As we look forward to the 110th Congress, one of my top priorities is to expand access to affordable health care for all Americans. There are still far too many Americans without health insurance or with woefully inadequate coverage. As many as 46 million Americans are uninsured, and millions more are underinsured.

Health care coverage matters. The simple fact is that people with health insurance are healthier than those who are uninsured. People without health insurance are less likely to seek care when they need it, and to forgo services such as periodic check-ups and preventive services. As a consequence, they are more likely to be hospitalized or require costly medical attention for conditions that could have been prevented or treated at a curable stage.

Maine is in the midst of a growing health insurance crisis, with insurance premiums rising at alarming rates. Whether I am talking to a self-employed fisherman, a displaced worker, the owner of a struggling small business, or the human resource manager of a large company, the soaring cost of health insurance is a common concern.

These cost increases have been particularly burdensome for small businesses, the backbone of Maine’s economy. Maine small business owners want to provide coverage for their employees, but they are caught in a cost squeeze. They know that if they pass on premium increases to their employees, more of them will decline coverage. Yet these small businesses simply cannot afford to absorb double-digit increases in their health insurance premiums year after year.

The problem of rising costs is even more acute for individuals and families who must purchase health insurance on their own. Monthly health insurance premiums in Maine often exceed a family’s mortgage payment. Clearly, we must do more to make our health care system more efficient and health insurance more available and affordable.

I have joined my colleague from Louisiana, Sen. Mary Landrieu, in introducing bipartisan legislation, the Access to Affordable Health Care Act, which combines a variety of public and private approaches to make quality health care coverage more affordable and available.

Since most Americans get their health insurance through the workplace, it is a common assumption that people without health insurance are unemployed. The fact is, however, that as many as 83-percent of Americans who do not have health insurance are in a family with a worker.

Uninsured working Americans are most often employees of small businesses. In fact, some 63 percent of uninsured workers either work for a small firm or are self-employed. Smaller firms generally face higher costs for health insurance than larger firms, which makes them less likely to offer coverage.

The Access to Affordable Health Care Act will help these employers cope with rising costs by creating new tax credits for small businesses to make health insurance more affordable. It will also provide grants to help businesses form group purchasing cooperatives. These cooperatives will enable small businesses to band together to purchase health insurance jointly. This will help to reduce their costs and improve the quality of their employee’s health care.

The Access to Affordable Health Care Act will also expand access to affordable health care for individuals and families. One of the first bills that I sponsored when I came to the Senate was legislation to establish the State Child Health Insurance Program, which provides insurance for the children of low-income parents who cannot afford health insurance, yet make too much money to qualify for Medicaid. Since 1997, this program, which is known as SCHIP, has contributed to a one-third decline in the uninsured rate of low-income children. Today, more than six million children – including approximately 14,500 in Maine – receive health care coverage through this remarkably effective health care program.

Our legislation builds on the success of this program and gives states a number of new tools to increase participation. States would have the option of covering the parents of the children who are enrolled in programs like MaineCare. States could also use funds provided through this program to help eligible working families pay their share of an employer-based health plan. In short, the legislation will help ensure that the entire family receives the health care they need.

Our legislation also strengthens the health care safety net by increasing funding for community health centers, which provide critical primary care services to millions of Americans, regardless of their ability to pay. And, it addresses inequities in the Medicare system that have hurt rural states like Maine.

Finally, health insurance alone is not going to ensure good health. As noted authority and physician Dr. Michael Crichton has observed, “The future of medicine lies not in treating illness, but preventing it.” Many of our most serious health problems are directly related to unhealthy behaviors – smoking, lack of exercise and poor diet. These three major risk factors alone have made Maine the state with the fourth highest death rate due to four largely preventable diseases: cardiovascular disease, cancer, chronic lung disease and diabetes. These four chronic diseases are responsible for 70-percent of the health care problems in our state.

The Access to Affordable Health Care Act therefore contains a number of

provisions designed to promote healthy lifestyles. An ever-expanding body of evidence shows that these kinds of investments in health promotion and prevention offer returns not only in reduced health care bills, but in longer life and increased productivity. The legislation provides grants to states to assist small businesses with “worksite wellness” programs for their employees.

It also authorizes a grant program to support new and existing “community partnerships” such as the Healthy Community Coalition in Franklin County, to promote healthy lifestyles among hospitals, employers, schools and community organizations.

The Access to Affordable Health Care Act outlines a blueprint for reform based on principles upon which I believe a bipartisan majority in Congress could agree. The plan takes significant strides toward the goal of universal health care coverage by strengthening the health care safety net and by bringing millions more Americans into the health insurance system.

Sen. Susan Collins is the junior senator from Maine. She has recently introduced a bill in Congress addressing the affordability of health care.

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