UNINSURED: Gore Unveils Major Campaign Initiative
As expected, Vice President Gore yesterday chose health care as the topic with which to kick off the "policy phase of his campaign," proposing an ambitious amalgam of proposals designed to bring more Americans under insurance coverage (Rovner, CongressDaily, 9/7). Speaking at Children's Hospital of Los Angeles, he said, "If you elect me president, I will ensure that by the year 2005, every single child in our country has full access to fully affordable health coverage" (Pear, New York Times, 9/8). Gore "called for a new system of financial bonuses and penalties to help motivate states do a better job of locating the millions of children who qualify for -- but are not enrolled in -- Medicaid" and CHIP. He would also expand eligibility for CHIP and allow those who earn too much to qualify to buy into the program. Borrowing from President Clinton, he said he would allow those aged 55 to 65 to buy into Medicare (Connolly/Goldstein, Washington Post, 9/8). On the tax front, Gore would allow individuals a 25% deduction to purchase coverage, and businesses the same level deduction as an incentive to pool together to offer coverage to employees. Finally, Gore reiterated his support for HMO reform along the lines of Democratic proposals in Congress. He said, "Taken together, these steps will make health care affordable for millions of Americans who can't afford it today. They will move us toward the day when every American has access to affordable, quality coverage."
The Fourth Branch
Several press reports were quick to point out shortcomings in the vice president's blueprint. The Los Angeles Times noted that he was "mum on the question of how he would finance a program that could easily reach into the multibillion-dollar range." Spokesperson Chris Lehane said, "It's all going to be done in the context of a balanced budget" (Decker, 9/8). The Washington Post remarked that he was "remarkably silent on the health care issue vexing much of Washington: how to restructure Medicare so that it remains financially solvent well into the future" (9/8). And the New York Times points out that the plan expands "on a program enacted two years ago that [Gore] conceded has had limited success so far." Indeed, a Gore campaign paper calls enrollment in new health programs "woefully inadequate" (9/8).
Experts, Pols and Such
Reaction to the plan among health policy experts and other politicians was predictably mixed. "The biggest gap in coverage is adults and this is an efficient way to begin to reach them," said Judy Feder, dean of policy studies at Georgetown University. But E. Richard Brown, director of the UCLA Center for Health Policy Research, said, "It sounds like a number of interesting and useful small pieces which will help states expand (coverage) if they want to. But it still will leave probably the largest segment of the uninsured population out in the cold." He noted that a tax deduction will not help most of the uninsured, in that "most people cannot come up with the up-front money" (Los Angeles Times, 9/8). Ron Pollack, executive director of Families USA, said, "In a period of incrementalism, this is a big deal and very practical" (Washington Post, 9/8). In a release, Rep. John Boehner (R-OH), said, "Unfortunately, the vice president's plan to help the uninsured has a catch. If you're an employer who voluntarily provides health benefits for your employees, you'll be eligible for a 25% tax credit -- but you'll also be eligible for a billion-dollar lawsuit" (9/7). Chip Kahn, president of the Health Insurance Association of America, said, "Gore should be commended for beginning to address the needs of the nation's uninsured. However, his support for warmed-over so-called 'patient protections' and other expensive regulations would hurt the very people he intends to help" (release, 9/7).
The Washington Times reports that Gore's proposals are a reaction to rival Bill Bradley's strong support from the left wing of the Democratic Party. Marshall Whittmann, a senior policy analyst at the Heritage Foundation, said, "I think that right now Al Gore hears footsteps approaching him on his left flank. The health care initiative is his latest effort to bolster his left flank and to inoculate himself from attacks that he is too much of a centrist. ... But he is gradually moving in the direction that is undermining the notion that he is truly a New Democrat." John Goodman, a senior adviser to Republican front-runner George W. Bush who is helping the Texas governor devise his own health care package, said of Gore's plan, "It would expand Medicare. It would expand Medicaid. It would expand [CHIP]. This is creeping HillaryCare because it is an expansion of government health care programs." But Gore adviser Bill Galston said, "It's not a question of left or right. It's a question of forward" (Lambro, 8/9). Bradley said, "Millions of Americans have serious concerns about the availability of health care coverage and the quality of their care. I'm glad to see that the vice president shares my belief that these concerns should be a top priority" (Washington Post, 9/8).