Health reform should make insurance simple

This article is the archived version of a report that appeared in the August 2009 Consumer Reports magazine.

Parents like Amanda Buchanan and Jason Vlcek have plenty to keep them busy without worrying about health insurance for their children.

Yet the couple, from Weiser, Idaho, were trapped by one of the Catch-22s that abound in the current system. To get coverage for their first child, Kwei, now 2, they chose a so-called catastrophic plan with a steep $3,000 deductible and 30 percent copay. It was all they could afford on Vlcek's $34,600 salary as a second-grade teacher. So when their next child was on the way, they checked into the federal/state CHIP program that is supposed to cover children who lack other protection.

Problem was, Buchanan and Vlcek fell through a crack. "We totally qualified financially," Buchanan says, "but would never be accepted because Kwei was already insured, which somehow meant we could afford it even though we really couldn't." So in March, the couple canceled Buchanan's coverage so that they could continue to insure new son Merin. That saves $280 a month—but leaves Buchanan without protection.

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Consumers Union supports health reform that would end those headaches. We favor the creation of a National Health Insurance Exchange, for example, that would function something like a big insurance store. Couples like Buchanan and Vlcek who either couldn't get or couldn't afford insurance from their employers could buy it directly from a private or public insurer through the exchange, with sliding-scale subsidies based on their income to help make it affordable.

Every policy sold through the exchange would provide at least a standard set of comprehensive protections. That means it would cover all major expenses, including immunizations, checkups, and screenings. And each new baby would be automatically included.

Best of all, there wouldn't be the tangle of bureaucracies and rules that forced this couple into a no-win situation. A reformed system would give them, and everyone, the peace of mind of having good coverage that couldn't be taken away. And it would put simple, affordable coverage within reach of every family.