Opinion: A Bipartisan Way Forward on Health Care

(Feb. 5) -- For some, Thursday may have marked the official death of comprehensive health care reform. It was the day Scott Brown was officially sworn in as Massachusetts' Republican senator, killing the filibuster-proof majority Democrats had relied on to get reform through the Senate.

But health reform could be resuscitated -- if, that is, Democrats were willing to live up to the model of the man who held Brown's seat for decades.

During his long Senate career, Ted Kennedy successfully moved the ball forward on a number of initiatives, including health reform, by partnering with Republicans. For example, Kennedy teamed up with Republican Sen. Nancy Kassebaum to pick up the pieces of the failed Clinton health plan and pass the Health Insurance Portability and Accountability Act in 1996, limiting pre-existing conditions and expanding access to health insurance to many workers who lost their jobs. Later, he crossed the aisle to work with Sen. Orrin Hatch and get the State Children's Health Insurance Program (SCHIP) passed, which provides coverage to low-income children across the country.

Even now, despite the rancor and partisanship over health reform, there are several reform ideas that have widespread, bipartisan support.

And taken together, these proposals would move the country a long way toward President Barack Obama's goal of ensuring that everyone, even those with pre-existing medical conditions, has access to affordable, quality coverage. Bipartisan reforms would:

Guarantee access: Both the House and Senate bill include a provision to set up high-risk pools for those rejected by private insurance companies, following the successful example of 34 states. The addition of modest federal subsidies to high-risk pools can ensure that these plans are affordable. This reform has bipartisan support, but Democrats unfortunately chose to make the fix only temporary.

Eliminate job lock: Existing laws like COBRA largely guarantee access to health insurance for those leaving their jobs, but they don't ensure that coverage is affordable. The next step is to let workers choose either their existing plan or one that is more affordable. Congress undermines portability by limiting the kind of insurance a newly unemployed person can buy with tax subsidies. That needs to change.

Provide a safety net for the poor: Expanding Medicaid was a big part of the president's plan. Medicaid, SCHIP and other programs provide insurance, but often fail to deliver quality health care. Instead, we should increase funding to federally qualified health clinics that provide health care in areas accessible to the poor.

Increase competition: Obama has argued that a public option would increase insurance competition, but the idea has been rejected by the Senate. A better way is to let insurance companies compete across state lines, which will almost immediately increase competition. The idea has widespread Republican support, but the House included only a limited version of this idea in its bill.

Equalize tax treatment: Americans buying health insurance on their own don't get the same tax treatment as those buying a plan through their employer. This makes coverage even more expensive for these individuals. Congress can and should fix this disparity.

Reform medical malpractice: States have shown that medical malpractice reform cuts costs and increases competition, which results in more access to affordable health care. The president has recently been saying he's open to discussions about malpractice reform.

These proposals aren't revolutionary, and they won't transform our health care system. But they do have Republican support, and elements of them were in the Democrats' plans already.

And most important, they are concrete solutions to real problems that could get enacted immediately, which is exactly what the American people are looking for.
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J.P. Wieske is director of state affairs for the Council for Affordable Health Insurance, a nonprofit, nonpartisan research and advocacy association whose membership includes health insurance companies active in the individual, small group, health savings account and senior markets; small businesses; physicians; actuaries; and insurance producers and brokers.