Democratic Presidential Candidate Clinton Unveils Universal Health Care Plan That Includes Health Insurance Requirement

Main Category: Health Insurance / Medical Insurance
Also Included In: Public Health;  Medicare / Medicaid / SCHIP
Article Date: 20 Sep 2007 - 6:00 PDT

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Presidential candidate Sen. Hillary Rodham Clinton (D-N.Y.) on Monday announced the details of her proposal to expand health insurance to all U.S. residents during a speech in Des Moines, Iowa, the Washington Post reports (Bacon/Kornblut, Washington Post, 9/18). The proposal, called the American Health Choices Plan, would:

• Require all residents to obtain health insurance;
  
  
• Require large employers to contribute toward the cost of health insurance for employees and provide tax subsidies to small businesses to help cover the cost of coverage for workers;
  
  
• Provide tax breaks to ensure that health insurance premium payments do not exceed a certain percentage of household income;
  
  
• Mandate that health insurers cannot deny coverage to applicants because of pre-existing medical conditions;
  
  
• Allow residents without health insurance or with inadequate coverage to participate in a program similar to Medicare or the Federal Employees Health Benefits Program; and
  
  
• Expand Medicaid to cover low-income adults without children (Thomma, McClatchy/Philadelphia Inquirer, 9/18).

Clinton estimated that the proposal would cost $110 billion annually and said that she would finance the plan in large part through the elimination of tax cuts proposed by President Bush and approved by Congress for households with annual incomes of more than $250,000 (McAuliff, New York Daily News, 9/18). According to Clinton, the proposal would expand health insurance to all residents and improve "health care by lowering costs and improving quality" (Carey, CQ HealthBeat, 9/17). She said, "This is not government-run: There will be no new bureaucracy," adding, "You can keep the doctors you know and trust. You can keep the insurance you have, if you like that. But this plan expands personal choice and keeps costs down" (Healy/Toner, New York Times, 9/18).

Reaction, Comparison With 1993 Proposal
Andrei Cherny, a Democratic strategist, said, "What is unique to her and that no one has really done is this emphasis on choice," a focus that she has taken to address concerns about her 1993 health care proposal (Washington Post, 9/18).

Stuart Altman, a health care economist at Brandeis University, said that the current proposal is "much less radical" than the 1993 proposal, adding that "it's not fair at all to say it's a redo of the old plan" (New York Times, 9/18).

Paul Ginsburg of the Center for Studying Health System Change, said, "This is designed to be less threatening to insurers," who led the effort to defeat the 1993 proposal (Wolf, USA Today, 9/18).

Karen Ignagni, president of America's Health Insurance Plans, said, "The new Clinton plan includes important ideas to make coverage more affordable," adding, "Unfortunately, some of the divisive rhetoric seems reminiscent of 1993" (Gosselin/Nicholas, Los Angeles Times, 9/18).

Michael Donohue -- a spokesperson for the National Federation of Independent Businesses, which opposed the 1993 proposal -- said, "One of the standout features of this is it specifically looks to help small-business owners, and that's a good thing" (Meckler/Calmes, Wall Street Journal, 9/18).

Drew Altman, president and CEO of the Kaiser Family Foundation, said, "All of the Democratic candidates have now come out with big plans. Those plans in the end are going to look more similar than different to Democratic voters in the primaries" (Pearson/Dorning, Chicago Tribune, 9/18).

Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, said that the health care proposals of the Democratic presidential candidates have "a great deal of similarity" and "are fundamentally moving toward universal coverage" (Bellantoni, Washington Times, 9/18).

Reaction From Democratic Candidates
Presidential candidate and former Sen. John Edwards (D-N.C.), said of the Clinton proposal, "The cost of failure 14 years ago isn't anybody's scars or political fortune, it's the millions of Americans who have now gone without health care for more than 14 years and the millions more still crushed by the costs. So I'm glad that, today, the architect of the 1993 plan has another care proposal -- and if imitation is the sincerest form of flattery, then I'm flattered. But unless Senator Clinton's willing to acknowledge the truth about our broken government and the cost of health care reform, I'm afraid flattery will get us nowhere" (Bombardieri, Boston Globe, 9/18).

Presidential candidate Sen. Barack Obama (D-Ill.) said, "I commend Senator Clinton for her health care proposal. It's similar to the one I put forth last spring, though my universal health care plan would go further in reducing the punishing cost of health care than any other proposal that's been offered in this campaign." Obama added, "But the real key to passing any health care reform is the ability to bring people together in an open, transparent process that builds a broad consensus for change."

Presidential candidate Chris Dodd (D-Conn.) said, "While (Clinton) talks about the political scars she bears, the personal scars borne by the American people are far greater. ... We've known what the problems have been for nearly 15 years and what the solutions could be. What's been missing is leadership that knows how to bring people together and get the job done" (Des Moines Register, 9/18).

