Statement of the American Hospital Association

The American Hospital Association, on behalf of its nearly 5,000 hospital, health system, network and other health care provider members, submits this statement for the record regarding the hearing on the uninsured. We applaud the committee’s efforts to search for a solution to the plight of 43 million people living in the United States without health care coverage. Every day in America's hospitals, caregivers experience firsthand how the absence of health care coverage acts as a significant barrier to care, reducing the likelihood that these patients will receive appropriate and timely preventive, diagnostic and chronic care services.

As a nation we continue to enjoy a robust economy, despite recent stock market fluctuations. The Congressional Budget Office is forecasting a bright outlook for the economy, with federal budget surpluses projected for the next 10 years. However, a robust economy and historic lows in the number of unemployed Americans contributed to only a slight reduction in the numbers of uninsured between 1998 and 1999.

Expanding health insurance coverage and sustaining access to essential health care services for the uninsured as well as those with coverage must be at the top of the national public policy agenda. The American Hospital Association believes that every American deserves access to basic health care services, services that provide the right care, at the right time, in the right setting.

To generate greater public attention to the plight of the uninsured, the AHA has partnered with the Robert Wood Johnson Foundation and other national associations with diverse interests but a similar goal: getting health care coverage to the uninsured. Among the many activities we have participated in are an advertising campaign, and "Expanding Health Coverage: Make it America's Priority," a national town meeting broadcast by satellite to more than 200 hospital sites across the country. This subcommittee’s chairman, Rep. Nancy Johnson, participated in the broadcast, effectively setting the stage for the congressional debate on the uninsured.

One of the first steps that should be taken to reduce the number of uninsured is to improve access to coverage for low-income workers and their families. Eighty-four percent of the uninsured live in families headed by workers.

Refundable tax credits would give individuals and families the means and the flexibility to purchase the type of coverage that meets their needs. Tax credits targeted to low-income families and individuals will ensure that federal subsidies will benefit those most in need. The AHA supports legislation such as the Fair Care for the Uninsured Act of 2001 and the Relief, Equity, Access, and Coverage for Health (REACH) Act of 2001 --both approaches that use refundable tax credits to make insurance more accessible.

Because the high cost of health premiums is the number one reason workers decline coverage that is made available by their employer, the AHA supports tax code changes that would provide employers with a tax credit to help subsidize the purchase of health care coverage for their low-wage workers. In addition, the AHA supports allowing the self-employed to deduct the full amount of their health insurance premiums, and providing tax credits so small employers can afford to provide insurance.

While these tax code changes are important steps, more needs to be done. Coverage expansions should also build on the current successes of public programs such as Medicaid and the State Children’s Health Insurance Program (S-CHIP). The AHA supports expanding Medicaid and S-CHIP to single adults and families, including legal immigrant children and pregnant women.

Still, placing an insurance card in the hands of every American does not guarantee access to services. The AHA urges that, as attempts are made to tackle the problem of the uninsured, the committee also recognize the critical importance of making sure key health care services remain available. This requires investment in America's health care facilities, technology and workforce.

The AHA looks forward to working with the committee to expand health care coverage to the uninsured, and to ensure that high-quality health care services are accessible to all Americans.