VICKSBURG — Wonder if it will be called Haleycare? One thing for sure is that it isn't Hillarycare.
Gov. Haley Barbour has put forward a plan to get more of Mississippi's 500,000 uninsured adults at least some health coverage.
In keeping with the Republican ethic, it is a 100 percent private deal, far removed from the 100 percent government-managed and government-funded approach endorsed by the junior senator from New York.
Its biggest plus is that it recognizes how things really are.
Mississippi has 3 million residents. The same number of them as have no insurance, a half-million, are enrolled in Medicaid, the federal-state program that provides health expenses either at no cost or with small copays for children and adults living in or near poverty. Medicaid isn't perfect or all-encompassing, but at least it exists, paying for at least $3 billion worth of services, including medicines, transportation, hearing and mobility aids and nursing home care, in Mississippi every year.
For residents 65 or older, there is Medicare. Again, it's not perfect or all-encompassing, but Medicare, which is fully funded by federal taxpayers, is there. It adds billions more toward the total health-care tab of Mississippians.
For government employees and those working for larger firms, there are employer-sponsored group plans with all or part of the cost of private policies paid by the employer.
And then there are those in the lurch: Households with incomes in the $40,000 to more than $100,000 range, yet have no coverage at all.
Typically, this is a family where there's a mom and dad in the house, usually both with paychecks coming in. Often their jobs are at private, small businesses of which they may even be owners or part-owners. But these employers, due to the cost, do not offer group health plans as a full or cost-shared benefit. Barbour said at least 135,000 of the state's uninsured fit this definition. They are working people, with homes, vehicles. They are self-reliant. They are good citizens. But they can't go to a doctor. A broken arm, costing, say, $12,000 to mend, could bankrupt them.
Once these folks pay their taxes, mortgages, car notes, utilities and other expenses, especially if a child has made it to college, there's not enough money in the household kitty to shell out $600 to $1,000 a month for a health policy on the private market, if they can qualify at all. And even if they could afford a decent policy, they'd have to pay for it with after-tax dollars. The Internal Revenue Code only allows pre-tax dollars to be used for employer-sponsored plans.
Enter the "Mississippi Health Insurance Exchange," which Barbour is asking the Legislature to create this year.
It isn't complex.
The state would serve as a clearinghouse for employees of small businesses to pool with employees of other small businesses in purchasing group policies. No state funds would be involved other than start-up costs. Once the consortium is established, operating overhead would be derived from plan participants.
Doctors and lawyers and others already use such arrangements for their liability coverage. Policies for their individual practices would be more expensive, so they pool with others for malpractice insurance.
In the same way, group health policies are also far cheaper than individual policies, so that advantage is obtained. Savings might be enough to induce some small employers to pick up at least a share of the cost of insurance for workers. Even if not, however, coverage would become perhaps half as expensive and also, since the employer would be the conduit for premiums, policies could be purchased with pre-tax dollars.
Statewide health insurance exchanges are described in a memo written by Robert E. Moffitt, Ph. D., and distributed by The Heritage Foundation, an institutional promoter of conservative approaches to governance.
Barbour said new Louisiana Gov. Bobby Jindal, also a Republican, will ask his state's lawmakers for enabling legislation, too.
Another strong point of the plan is that the policies would belong to the individual, not to the employer. A mechanic who works at a Ford dealership in Greenwood could accept a better offer from a dealership in McComb. The policy would travel right along. The new employer would merely need to agree to deduct the premiums and mail a check to the pool.
Absent Hillarycare (and perhaps even with it) there will always be some people without health insurance. Barbour recognizes that. But there's something fundamentally wrong when coverage is available for the poor and for senior citizens and for people who work for government agencies or larger firms and is simply too pricey for everybody else - especially when "everybody else" consists of the backbone of the state's economy.
Haleycare, if it comes to be known as that, is worth trying.
