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June 11, 2009

Contact: AARP Media Relations, 202-434-2560,

Chairman Kennedy, Ranking Member Enzi, distinguished Committee members, thank you for inviting AARP to this timely discussion on health care reform options. I am John Rother, executive vice president and director of policy and strategy for AARP. AARP appreciates your leadership and the opportunity to participate in this roundtable.

Today, I am proud to represent nearly 40 million members of AARP – half of whom are over age 65 and therefore participate in the Medicare program, and half who are under age 65. As many as 7 million of all persons age 50-64 are uninsured today, both age groups face serious problems in access to appropriate care, even if they are insured. I am happy to be here today to discuss some of the options you are considering to address these problems.

Insurance Market Reforms

There are few issues of greater concern to AARP’s membership than improving health insurance markets across the United States to assure that all Americans have available to them affordable high quality coverage choices. Many older Americans, especially those age 50-64 who are not yet eligible for Medicare or those with pre-existing chronic conditions, often cannot secure health coverage at any price. Industry data show that insurers reject between 17% and 28% of applicants aged 50-64. Those who can find individual coverage tend to receive less generous benefits than those with employer coverage, yet on average pay premiums that are three times higher and have total out-of-pocket spending that is over twice that of those with employer coverage. The AARP Public Policy Institute estimates that 13% or 7.1 million adults aged 50-64 were uninsured in 2007 – 1.9 million more than in 2000 – and this figure is growing rapidly in our current difficult economy.

AARP believes that the best way to make coverage affordable for everyone is by:
• Guaranteeing that all individuals and groups wishing to purchase or renew coverage can do so regardless of age or pre-existing conditions;
• Prohibiting insurers from charging higher premiums because of age, health status or claims experience;
• Providing a choice of qualified plans through a “Gateway” or Exchange with subsidies based on income and the actual premiums each age group faces in the market so coverage is affordable for everyone;
• Addressing costs system-wide through prevention and wellness, care coordination, fighting fraud, waste, and abuse, and revising incentives to reward quality rather than quantity of care; and
• Ensuring that any cost-sharing obligations do not create barriers to needed care.

We are pleased that many of these issues have been addressed in the Committee’s proposed legislation released this week.

Connector/Gateway: The intent of the Gateways is to facilitate the purchase of coverage and products at an affordable price by qualified individuals and employer groups. AARP embraces the establishment of an Affordable Health Benefit Gateway in each state. As described, the Gateway construct would provide balance and flexibility -- clear federal guidelines and standards to assure quality coverage while maintaining the traditional state role in the oversight of insurance.

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