Later today, President-elect Barack Obama will nominate former Sen. Tom Daschle (D-SD) to head the Department of Health and Human Service and appoint Center for American Progress Senior Fellow Jeanne Lambrew to the position of deputy director of the White House Office of Health Reform.
As the Politico’s Mike Allen reports, the new White House health office “will be like a special-projects arm of the White House” designed to achieve “significant changes” in health care reform. Lambrew has advocated for these changes throughout her career, most notably in a 2005 Health Affairs article she co-authored with John Podesta and Teresa L. Shaw.
Lambrew’s approach builds on the two major existing sources of health coverage — the employer based system and Medicaid — and minimizes the fears that have toppled previous reform efforts: the loss of existing coverage, excessive government involvement, and limitations on choices. Obama has advocated similar reforms.
Indeed, this approach allows Americans satisfied with their plans to keep their existing coverage, while offering affordable options to those who need them:
- Americans lacking job-based insurance, for instance, could purchase affordable coverage through a new national insurance pool that would offer “the same private health plans offered to federal employees and members of Congress.”
- While the plan does not include an employer mandate, “employers would have access to the Healthy America insurance pool.” Individuals offered coverage through an employer would be free to decline that coverage and enroll in a plan through the pool instead.
- The plan would simplify and extend Medicaid to cover all below a certain income level (for example, 100–150 percent of the federal poverty level).
Under the proposal Lambrew developed at CAP, Americans would be required to have access to affordable coverage through their employer, a new health care exchange, and/or Medicaid, and the government would offer a refundable tax credit to ensure that nobody spends more than a certain percentage of income (for example, 5–7.5 percent) on health insurance premiums. During the campaign, Obama opposed an individual health mandate, but supported an employer mandate (with the exception of small businesses).
While at CAP, Lambrew also developed the idea of a ‘Wellness Trust’ to “carve prevention out of health insurance and take responsibility for a new, outcomes-oriented system.” The Trust would implement national prevention priorities, align financial incentives with effective practices for prevention, and place wellness ahead of sickness in allocating U.S. resources and priorities.
“The priority is to ensure that all Americans have affordable health coverage,” Lambrew writes. “Providing and improving health care for every American may be the current test of our country’s strength of conviction, as was enacting civil rights for all in the 1960s and the creation of the New Deal in the 1930s.”