Issue Overshadowed by Medicare, Rx Drugs

While health care issues have dominated this year's presidential campaign, the problem of the uninsured has been largely overlooked compared to the high profile issues of Medicare and prescription drug benefits, the California Journal reports. The difficulties faced by the uninsured are particularly salient in California, where 6.9 million residents lack health insurance, a number that accounts for one-sixth of the country's 42.6 million uninsured. The California HealthCare Foundation estimates that nearly one-half of all Californians have been affected by the issue. According to Drew Altman, president and CEO of the Henry J. Kaiser Family Foundation, the candidates' focus on Medicare and prescription drugs reflects the fact the seniors -- the constituency most affected by these issues -- vote at a 90% rate, while less than 50% of the uninsured tend to vote. And given that reducing the number of uninsured residents is not a simple endeavor, the issue has been "up there but not at the front," Altman said. Despite all the discussion about health care in this year's campaign, the "incremental, bite-sized" proposals made by Vice President Al Gore and Texas Gov. George W. Bush (R) are much more modest than those proposed by President George Bush and Bill Clinton during the 1992 election. Bush offered a $3,750 refundable health insurance voucher to the poor and a "sizeable tax deduction" for the middle class, while Clinton called for universal health coverage. However, the failure of the Clinton plan has pushed the current candidates away from "big government solutions," leading Bush and Gore to offer cautious proposals for tackling the problem of the uninsured.

To help the uninsured gain coverage, Bush has proposed offering tax deductions and "refundable health credits" for low-income families and expanding medical savings accounts. Gore has also proposed tax credits, as well as allowing people ages 55-64 to buy into Medicare. However, health care experts believe that "neither proposal [would] significantly reduc[e] the number of uninsured Americans" and tax credits or rebates would more likely help middle-class families than poor families. Beth Capell, chief lobbyist with the consumer group Health Access California, said, "(A tax credit) doesn't deal with the issue of
month-to-month cash flow for families or for small businesses. You still have to lay out the cash every month to buy the coverage." One KFF-commissioned study found that "even a large refundable tax credit costing $13 billion a year would reduce the ranks of the uninsured by only four million." Altman added that to significantly reduce the number of uninsured Americans, tax credits must be combined with an expansion of government programs (Rodriguez, California Journal, 11/2000).