OK Policy Blog comments on health care coverage initiative

David over at OK Policy Blog has this commentary on the Oklahoma State Coverage Initiative.

I'm not sure what I think of either the initiative or the commentary, but it's sure an interesting read. The SCI is apparently a project of Oklahoma Insurance Commissioner Kim Holland which has been developed over the past two years. The goal is to find a way to bring health care coverage to the 640,000 Oklahomans who lack it. Last week a meeting of the SCI reportedly reached consensus on a way to do this. According to David:

The cornerstone of the plan would be a gradual expansion of Insure Oklahoma, the public-private partnership which provides subsidized employer-based coverage for working adults, along with a public product for eligible adults without access to employer coverage. The program, which is funded by a portion of tobacco tax revenues approved by voters in 2004, has now grown to cover just under 20,000 Oklahomans, which is about half of the capacity under existing revenues. The principal SCI recommendation is to generate new revenues by assessing a dedicated fee on all health insurance claims paid by health insurers in Oklahoma. It is estimated than an initial 1 percent fee would generate $78 million that, along with matching federal funds, could insure an additional 80,000 Oklahomans.

David also summarizes other parts of the plan:

In addition to expanding Insure Oklahoma through a targeted assessment, the SCI plan includes several other components:

• It endorsed creation of lower-cost commercial health plans targeting younger adults through the waiving of mandated benefits, as was recently enacted by HB 2026. This approach is unlikely to have any real impact on expanding coverage as insurers already enjoy considerable flexibility in the individual market and limited-benefit plans have proven unpopular with consumers;
• It added a recommendation that OK Policy has strongly advocated to extend Medicaid coverage to all adults with incomes below the poverty level. Currently, Medicaid extends to less than 40 percent of the poverty level, and this population of very-low income adults is unlikely to be able to afford any of the cost-sharing obligations required of Insure Oklahoma
• The group weighed recommending an individual health insurance mandate, in conjunction with guaranteed issue of coverage, but stopped short. Instead, they are calling for a variety of strategies to “induce” Oklahomans to purchase coverage, stating that “the failure of these strategies will require policymakers to consider mandating that all individuals secure health insurance”.

David admits that it's uncertain how well the plan will work, but seems to believe that on the whole it "represents a realistic, middle-ground approach to tackling this huge and urgent issue." Meaning, perhaps, that it doesn't seriously tread on toes of insurance companies and won't arouse their well funded opposition, even if it can't result in significant expansion of health care coverage?

Single payer health-insurance is often criticized on the grounds that it is not a middle-of-the-road, realistic approach. But single-payer, or possibly the creation of a voluntary public health care plan that could compete with private insurers, seems to be the only effective ways to actually contain health care costs and provide universal coverage. If the Oklahoma State Coverage Initiative is a realistic and effective approach, surely it will succeed without any support from me. Given what I've read, it's difficult for me to work up any enthusiasm about working to support it.