified as needed for transition costs, including savings from other health subsidies for uncompensated care in the system that will no longer be needed once universal coverage is in place.

People will be issued a plan card and receive services according to the plan they select. If people fail to enroll, they will be automatically enrolled in a plan or Medicaid, depending on eligibility, at their point of service when they show up for health care; when they file income tax forms; or when they complete W-4 forms at the start of employment, similar to the way people sign up for health insurance when they start a new job now.

Universal coverage will be phased in over 4 years. Within 2 years of enactment, all children, young adults to age 29, and adults age 55-64 will have health insurance. In the next 2 years, all remaining adults age 30-54 will be enrolled.

In addition to using market leverage to reduce prices, Universal HealthMart will provide incentives to improve quality, expand the use of health information technology, and facilitate chronic disease management and preventive care. Specifically, Universal HealthMart will initiate integrated systems of chronic disease management within health plans modeled after the Veterans Administration approach. This includes the use of interoperable information technology systems and mechanisms to coordinate care between providers and levels of care.

Today, insurance companies have little incentive to invest in long-term wellness because their customers may be enrolled with a competing insurance company when those preventive investments begin to pay off through better health down the road. With the kind of coverage federal employees get, health plans know their customers will be with them for years, so they have an incentive to invest in quality of care and long-term health improvements to keep market share. This approach to health care coverage restrains cost growth without heavy-handed measures.

First, as more and more Americans participate in the universal health care marketplace, the agency contracting with health plans on their behalf gains increasing leverage to require sensible efficiencies, such as using a single claims process for all physicians and including prevention measures that we know work. Second, enrollees pay more for selecting more expensive plans, giving both consumers and health plans incentives for more efficient care. Third, price discrimination based on condition, a substantial portion of insurance company excess administrative expense, is eliminated. Fourth, marketing, another driver of high premiums, is consolidated and streamlined. These are some of the reasons why federal employee health premiums have risen much more slowly than premiums for other employers during the past five years.

The Dodd Health Plan: Advantages to Employers

• Employer costs will decline as they reap the benefits of a large pool with rigorous premium bargaining on behalf of users.
• Employers contribute according to their ability to pay.
• Employers will no longer need to struggle to get a source of insurance; they and their employees have guaranteed access to high-value insurance products.
• Employers can automatically offer a wide array of health care choices for a fixed amount and do not have to intrude into employee health care decisions. Employers are freed of having to negotiate coverage arrangements every year and administering employee plans.
• Employees are guaranteed coverage and will therefore have improved health, less absenteeism, and higher productivity.

The Dodd Health Plan: Advantages to Workers

• Coverage will be affordable. Families and individuals are guaranteed coverage and contribute according to their ability to buy a policy.
• Coverage follows the person, not the job. Coverage in the same plan can continue on the same basis regardless of how employment changes. People can keep their same doctors over longer periods of time, leading to better quality of care.
• Everyone will have access to the same coverage as that of Members of Congress, assuring that coverage will have value.
• The health status of workers and their families will improve.

The Dodd plan not only provides universal coverage by building on the existing system; it also creates substantial efficiencies and savings to help pay for expanded coverage. Its approach will create a healthcare system that not only can be sustained but will flourish into the future. Americans deserve a health care system that is worthy of our potential as a nation.