Thursday, January 31, 2008

A D.C. Council member will propose a program this year aimed at bringing universal health care coverage to the District — an idea that lines up with the priorities of the mayor and council chairman.

Council member David A. Catania is crafting a program he says would provide a bridge between health care coverage for the city’s poorest residents and those who have access to a plan through their employer.

“It’s a more incremental approach that I think frankly is going to be more successful,” said Mr. Catania, at-large independent and chairman of the council’s health committee.

The program — called Healthy D.C. — would be partially government-subsidized but include a reduced premium that depends on the income of the enrollee.

It also would include a co-pay and deductibles and provide coverage for primary care and hospitalizations, but it would not cover services such as home visits or chiropractic care.

Mr. Catania said his proposal is part of a three-pronged approach to expand health care that includes enrolling additional residents and children in the District’s Medicaid and HealthCare Alliance programs.

He said it would ideally target residents at 200 percent to 300 percent of the federal poverty level and reduce the city’s number of uninsured residents by roughly 12,000.

A report commissioned by the D.C. Council and released yesterday by the Rand Corp. shows that 9.8 percent of D.C. residents — or about 55,000 — are uninsured.

The District — which had a population of roughly 581,000 in 2006, according to U.S. Census Bureau estimates — has a lower percentage of uninsured residents than other cities with comparable demographics.

Nearly 16 percent of Atlanta residents are uninsured, compared with 19 percent in Philadelphia and 22 percent in Detroit.

Mr. Catania’s proposal comes as other states have adopted or are contemplating universal health care coverage amid calls for reforms on the national level.

Massachusetts in 2006 adopted a first-in-the-nation mandate that every resident have health insurance if an affordable plan is available.

In California, a state Senate committee on Monday effectively killed a $14 billion plan pushed by Gov. Arnold Schwarzenegger, a Republican. That plan also would require state residents, with few exceptions, to buy minimal health insurance. A universal health care plan passed by the city of San Francisco was initiated last year but has faced legal challenges.

Expanding health care coverage has been identified by both Mayor Adrian M. Fenty and the D.C. Council as a priority for the upcoming year.

“We’re not that far away,” said council Chairman Vincent C. Gray, a Democrat. “There’s some who would argue that right now we’re probably at 95 to 96 percent coverage … It also makes a very strong case for let’s go the extra mile and make that happen.”

Mr. Fenty, a Democrat, last week said one of his goals for 2008 would be “developing feasible and sustainable strategies to expand access to health care to uninsured District residents.”

The mayor said his administration would study plans like those used in San Francisco and Massachusetts for “best practices,” but his main goal would be to strengthen the city’s HealthCare Alliance model.

The mayor also said his administration would have input on the Catania insurance plan, which the council member stressed is not a single-payer system or a model “that gets everyone all at once.”

Mr. Catania said the proposal could be wrapped up by spring, after it is vetted with the city’s health care community and a deal with an insurance company to offer the benefits is solidified.

Language authorizing the program’s creation was included in the fiscal 2006 budget, and the actual program could be included in this year’s budget, which the mayor will submit to the council in March.

“It’s got to be a product that is usable for this population,” Mr. Catania said. “I don’t see any reason to drag our feet about it.”

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