Universal Access to the U.S. Health Care System

Health Care is a Right

In 2010, the Patient Protection and Affordable Care Act (ACA) became law in the United States. The ACA resulted in millions of Americans receiving health insurance, bringing major changes to the health care landscape and offering 25 million more Americans access to health care through the individual Marketplaces and the expansion of Medicaid at its peak. During the COVID-19 pandemic, we all recognize the need to safeguard our health and the health of our communities. Now, more than ever, we are all in this together.

Our priorities

Health care is a right, not a privilege. Americans deserve affordable access to health coverage, no matter the age, income, or health status. That’s why our path to achieving a more balanced, sustainable health care system should not be political. Now is the time for a public, private partnership. This is especially true in 2020 as we navigate the challenge of the pandemic through strong partnerships between public officials, insurers, community leaders, health care providers, hospitals and other stakeholders.

To achieve a more sustainable health care system we must:

  • Ensure and enhance access to health coverage for all people;
  • Build on what works and continue to find ways to make health care better;
  • Maintain choice for all consumers, empowering them to be active participants in their own health care; and
  • Lower costs, especially when it comes to prescription drugs.

The progress we made in guaranteeing that every American has affordable health coverage is also being challenged by COVID-19. It is critical to ensure state Medicaid programs, COBRA insurance, and the individual consumer market are strong and stable to help the millions of Americans who have lost their job and health insurance during the pandemic.

Achieving a Sustainable Health Care System

Projections of National Health Expenditures and Their Share of Gross Domestic Product, 2013-2023

Source: The Henry J. Kaiser Family Foundation Projections of National Health Expenditures and Their Share of Gross Domestic Product, 2013-2023

The cost of health care remains the top concern for most Americans. Instead of creating a new unproven system from scratch, policymakers, insurers, providers, hospitals, businesses, and communities should focus on solutions that lower costs for everyone. This means addressing the cost of chronic diseases, lowering prescription drug prices, and harnessing technology to better address health needs.

Americans are best served by a competitive, private health insurance market that offers quality and choice that individuals deserve, at a price they can afford. We can achieve universal access if we deepen the collaboration between the private sector and public programs.

The future of health care

The American system is a global leader in health care innovation and has some of the world’s best hospitals and treatments.

People in the U.S. have more personal choice than anywhere else in the world when it comes to health insurance. But 28 million Americans continue to be left without access to the system, and especially during this COVID-19 pandemic, opportunities to do better cannot be ignored.

When all pieces of the health care system work together, we can encourage innovation, harness technology, and increase access beyond what is merely acceptable. As we look to the next phase of our recovery from the pandemic, we are challenged to learn from the hard lessons, to embrace the ingenuity, and continue to work together to refine and improve upon the foundation of our health care system.

In order to move forward, we need to come together and put aside our differences to find solutions that provide predictability and certainty for consumers.

Transitioning to a Better Market Structure

Moving Forward

We should not give up on what’s good about the American health care system. But we must be committed to working with partners throughout the health care industry to make sure everyone has access to quality, affordable care. By using the power of our free enterprise system with help from public partnerships we can ensure competition and choice for all.

By pooling resources and building upon each other’s strengths, we can take the necessary steps toward meaningful solutions that improve the system through:

Maintaining a robust employer health care market. At the start of 2020, more than 156 million Americans received their health coverage through their job and reported a relatively high rate of satisfaction. Employer-sponsored health benefits are essential to the American economy and assuring that this choice continues to be available to employers and employees is key to future economic stability.

Leveling the playing field in the individual market. The ACA included a temporary nationwide reinsurance program for the individual market to cover the costs of patients with high-cost conditions. Today, we should encourage every state to reestablish this program to stabilize their individual insurance markets. We should also expand premium tax credits on the individual Marketplace, which will offer additional support to more young people and working families, providing even greater access to affordable care.

Addressing social determinants of health. Through public-private partnerships, Medicare Advantage and Medicaid plans help millions of seniors and people with disabilities get the quality care they need. But there’s always room for innovation. By implementing innovative new benefits tied to in-home care, food delivery, and transportation, we can keep people healthier for longer.

Incentivizing states to adopt Medicaid managed care models. We must preserve the Medicaid safety net — it supports over 70 million of our nation’s most vulnerable, including the working poor, seniors, people with disabilities, and those suffering from substance use disorder. The existing public-private partnership between states and Medicaid managed care organizations reduces costs while improving plan management, performance, health care quality, and outcomes. This should be a standard state plan option.

Greater access to mental health services. A person’s physical health is closely linked to their mental well-being. However, the number of doctors specializing in mental health treatment is not meeting the needs of Americans. We need to improve access and address swelling demand through community collaboration and new technology-based delivery methods.

Accelerating the Transformation of Health Care

Changing the Delivery of Health Care

Independence is already taking steps needed to move forward by:

  • Developing innovative approaches to working with hospitals and doctors that are designed to engage both the insurer and the health care provider to improve quality of care and reduce health care costs for members through better care coordination.
  • Engaging consumers in health care decisions. Consumers need the right information at the right time to be able to take an active role in their health care. They need the right tools to understand the services available to them, so they can make the right decisions for themselves and their families.
  • Making it easier for physicians and hospitals to do their jobs by giving them the support they need through clinical programs, tools, and reports.
  • Creating a two-way exchange of data, so that insurers, hospitals, and physicians have a complete view of patients’ health issues in order to make better informed decisions. This exchange of data can also help address larger issues, like helping to tackle or avoid dangerous drug prescribing patterns or identifying potentially avoidable emergency room visits.
  • Reviewing products, networks, and policies — using industry benchmarks and best practice standards — to ensure members receive high-quality care in the safest, most cost-appropriate settings.
  • Helping members find the best place to receive specialty care through our Blue Distinction® and Blue Distinction®+ designations.

Accelerating health care one relationship at a time

We are accelerating health care in southeastern Pennsylvania by collaborating with area health systems and physician groups in new and innovative ways.