So here’s a taste… 12 pages of good idea to follow

Addressing this aspect in a comprehensive reform is a necessity not only to benefit the naturalized workforce, but to benefit all uninsured Americans. In 2002 the uninsured workforce cost the federal government $2.2 billion dollars in federal assistance for uncompensated care at hospitals.(AHA 2002) A survey conducted by the American Hospital Association (AHA) in 2000 determined that hospitals in 24 Southwest border counties in Arizona, California, Texas and New Mexico reported uncompensated care costs totaling nearly $832 million; about 25% of those non-reimbursed costs resulted from emergency medical treatment provided to undocumented immigrants.
There are currently several prototypes for health care reforms proposed by the Institute of Medicine (2004), and applications of the Institutes Prototype 1 to this situation caused by uninsured noncitizen workers, proposes requiring employers to offer health coverage to all employees, either through federal assistance programs, like a combined Medicare/Medicaid/SCHIP program, or through a private insurance provider. Employers that opt to use a private insurance provider would be eligible to receive incentives or tax credits from the federal government; the government would also provide credits or subsidies for the purchase of health coverage for employees by small businesses to defer some of the cost. (Institute of Medicine, p. 5-6) As with the proposed immigration reform, changes and initiatives must begin at the most feasible level, in both; more importantly to incorporate the important issue of health coverage for the uninsured and underinsured workforce, families and children in the U.S. is a large step towards a comprehensive reform. Simultaneous implementation of a combination of the universal health care prototypes suggested by the Institute of Medicine, with this comprehensive immigration reform policy, will begin to reduce the cost imposed upon federal government health care assistance programs that cover the uncompensated care costs for the uninsured.
This restructuring of the health care system must begin from within and work outwards to cover all in need; strengthening workforce by providing better conditions by requiring benefits purchased for workers will lead to providing consistent high quality medical coverage to all individuals. I would like to also make the suggestion that to better reform and regulate a universal health plan to offer consistent, lower cost coverage from private insurers and reduce cost to federal programs would be to reverse the roles of states and federal governments on managing the plans and insurance providers. State level reforms are the Federal government would take over the position of managing programs like Medicare, Medicaid, and coordinating a uniform payment arrangement for all benefit providers within the state. (Brookings Institute p.3) A federal program can then address uncompensated coverage costs, which gradually will reduce with this plan. The federal program, which could be the combination and consolidation of several current programs, could then offer coverage to those left uninsured, which, with state reforms to the programs, will also gradually decrease; thus closing the gap between the quality and amount of coverage available to any individual.
The Institute of Medicine study suggests a prototype for federal subsidies, tax breaks, or incentives available to small businesses or individuals seeking coverage. (see prototype 3, Inst. Of Medicine) Instead, while states are able to bring insurance premiums down by offering incentives to private insurance companies to consolidate with state providers to lower the cost of comprehensive coverage available. States can arrange contractual deals with private insurance providers to differ some of the loss by paying into a pool with the money from payments that were previously made by numerous federal programs and departments. Payments come from various federal agencies (primarily the Centers for Medicare and Medicaid Services, the Defense Department, the Indian Health Service, and the Veterans Administration). This will allow for competition among insurance providers to offer quality coverage at lower rates to states, in order to be eligible to receive deferment of some loss by the federal program. States could also offer tax incentives to health care professionals for contribution into the federal deferment pool which would allow specialized physicians and care providers to not be subject to salary caps or cost of care restrictions. Because the majority of the health care coverage process would be reformed at the state level, compliance with such reform would need to be enforced by the federal government to ensure stability and functionality. The need for federal programs would, gradually decrease as state incentives for collaborations and reform among the programs at a more easily regulated level. It is possible that this would allow the states individual private purchase of coverage, to drive premium costs lower for employers who are, as regulated by proposed state reforms, to offer health benefits to all employees. This creates incentives for private insurance companies in that there would be a consistent consumer pool, and the consumer workforce would have consistent quality coverage available to them.