By Bryan A. Liang
Due to the economic downturn, underwriting major healthcare reforms will be difficult. But three approaches to covering some of the uninsured may be feasible for the new president and Congress:
Sign up everyone who qualifies for public health insurance.
Amazingly, 12 million uninsured Americans, including 75 percent of uninsured children, are already eligible for public insurance. They simply haven't been signed up.
Lawmakers should simplify public-insurance enrollment procedures and cut down on administrative steps that might act as barriers to access.
Furthermore, the federal government needs to increase funding and encourage state-level outreach programs. Part of this effort could allow state administrators to implement "express-lane eligibility" enrollment programs.
In California, those registered for other public assistance programs are rapidly enrolled in public insurance.
Sign up everyone who qualifies for employer-provided health insurance.
More than five million uninsured Americans already qualify for insurance coverage through their employers.
We could cut down on the number of uninsured working Americans by allowing businesses to auto-enroll employees in insurance. Workers wouldn't have to actively buy in, but they would be free to opt out.
This kind of auto-enrollment has already proven effective in getting employees to sign up for retirement plans.
Expand access to private health coverage.
Lawmakers should extend a tax credit to small businesses to cover a portion of their insurance expenses. The California Healthcare Foundation found this to be an effective means of expanding insurance access.
States should encourage pooling arrangements that allow small businesses to group together to purchase insurance plans.
Of course, these steps would not be a panacea. But the Obama administration can make some progress by adopting these approaches that focus on patients, not politics.
Bryan A. Liang, M.D., P.hD., J.D. is executive director of the Institute of Health Law Studies at California Western School of Law, and co-director of the San Diego Center for Patient Safety, University of California, San Diego School of Medicine.