By Mary Agnes Carey, CQ HealthBeat Associate Editor
September 17, 2007 – Democratic presidential candidate Hillary Rodham Clinton unveiled a sweeping universal health care plan Monday that includes an individual mandate requiring each American to have health insurance. Individuals could keep their current coverage or pick from the same menu of private coverage options available to members of Congress, and the plan would provide refundable tax credits to help individuals pay their premiums.
Clinton's proposal, which reportedly would cost the government about $110 billion a year, also would allow Americans to choose a coverage option similar to Medicare, the federal health care insurance program that now covers more than 43 million elderly or disabled Americans. Employers would be required to provide health care coverage or pay into a fund that would finance coverage for the uninsured. Small businesses would receive tax credits to continue offering coverage or to begin offering it to their workers. Insurers could not deny coverage based on a pre-existing medical condition or charge excessive premiums.
"My plan covers all Americans and improves health care by lowering costs and improving quality," Clinton said during a speech at Broadlawns Medical Center in Des Moines, Iowa. "It's a plan that works for America's families and America's businesses, while preserving consumer choices."
Critics said Clinton's plan would add to the federal bureaucracy, contrary to her claims that it would not. Republicans and Democrats alike said the plan would be as unsuccessful as her ill-fated attempt in 1993 to revamp the nation's health care system.
"If you liked Michael Moore's 'Sicko,' you're going to love HillaryCare 2.0," said Katie Levinson, communications director for Republican presidential candidate Rudy Giuliani. "Sen. Clinton's health care scheme includes more government mandates, expensive federal subsidies and more big bureaucracy—in short, a prescription for an increase in wait times, a decrease in patient care and tax hikes to pay for it all."
Another GOP presidential contender, Mitt Romney, called Clinton's plan "bad medicine" that would rely on "government insurance, instead of . . . . private insurance."
Clinton, D-N.Y., said Monday her plan would be financed by reducing waste, fraud, and abuse in the health care system and by discontinuing some of the Bush administration's tax cuts for individuals making $250,000 or more. The plan would protect the current exclusion from taxes of employer-provided health premiums, except for some premiums paid for "very generous" plans provided to individuals making over $250,000.
The universal health care proposal is a component of her three-part approach to ensure health care coverage for all Americans. In May, she released a plan to increase national investment in health care information technology, place greater emphasis on preventative medical care, and overhaul the nation's medical malpractice system.
Clinton's Democratic rivals said Monday her plan would not provide universal coverage. Sen. Barack Obama, D-Ill., said Clinton's plan was similar to the one he proposed last spring, adding "My universal health care plan would go further in reducing the punishing cost of health care than any other proposal that's been offered in this campaign." Unlike Clinton, Obama would not require that individuals purchase health care coverage, known as an "individual mandate."
At a speech to the Laborers Leadership Convention in Chicago, Democratic candidate John Edwards—who does favor the individual mandate—said if he were elected president he would introduce legislation that would end health care coverage for the president, all members of Congress and all senior political appointees in both branches of government by July 20, 2009, unless all Americans had health care insurance. "If you defend the system that defeated health care, I don't think you can be a president who will bring health care," Edwards said.
Karen Ignagni, president and CEO of America's Health Insurance Plans, a trade group representing health care insurers, said while Clinton's plan "includes important ideas to make coverage more affordable; unfortunately, some of the divisive rhetoric seems reminiscent of 1993." Ignagni added that insurers back universal coverage and the group has offered its own proposal to achieve that goal.