While considering the merits of AHIP’s latest health care proposal, it’s important to keep in mind that the organization — under its previous incarnation as Health Insurance Association of American (HIAA) — embraced universal coverage once before, during Hillary Clinton’s efforts to reform the system.

Back in December of 1992, HIAA called for “a new Federal law that would require coverage for all Americans, define the basic set of benefits, and try to contain health care costs by limiting tax breaks for the purchase of insurance“:

- Every American was required to buy ‘an essential package’ of benefits

- The government would help define the essential package and private insurers would provide the standard package “regardless of a person’s medical history”

- Only the essential package would be protected from taxation. If employers bought more than the basic benefits, the premiums pad for the extra coverage “would be treated as income to the employees, and they would have to pay income tax on it.”

- The government would work with private insures to “stabilize health-care prices” and make sure private insures and government programs pay similar amounts for the same services in the same geographic area.

Recall that HIAA’s cooperation with reform did not last long. The insurers, afraid that the regional alliances in the president’s bill would bar some smaller insurers from the marketplace, opposed the plan’s premium growth constraints and rejected community rating. Seeking to “plant seeds of doubt” about Clinton’s reforms, the HIAA developed the influential Harry and Lousie ads, organized grassroots campaigns, hired field operatives in six states whose lawmakers were expected to be swing votes, and recruited ground troops from members companies’ networks of employees, managers, and agents.

By the end of its campaign, HIAA generated more than 450,000 phone calls, visits, and letters to Congress. “The government may force us to pick from a few health care plans designed by government bureaucrats. Having choices we don’t like is no choice at all. They choose. We lose,” the Harry and Louise ad warned.

AHIP’s new proposal contains some reforms progressives could generally support. Sen. Ted Kennedy (D-MA) issued a statement praising AHIP’s plan:

There’s a spirit of optimism about our work to ensure quality, affordable health care for all Americans – and today’s announcement adds to that optimism. The insurance industry has advanced serious proposals that deserve serious analysis and consideration.

But today’s plan, like their 1992 proposal, is profit-conscious. As Carl Schramm, president of HIAA pointed out, the 1992 plan was “the only way you preserve the private health insurance industry. It’s plain-out enlightened self-interest.”

America’s Health Insurance Plans desperately want a seat at the table of reform. Today, during a press conference at the National Press Club, which the Wonk Room attended, Karen Ignagni — the CEO of AHIP — unveiled the industry’s new health care plan.

“We’re hoping that by offering these proposals early we can contribute to the discussions…[we] wanted to play a leadership role and not shrink from the challenges of here and now,” she said.

The plan is comprehensive. It addresses almost every element of health care reform — access, affordability, cost, and quality — and is a competitor to the proposals of Sen. Max Baucus (D-MT) and the forthcoming Kennedy plan.

In short, the “uniquely American proposal” seeks to build on the current employer-based system to “get everyone covered.” This, is “not negotiable,” Karen Ignagni, the CEO of AHIP explained. Here are the basics:

- Build on the current employer-based system: The more than 160 million Americans who receive their health insurance through an employer should be able to keep their coverage, if they so choose.

- Strengthen the health care safety net: Medicaid should establish a “clear, simple, transparent income test” where everyone above 100% of the Federal Poverty Level (FPL) is eligible for coverage. The State Children’s Health Insurance Plan (SCHIP) should also be expanded to children in families with incomes up to 300 percent of FPL.

- Helping hand for working families: The federal government would subsidize coverage on a sliding scale up to 400% of the FPL.

- Guaranteed coverage requirement: If every American is required to purchase health insurance coverage — a.k.a. individual mandate requirement — the insurance companies would provide everyone withe coverage.

- Uniform benefit packages: Available in all fifty states, these plans would include prevention, wellness, acute care and chronic care coverage but would be “free from conflicting mandates” and could provide an “affordable alternative to COBRA for the unemployed.

- Cost containment Congress should set a target of 300% reduction in future growth and establish an independent commission to look at variations in practice patterns, cost shifting, supply patterns, cost consolidation and lay out a road map to achieving a national target.

The group opposes an employer-mandate, wants the government to subsidize discriminating premiums based on age, gender, and medical condition, and is reluctant to accept an agreement that would force private plans to compete with a public Medicare-like plan within an new national insurance exchange.

AHIP is all for “affordable” coverage on the government’s dime. That is, rather than agreeing to end premium discrimination based on age or sex, it wants the government to issue tax credits and cap total health expenditures for lower-income individuals to protect Americans from bankruptcy. The plan calls on the government to ensure affordability, while protecting industry profits.

Asked if they supported the “national insurance exchange” proposed by President-elect Obama, James Roosevelt, President and CEO of Tufts Health Plan and a member of AHIP’s Board of Directors explained that while his company “participates in the Massachusetts plan,” which “has been very successful in Massachusetts,” “you can’t take the Massachusetts experiment and translate it directly nationally.” “We are proposing alternatives here that will address these problems,” Roosevelt explained.