Health insurance is a critical component of a middle-class standard of living. Yet, fewer companies offer health insurance to their employees now than did in 2000 (69% compared to 60%). 46 million Americans, including 8 million children, are currently without health insurance. Indeed, health care premiums are increasing: health care coverage costs have outpaced increases in wages by a ratio of more than 3:1 since 2000 and premiums have increased 78% since 2001. Faced with high health care costs, families skip necessary medical procedures or become mired in debt trying to pay bills. The AmeriCare Health Care Act of 2009 entitles all U.S. residents to health insurance. The legislation models a new AmeriCare public insurance system on Medicare. However, individuals could elect not to enroll in AmeriCare if they demonstrate equivalent coverage. This means that employees can continue to receive health insurance through their employer-sponsored group plans. Supplemental private policies are permitted. AmeriCare would expand Medicare benefits, particularly for pregnant women, children, and low-income individuals. The legislation sets forth deductibles and coinsurance costs and limits out-of-pocket expenses. Out-of-pocket expenses are capped at lower levels for low-income individuals. The bill exempts children, pregnant women, and low-income individuals from paying deductibles and coinsurance. The Secretary must negotiate prescription drug prices with pharmaceutical manufacturers, which is currently prohibited.

AmeriCare would be funded by withholding premium payments from the paychecks of individuals covered by the program. Employers could elect either to pay 80% of the AmeriCare premium or to provide equivalent benefits, paying at least 80% of the cost of a group health plan.