Get ready for more.
As Democratic presidential candidate Richard Gephardt unveiled his plans for universal health coverage last week, political observers said many more proposals taking aim at the uninsured will be coming from the crowded field of aspirants for the party's nomination.
Gephardt, a House member from Missouri, unveiled his ambitious and politically risky plan for covering about 97% of the nation's 41.2 million uninsured in a speech last week to the Service Employees International Union in New York.
While his is the most detailed of any plan that has been made public, expect to hear proposals from other Democratic candidates in the near future, said Ron Pollack, executive director of Families USA, a nonpartisan advocacy group that supports universal coverage.
"My view is that this is going to be part of a larger pattern in which Democratic candidates are going to accentuate this issue," Pollack said. Saying the Bush administration has done little to solve the problem, he added, "There'll be a real record to contrast for the Democrats."
So far, former Vermont Gov. Howard Dean and Sen. John Edwards of North Carolina also have spoken about expanding coverage, but at a time when the number of uninsured is rising and healthcare spending is going up, the issue may become a battle cry for Democrats, who historically have taken the lead on health issues.
Other groups also recently have pushed for more initiatives in covering the uninsured. Last week, the Commonwealth Fund, a New York foundation, offered its own plan with a price tag of $90 billion per year. The plan calls for the creation of a new private group insurance plan modeled after the Federal Employees Health Benefits Program that would be open to the self-employed, small businesses and those who have been uninsured for at least six months. Public insurance programs such as Medicare and the State Children's Health Insurance Program would be expanded to capture more of the uninsured as well.
Under the Gephardt proposal, all companies would be required to insure their workers. Refundable tax credits would pay for 60% of the cost, up from the approximately 30% that employers currently receive when they deduct the cost of insurance on their taxes.
He estimated the bill to be $214 billion in 2005, $231 billion the next year and $247 billion in 2007. To fund it, Gephardt would repeal parts of President Bush's 2001 tax cuts that won't fully phase in until 2006. A new round of tax cuts, including provisions that would accelerate the 2001 cuts, are being considered in Congress. Gephardt, who resigned as House minority leader to run for president, opposes those cuts, too.
The tax credit would cover the healthcare costs of part-time employees, retirees and the self-employed. Workers still have to pay their portions of premiums, but those employers that shifted more of the premium costs onto their workers would not qualify for the tax credit. His plan subsidizes employee contributions for those below or near the poverty line. The plan, the most ambitious since Clinton's 1994 proposal, already is being attacked by Republicans and business groups who portray it as being fiscally irresponsible. The Republican National Committee coined it "Dr. Gephardt's Take-Two-Tax-Hikes-and-Call-Me-in-the-Morning remedy."
Mary Grealy, president of the Healthcare Leadership Council, a Washington-based coalition of healthcare executives, voiced several concerns about the proposal, including its cost and mandates for benefits offered by employers. "Taking on (an) employer mandate is not something that sits well with the business community," she said.
But Pollack said the majority of employers already offer health insurance, and Gephardt's plan gives them more money to continue doing so. Despite the steep price tag, Pollack said, "It's not a question of can we afford it."