The heads of America’s Health Insurance Plans and the Blue Cross and Blue Shield Association say they are willing to guarantee coverage to all Americans, despite pre-existing conditions, as one of a series of recommended reform measures.

The approved reform measures were included in a letter sent March 24 to four U.S. senators taking the lead on a major overhaul to health care in America: Sen. Ted Kennedy (D-Mass), Sen. Max Baucus (D-Montana), Sen. Mike Enzi (R-Wyo.) and Sen. Charles Grassley (R-Iowa).

Karen Ignagni

Pledging a collaborative spirit to any reform, Karen Ignagni, president and CEO of AHIP, and Scott P. Serota, president and CEO of the organization for 37 Blue Cross and Blue Shield affiliates around the country, said in their letter “a robust private insurance system is critical to achieving these needed delivery system reforms.”

“Creating a new government-run plan would thwart the ability of the health care sector to implement meaningful delivery system reforms, exacerbate the cost-shift from public programs to consumers and employers in the private market, and destabilize the employer-based system,” the pair wrote. “Government safety-net programs do have a vital role to play in achieving universal coverage. Under our reform proposals, every uninsured American living in poverty would be eligible for Medicaid.”

Another reform proposal by Ignagni and Serotta was ditching premiums by insurers based on medical conditions.

“Specifically, by enacting an effective, enforceable requirement that all Americans assume responsibility to obtain and maintain health insurance, we believe that we could guarantee issue coverage with no pre-existing condition exclusions and phase out the practice of varying premiums based on health status in the individual market,” they wrote.

In endorsing that condition, the pair said rating flexibility based on criteria including age, geography and family size is “needed to maintain affordability.”

“We are also exploring the development of a risk-spreading mechanism to protect consumers from unintended consequences associated with these reforms. To promote better health and personal responsibility, we also encourage the allowance of premium discounts for individuals who make healthy choices such as not smoking, participation in wellness programs, and adherence to treatment programs for chronic conditions,” Ignagni and Serotta said.

Other reform ideas by the pair are that individuals from low-and middle-income families participating in health coverage will receive health care tax credits and that tax equity should also be realized for those without access to coverage through their employers.

“These tax reforms will further encourage individuals to purchase and retain coverage over the long term,” they said. “We believe this package of interrelated reforms will give the American people peace of mind and help the nation achieve universal coverage.”