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Washington -- A framework for policies that would enable all Americans to have access to affordable health insurance coverage was released by the American College of Physicians (ACP). The updated position paper, Achieving Affordable Health Insurance Coverage for All Within Seven Years: A Proposal From America's Internists, Updated 2008, is based on a 2002 College position paper.

ACP reviewed the key reforms recommended in the 2002 paper and said they remain, with some revisions, a viable approach to making health insurance coverage available to all Americans. The paper emphasized ACP's belief that reforms to expand coverage should be done in concert with changes in health care financing and delivery to improve outcomes and efficiency of care.

"Expanding health insurance coverage to all Americans is a moral imperative," said Jeffrey Harris, MD, FACP, President of the American College of Physicians. "ACP's framework would assure that all lower-income working persons-who constitute the vast majority of the uninsured will have access to affordable coverage either from improved public safety net programs or by having the means to buy into the same insurance program available to members of Congress and their families."

The framework outline in the paper represents a logical series of reforms necessary to achieve universal coverage. The seven recommended elements of reform are:
· States should have the option to expand Medicaid coverage to all residents up to 100 percent of the federal poverty level. States should also have the option to unify SCHIP and Medicaid coverage;
· Advance, refundable and sliding scale tax credits should be made available to uninsured working Americans with incomes up to 200 percent of the federal poverty level;
· Tax credit recipients should have the options of buying coverage through state purchasing group arrangements modeled after the Federal Employees Health Benefits Program;
· Small employers should have new options for obtaining coverage;
·Once coverage is affordable and available, national and/or state-based health plans should ensure that all individuals participate in the plan; and
· An expert advisory commission should be created to recommend a core set of benefits.
· The federal government should provide dedicated funding to states that have requested federal support for efforts to redesign their health care delivery programs to expand coverage and organize care around a Patient-Centered Medical Home.
Many of the key elements of ACP's framework already have been incorporated into a bipartisan bill, called the Health Coverage, Access, Responsibility and Affordability Act (HealthCARE Act - HR 2351), introduced by Reps. Marcy Kaptur (D-OH) and Steve LaTourette (R-OH).
"Reforms are also needed to assure that patients will have access to a personal physician who knows them and who has the tools and systems needed to improve care coordination - a Patient-Centered Medical Home-supported by a reimbursement system that pays for coordination and prevention, not just volume of services," Dr. Harris concluded.
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include more than 125,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illnesses in adults.