Skip to content
U.S. National Debt:


By Senator Mike Crapo

Not too many years ago, Idaho doctors still made house calls, spending considerable parts of their days (and nights) visiting patients and getting to know their families. That era is gone-today's health care often requires patients to visit the doctor, virtually or in person, not the other way around. What hasn't vanished is the sentiment that health care is extremely personal. We want to choose our doctors and medical professionals and we want them to know us. Almost as compelling is the issue of affordability. With soaring health care costs ($2 trillion last year even as 43 million Americans lacked health insurance), federal health care policy must encourage coverage for all Americans and competitive choice in health care plans. Competition would give us what we, as patients, want-choice, access, and personalized care for the best value. In the current environment in Congress, federal health care policy can only move forward in a bipartisan fashion. 


The Healthy Americans Act (HAA) is an important step toward that comprehensive bipartisan health care reform.  I recently co-sponsored Senators Ron Wyden (D-OR) and Bob Bennett's (R-UT) innovative plan which aims to provide every American with health insurance while simultaneously recognizing the importance of a free market approach.


In addition to guaranteeing every American quality private health insurance, HAA would:     

            • Give Americans affordable choice;

            • Make health care portable from job to job;

            • Promote personal responsibility and preventive medicine;     

            • Reform the insurance market so that insurers compete on price, benefits and quality.


The bill includes provisions requiring health plans to offer minimum benefits packages and more comprehensive coverage alternatives for additional costs. Plans would compete on the basis of price and, once enrolled, individuals would only be dropped from coverage if they die, move or age into Medicare.


Premium payments would be computed as an add-on to tax liability. Those living below 100 percent of the poverty level would pay no premium, with a sliding scale for those between 100 and 400 percent of the poverty level. The legislation includes incentives for insurers and individuals to promote and seek preventive care, wellness and chronic disease management. Finally, the legislation promotes cost containment measures in administrative and health information technology provisions. HAA creates a standard deduction based on the type of coverage the taxpayer has. The deduction, factored into a filer's adjusted gross income, would be phased out at certain income levels. 


The program would be administered through state-level Health Help Agencies. Employers would bear responsibility in educating employees about plans and helping employees pay for health care, but the primary payment burden would fall on the individual. 


As a member of the Senate Finance Committee, which has jurisdiction over the bill, I'll be involved throughout the process . There are provisions that I have serious concerns about. In order to achieve a broad-based coalition, HAA is the result of compromise between very different views on what government's role in health care policy should be. Still, I believe we can work through important compromises to achieve a successful legislative outcome. Ultimately, HAA is a free market approach that puts health care choices in our hands instead of a government-run program that puts these choices in the hands of the federal government. It helps empower consumers and the free market to extend coverage to all Americans. 


The Healthy Americans Act represents a bipartisan step toward more affordable and comprehensive health care for Americans. While we cannot go back to the days of country doctors and house calls, we can incorporate life-saving developments of today's health care treatment and technology into a system that gives patients old-fashioned access, choice and personalized care.