Reaction From Republican Candidates
Presidential candidate and former Massachusetts Gov. Mitt Romney (R) compared the Clinton proposal to health care systems in "European bureaucracies." He said that "HillaryCare continues to be bad medicine," adding that "in her plan we have Washington-managed health care" (Lambro, Washington Times, 9/18). Romney said, "I don't want to have the people who did the Katrina cleanup taking care of my health care" (Syeed, AP/Salt Lake City Deseret Morning News, 9/17).

Presidential candidate and former New York City Mayor Rudy Giuliani (R) criticized the proposal as a "pretty clear march toward socialized medicine" (Anderson, AP/Florida Times-Union, 9/17). He said, "Government command and control only increases costs and decreases quality" (New York Daily News, 9/18).

Katie Levinson, communications director for the Giuliani campaign, in a statement said, "Senator Clinton's latest health scheme includes more government mandates, expensive federal subsidies and more big bureaucracy -- in short, a prescription for an increase in wait times, a decrease in patient care and tax hikes to pay for it all" (Washington Post, 9/18). The proposal is available online.

A webcast of Clinton's speech is available online at health08.org.

Broadcast Coverage
Several broadcast programs reported or plan to report on the Clinton proposal and related issues. Summaries appear below.

• ABC News Now: The segment includes a discussion with ABC News correspondent David Challian about health care proposals from Clinton and other presidential candidates (Donaldson, ABC News Now, ABC.com, 9/17). Video of the segment and expanded ABC News Now coverage are available online.
  
  
• CBS' "Evening News": The segment includes comments from Clinton, Romney and Edwards (Axelrod, "Evening News," CBS, 9/17). Video of the segment and expanded CBS News coverage are available online. Related CBS News coverage is available online.
  
  
• CNBC: The segment includes comments from Clinton and Obama (Harwood, CNBC, 9/17). Video of the segment is available online.
  
  
• CNN: The segment includes a discussion with CNN correspondent Candy Crowley (Holmes, CNN, 9/17). A transcript of the segment is available online.
  
  
• CNN's "Lou Dobbs Tonight": The segment includes comments from Clinton, Romney and Edwards (Crowley, "Lou Dobbs Tonight," CNN, 9/17). A transcript of the segment is available online.
  
  
• Fox News' "Special Report with Brit Hume": The segment includes comments from Clinton, Romney, Obama and Edwards (Brown, "Special Report with Brit Hume," Fox News, 9/16). Video of the segment is available online.
  
  
• KCRW's "To the Point": The program on Tuesday is scheduled to include a discussion about the Clinton proposal, SCHIP and health care reform ("To the Point" Web site, 9/18). A broadcast schedule and additional details about the segment are available online. Audio of the segment will be available on the program Web site after the broadcast.
  
  
• MSNBC's "Tucker": The segment includes a discussion with Michael Crowley of the New Republic and Democratic strategist Peter Fenn (Carlson, "Tucker," MSNBC, 9/16). Video of the segment is available online.
  
  
• NPR's "All Things Considered": The segment includes comments from Clinton, Romney and Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health (Rovner, "All Things Considered," NPR, 9/17). Audio and a partial transcript of the segment are available online.
  
  
• NPR's "Morning Edition": The segment includes comments from Clinton, Blendon and prospective voters (Rovner, "Morning Edition," NPR, 9/18). Audio of the segment is available online.
  
  
• PBS' "NewsHour with Jim Lehrer": The segment includes a discussion with "NewsHour" health care correspondent Susan Dentzer and Karen Tumulty, national political correspondent for Time Magazine (Ifill, "NewsHour with Jim Lehrer," PBS, 9/17). Audio of the segment is available online. Video and a transcript of the segment will be available Tuesday afternoon.
  
  
• WAMU's "The Diane Rehm Show": The program on Tuesday is scheduled to include a discussion about the health care proposals of presidential candidates. Scheduled guests include Joseph Antos, a health policy scholar at the American Enterprise Institute; Ron Pollack, executive director of Families USA; and Laura Meckler, a reporter for the Wall Street Journal ("The Diane Rehm Show" Web site, 9/18). A broadcast schedule and additional details about the segment are available online. Audio of the segment will be available online about one hour after the broadcast.
  
  
• WBUR's "On Point": The program on Tuesday is scheduled to include a discussion about the current Clinton proposal and the 1993 proposal. Scheduled guests include Susannah Meadows, a senior writer for Newsweek; Atul Gawande, an associate professor of health policy at the Harvard School of Public Health and a former Clinton adviser; and Stuart Altman, dean of the Heller School for Social Policy and Management at Brandeis University and an adviser to the Obama campaign ("On Point" Web site, 9/18). A broadcast schedule and additional details about the segment are available online. Audio of the segment will be available on the program's Web site after the broadcast.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.