Impact on Federal Government
- Negotiates discounts on prescription pharmaceuticals.
- Establish standards for program monitoring, electronic claims data, and electronic medical health records.
- The proposal establishes AmeriCare as secondary to Medicare but mandates that Medicare benefits conform to AmeriCare coverage.
Impact on States
Impact on Insurers
- Requires a uniform claims approach.
- Employer-based group plans remain in place.
Impact on Providers
- Providers will be paid as they are under Medicare, with new provisions in place for new benefits.
Impact on Employers
- Can provide coverage through private plans or pay 80% of AmeriCare premiums.
- Exempted from Medicare secondary payer requirements.
Impact on Individuals
- Coverage for adults comprises Medicare Parts A and B coverage, mental health and substance abuse coverage, preventive care, and prescription drug coverage. Benefits for children are comprehensive and include “Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage,” at no cost.
- Caps premiums and out-of-pocket costs based on family size and income. No costs for children, pregnant women, and those at less than 200% of the Federal Poverty Level.
- AmeriCare premiums are paid in conjunction with income tax payments.
Proponents/Opponents
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Proponents applaud the cost savings achievable under AmeriCare, based on the administrative savings that this universal plan will allow and the savings that will accrue from negotiating discounts on pharmaceutical prices.
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Among the critics of this plan are those who, despite the enhanced government role of AmeriCare, continue to oppose to the role of insurers given high administrative costs and rising premiums and instead advocate a single-payer plan.
Conversely, others object to the individual mandate that would be imposed by AmeriCare, decrying the need to buy in whether or not you can afford to. Modeling the program on Medicare raises questions as well; not all regard Medicare as an efficient, cost-saving program.
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Key Targets for Investment
- Electronic medical records.
Notable Feature
- Children are automatically enrolled at birth. (Those with access to other group coverage can opt out of AmeriCare.)
Experts' Comments"Experience around the world demonstrates that a social insurance system is the most effective, efficient way to achieve universal coverage, providing comprehensive benefits while controlling costs and driving quality improvements. AmeriCare is built on this principle, with truly shared financing that includes worker premiums as well as an employer role that ensures the coverage is affordable for workers. And in leveling the playing field between employers, AmeriCare ensures that workers won’t have to be victim to employers that skimp on health benefits in order to improve their bottom line."
--William Samuel,
Director of Legislation
AFL-CIO, July 25, 2006.
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Plan Briefs 
