Presidential Candidate Clinton's Health Care Proposal Supports Employer-Sponsored Health Care System

Main Category: Health Insurance / Medical Insurance
Also Included In: Public Health
Article Date: 21 Sep 2007 - 3:00 PDT

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Presidential candidate Sen. Hillary Rodham Clinton (D-N.Y.) during the development of her proposal to expand health insurance to all U.S. residents "considered doing away with the employer-based system but concluded that people like it," the Wall Street Journal reports.

The proposal, which Clinton announced on Monday, would require large employers to offer health insurance to employees or contribute to a federal fund that would help workers purchase coverage. In addition, the proposal would provide tax subsidies to small businesses to help cover the cost of health insurance for workers. The proposal also would allow employers to select health plans from a network of private plans part of the Federal Employee Health Benefit Program or a public plan modeled on Medicare.

According to the Journal, many analysts "say the employer-based system isn't the most efficient or logical way to deliver insurance," but "one of the lessons Mrs. Clinton said she drew" from the failure of her 1993 health care proposal is that "insured Americans get nervous if they think their coverage will have to change." Clinton said, "We looked at every permutation of how you get to universal health care," adding, "There's a great attachment to the employer-based system, even though it is eroding."

Many employers "want to be making ... decisions" about health insurance for employees, Clinton said, adding, "It may be because it's the only thing they know; it is something that has always been done, so they don't want to give it up. But that came as something of a surprise to a lot of us." In addition, many employees remain "adamant" that they retain employer-sponsored health insurance, Clinton said.

Meanwhile, the Clinton campaign said that the proposal, which would require residents to obtain health insurance, currently does not include punishments for those who do not obtain coverage but added that Clinton might consider such a provision (Meckler, Wall Street Journal, 9/19).

'Pay or Play' Requirement
In related news, health care experts on Friday met on Capitol Hill to discuss the potential effects of a "pay or play" requirement, a mandate that employers offer health insurance to employees or contribute to a government fund that helps workers purchase coverage, CQ HealthBeat reports. The Clinton proposal and health care plans announced earlier this year by presidential candidates Sen. Barack Obama (D-Ill.) and former Sen. John Edwards (D-N.C.) include such a requirement for large employers.

Mark Pauly, a health care systems professor at the Wharton School of the University of Pennsylvania, said that such a requirement likely would prompt employers to reduce wages for employees to cover the cost. He said, "The employer mandate is really using the employer to collect taxes from the workers."

In addition, some experts cited a recent study conducted by researchers at the University of Michigan that found such a requirement could result in the loss of jobs for 190,000 U.S. residents. Such a requirement also likely would have to exclude small businesses and, as a result, could leave some lower-income residents without health insurance, Kosali Simon, an assistant professor of policy analysis and management at Cornell University, said.

According to Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology, such a requirement should include significant penalties for employers who do not offer health insurance to employees to encourage them to offer coverage. Massachusetts recently enacted such a requirement, though Gruber noted that the penalty was set too low (Lubbes, CQ HealthBeat, 9/18).

Broadcast Coverage
Several broadcast programs reported on the Clinton proposal. Summaries appear below.

• CNN's "American Morning": The program includes a discussion with Clinton (Roberts, "American Morning," CNN, 9/18). Video of the segment is available online. A transcript of the segment is available online. The program also includes a discussion with John Dickerson, a political analyst for CNN and Slate.com, about the Clinton proposal (Chetry, "American Morning," CNN, 9/18). A transcript of the segment is available online.
  
  
• CNN's "Lou Dobbs Tonight": The program includes a discussion with Ed Rollins, a Republican strategist and former White House political director; Errol Louis, a columnist for the New York Daily News; and Robert Zimmerman, a Democratic strategist (Pilgrim, "Lou Dobbs Tonight," CNN, 9/18). Video of the segment is available online. A transcript of the complete program is available online.
  
  
• C-SPAN's "Washington Journal": The program includes a discussion with Perry Bacon, a staff writer for the Washington Post, about the Clinton proposal ("Washington Journal," C-SPAN, 9/19). Video of the segment is available online.
  
  
• NPR's "All Things Considered": The program includes a discussion with Clinton about her proposal and other issues (Block, "All Things Considered," NPR, 9/18). Audio and a transcript of the segment are available online.
  
  
• washingtonpost.com: Steven Pearlstein, a business columnist for the Post, on Wednesday at 11 a.m. ET is scheduled to discuss the health care proposals of presidential candidates in a washingtonpost.com online chat (washingtonpost.com, 9/19). Questions can be submitted online before or during the chat. A transcript will be available online after the chat.

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