Democratic Presidential Candidate Wesley Clark Unveils $695 Billion Health Care Proposal
As expected, presidential candidate and retired Army Gen. Wesley Clark (D) on Tuesday in a speech at the University of New Hampshire unveiled a proposal to spend $695 billion over 10 years to provide health insurance to all U.S. residents younger than age 22 and to expand access to coverage for adults, the New York Times reports (Seelye, New York Times, 10/29). The proposal -- which would provide health coverage to an estimated 31.8 million of the 43.6 million uninsured U.S. residents -- would begin in 2006 and become fully implemented by 2008 (Brownstein, Los Angeles Times, 10/29). Clark would repeal tax cuts enacted by President Bush for residents with annual incomes that exceed $200,000 to fund the proposal (Connolly, Washington Post, 10/29). In addition, Clark aides said that improvements in the purchase of health care and the modernization of health care administration through the use of information technology would offset $125 billion of the cost of the proposal (AP/USA Today, 10/29).
The proposal would require parents to provide health insurance for children younger than age 22. In addition, parents would have to report the health insurance status of their children when they file their taxes and could face tax penalties in the event that their children remain uninsured. "Children's health insurance status would be checked at schools and other convenient sites and, in the absence of parental action, they would be automatically enrolled" in public health insurance programs such as Medicaid or SCHIP, according to a summary of the proposal released by the Clark campaign (Washington Post, 10/29). According to the Los Angeles Times, the proposal would provide "substantial assistance" to help parents obtain health insurance for their children. Children in families with annual incomes that do not exceed 150% of the federal poverty level, or about $27,000 for a family of four, could enroll in Medicaid or SCHIP at no cost; the federal government would cover the cost. Families with annual incomes that do not exceed $90,000 would receive federal tax credits to cover most of the cost of health insurance for children. Parents with employer-sponsored health insurance for their children would receive smaller tax credits to offset the cost of premiums. The proposal also would provide federal funds to expand state Medicaid and CHIP programs to cover uninsured adults with annual incomes that do not exceed $13,775. In addition, the proposal would provide tax credits to cover more than 50% of the cost of health coverage for uninsured adults with annual incomes that do not exceed $25,000; uninsured adults with annual incomes that exceed $25,000 would not receive tax credits but could purchase health coverage through the Federal Employees Health Benefits Program. The proposal also would establish a federal commission to study and recommend measures, such as preventive care and disease management, to control health care costs (Los Angeles Times, 10/29).
"While much of the health care debate has focused on expanding coverage, the truth is there is just as great a need to make it more affordable for families who already have insurance," Clark said (Milne, Reuters/Philadelphia Inquirer, 10/29). According to the New York Times, the proposal is similar a one released by rival presidential candidate Sen. John Edwards (D-N.C.) that would provide health insurance for all U.S. residents younger than age 21 (New York Times, 10/29). Most of the Democratic presidential candidates -- except former Illinois Sen. Carol Moseley Braun and Rep. Dennis Kucinich (Ohio), who support a single-payer health care system -- have proposed a combination of tax credits and expansions of public health insurance programs to expand access to coverage (Washington Post, 10/29).
Presidential candidate Rep. Richard Gephardt (D-Mo.) on Tuesday in a speech in Des Moines, Iowa, delivered "one of his sharpest" criticisms of rival candidate former Vermont Gov. Howard Dean (D) for his support for measures to reduce growth in Medicare expenditures in the mid 1990s, the New York Times reports. "The fact is we need a Democratic nominee who is clearly different from George Bush. But on all these Medicare issues, there is very little difference between George Bush and Howard Dean. They both support cutting Medicare. They support turning it into managed care. They think recipients should pay more for services," Gephardt said (Swarns, New York Times, 10/29). Gephardt also said that Dean continues to support measures to reduce growth in Medicare expenditures to help balance the federal budget (Beaumont, Des Moines Register, 10/29). Gephardt and rival presidential candidate Sen. John Kerry (D-Mass.) in recent weeks have cited news reports that Dean in 1995 said he "fully subscribed" to a reduction in the growth of Medicare expenditures and that he supported part of a Republican-sponsored budget proposal to do that. That proposal would have reduced Medicare expenditures by about $260 billion over seven years (California Healthline, 10/16). Dean campaign manager Joe Trippi called the criticisms issued by Gephardt "preposterous" (New York Times, 10/29). Dean said that Gephardt should "tone this down," adding, "When Dick starts comparing anyone to George Bush, that's going too far" (USA Today, 10/29).
In related news, the Boston Globe reports that although Dean supported measures to reduce the growth of Medicare expenditures in a 1997 budget signed by former President Bill Clinton (D), he later wrote in a letter to HHS that the measures "unfairly hurt" beneficiaries at two Vermont hospitals. Rival presidential candidates maintain that the letter indicates that Dean is inconsistent on the Medicare issue. Erik Smith, a spokesperson for Gephardt, said that the letter "raises serious questions about Governor Dean's record." However, Jay Carson, a Dean spokesperson, said, "We don't see how it's news when a governor fights to ensure that seniors and hospitals in his state get the same treatment as every other state" (Schweitzer, Boston Globe, 10/29). In the first of a series of interviews with Democratic presidential candidates, NPR's "All Things Considered" on Tuesday interviewed Kerry about several issues, including Medicare. In the interview, Kerry said that when he joined the effort to reduce budget deficits in 1993 he separated himself from Dean, who he said "wants to balance the budget in about four or five years and who has put Medicare on the table as well as other entitlements, which I think is contrary to democratic values" (Siegel, "All Things Considered," NPR, 10/28). The full NPR interview is available online in RealPlayer.
In a town hall meeting in Las Cruces, N.M., on Tuesday, Edwards outlined a proposal to improve health care for Hispanics, the Raleigh News & Observer reports. The proposal would double funds for public health clinics, establish a national medical translation system to place on-site translators in larger hospitals, make translators available to smaller hospitals through a hot line and increase funds to research health disparities between whites and nonwhites (Raleigh News & Observer, 10/29).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.