Wednesday, January 21, 2004

Health care for the uninsured is shaping up to be the next big issue this election year, and President Bush staked his claim on Tuesday, outlining a handful of proposals to help the uninsured get medical coverage.

Senate Majority Leader Bill Frist said he intends to push all of the proposals in Congress this year, including refundable tax credits to help poor Americans buy health insurance — a proposal that has been pushed in the past and that aides say has a price tag of about $89 billion over 10 years.

Mr. Bush’s State of the Union health care proposals come on the heels of the $395 billion Medicare prescription-drug bill that the president and Republicans pushed through Congress just a few months ago. As with White House initiatives on education and Social Security, the Bush health care plan targets an issue on which Democrats long have held a political advantage over Republicans.

Sen. Edward M. Kennedy, Massachusetts Democrat, will fire back with a speech today saying Mr. Bush’s health care proposals are hardly enough and outlining the senator’s plan for universal health care coverage. The Kennedy plan would require most businesses to provide health insurance for their workers and would set up a government program to cover people who don’t qualify for employer-based health care or existing government programs such as Medicaid.

Democratic presidential hopefuls, including former Vermont Gov. Howard Dean and Sen. John Kerry of Massachusetts, also have endorsed universal health care coverage.

Mr. Kerry yesterday criticized Mr. Bush’s health care approach, saying it only benefits big drug companies and HMOs. He pledged to repeal the Bush-backed Medicare bill and pass a “real” one, and he put forth a proposal similar in some ways to the one proposed by Mr. Kennedy.

Kennedy spokesman Jim Manley yesterday said Mr. Bush’s proposals are “too little too late,” will not pass Congress and are politically motivated.

“This administration’s been AWOL when it comes to providing health care for the uninsured,” Mr. Manley said. “Now in an election year, the president is focusing on it.”

In addition to the refundable tax credit, which likely will be included in Mr. Bush’s budget due out Feb. 2, the president proposed allowing small businesses to group together and negotiate with insurance companies for cheaper rates, so they can cover more workers under Association Health Plans.

Mr. Bush also proposed allowing those who buy catastrophic health coverage under the new Medicare law’s Health Savings Accounts to deduct the entire cost of their premium from their income taxes. He favors computerizing health records to reduce mistakes and wants to cap damages in medical-malpractice lawsuits, which Republicans say drive up the cost of health care. A bill to limit malpractice damages passed the House last year, but stalled in the Senate.

“All of [Mr. Bush’s proposals] will be discussed and debated” in Congress this year, said Mr. Frist, Tennessee Republican. But he said it is “too early to tell” which will come up first and whether any will make it into law this year.

House Ways and Means Committee Chairman Bill Thomas said the use of tax credits has worked well in delivering health care.

“The president’s plan to expand these credits to a broader universe of uninsured individuals is a common-sense measure that will result in more Americans getting the health care they need,” said Mr. Thomas, California Republican.

But Ron Pollack, executive director of Families USA and a strong supporter of Mr. Kennedy, predicted that none of the Bush proposals will pass this year because they are “very partisan … and you don’t pass such proposals during an election year.”

Mr. Pollack said the refundable tax credits will give people only a fraction of the money they need for decent health coverage, and the proposal to reimburse people for their premiums is bad policy because only healthier, wealthier people will be attracted to tax benefits through Health Savings Accounts.

Mr. Kennedy said, “Each of these administration proposals demonstrate what we see so often — compassionate conservatism without the compassion.”

Under Mr. Kennedy’s plan, the new government program for the uninsured would be modeled after the health care program that covers members of Congress. Essentially, people would be able to choose from several private health plans and the government would subsidize it at different levels, depending on a person’s income.

The Bush proposals, said Mr. Manley, the Kennedy spokesman, are old ideas that never have been able to make it into law.

But Mr. Frist said on NBC’s “Today” show yesterday that Democrats are the ones promoting old ideas and playing politics.

“Right now, you hear all the Democrat presidential wannabes out there saying, ‘Universal health care. We’ll promise you everything. We’ll take care of you’ — the same old rhetoric from a long time ago,” Mr. Frist told NBC. “People are too smart for that today. They want specific solutions. And this president gave specific solutions.”

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