Regardless of income, family status, medical history or job situation, everyone deserves access to quality care. The uninsured’s health suffers from delayed care and incomplete treatments, and when family members, employees or customers are sick, miss work or are bankrupted by health care costs, we are all impacted. NM’s 400,000 uninsured are also crowding emergency rooms, taxing state and local budgets, and causing financial difficulties for hospitals.

This proposal ends discriminatory insurance pricing based on demographics, medical needs and company size. It includes a community responsibility to fund a core set of benefits for everyone and to provide extra help to low-income residents. It includes an individual responsibility for patient cost sharing and voluntary premium supplements for higher coverage; it allows penalties for costly behaviors. All individuals & businesses pay a fair share of the costs, there are no free riders.

A new large insurance purchasing pool allows each consumer to select a plan that best meets their needs in terms of price, cost sharing and access to specific providers. This gives everyone great benefit choices, no matter where they work. Buyers can never be denied or pay higher premiums because of their gender, age, or medical condition. Like a corporate benefits office, the pool makes choices easier by selecting a small number of private insurers to offer a few semi-standardized, good quality plans. Employers can still offer better health benefits through group coverage or cafeteria contributions.

Hospitals stop raising prices because of uncompensated care. More intense competition puts pressure on insurers to provide good service and control costs. Paying for premiums means many cost-aware consumers will select plans with income-appropriate cost sharing, and be more receptive to wellness incentives, prevention and care management programs, or shopping for non-emergency treatments. Streamlined insurance sales, fewer health plans and new information technology opportunities cut administrative costs too. Government spending is predictable and controllable.

No government or single entity should be given a dominant controlling power over healthcare providers’ pricing or hospitals’ staffing and technology budgets. This proposal defines the government’s role as funding core benefits, ensuring that quality plans are offered and simplifying some administrative procedures. Many complex state and county indigent care subsidies are no longer needed.