CareSource on Health Care Reform

CareSource strongly supports the need for national health care reform.  Our position is grounded in the mission or "heartbeat" of CareSource: "to make a difference in the lives of underserved people by improving their health care." 
 
It is the application of this mission to the 47 million Americans that do not have access to health care coverage that drives CareSource to take an active role in advocating for health care reform.

Key CareSource principals include:

1. Medicaid expansion to 150% of the federal poverty level (FPL) by 2013 and the elimination of categorical eligibility to cover those who have fallen through the gaps. In addition, CareSource supports full funding for the Children’s Health Insurance Program (CHIP) through at least 2019.

CareSource also believes the current infrastructure should be used for providing care to Medicaid enrollees whereby 70 percent of Medicaid consumers receive services through managed care. This demonstrated system is well suited for providing coverage for additional low-income and high-need populations at a lower cost than coverage would be in the private market.

2. Affordable coverage for all, including subsidies for those with income between 150% FPL - 400% FPL, a Medicare buy-in for those ages 55-65 and an individual mandate for all to ensure that all Americans participate in the insurance risk pool resulting in lower cost coverage options for all.  

3. Cost containment to bend the unsustainable curve of health care costs. Key opportunities for cost savings that also support quality improvement include:

  • health information technology
  • evidence-based medicine supported by independent comparative effectiveness research
  • payment reform to compensate health care providers based on health outcomes instead of volume
  • patient centered medical home (PCMH) concepts
  • extension of Medicaid rebates to pharmaceuticals purchased by Medicaid managed care plans, and strategies to address health care fraud and abuse

4. Use of a state based health care exchange to act as a transparent clearinghouse for consumer access. This builds on the significant role that states already have in health plan regulation and serves as a resource to consumers for industry information and addressing concerns. However, CareSource does not support the mainstreaming of Medicaid or CHIP populations into the health exchange private market because the unique needs of these consumers require the proven focus of Medicaid managed care.

5. Public plan options - use of private, non-profit consumer-oriented plans to serve as state-level public plan options.  These would be organized as non-profits with strong consumer focus on increased quality and appropriate utilization.  They would meet the same licensure standards as all plans as well as exchange rules.  Surpluses would be reinvested in the plan to benefit consumers. 

6. Medicare & Medicaid benefit integration and financing for dual eligibles within a managed care model to rebalance the long-term care system to increase use of home and community based support services. Shifting more of this high-need population into coordinated managed care arrangements could produce significant savings while ensuring options for consumers where they desire to reside.

For more information or to join the discussion on health care reform, visit our blog at www.OurHealthCareSource.com.