Boston Globe Examines McCain’s Health Plan

Presumptive Republican presidential nominee Sen. John McCain (Ariz.) has said the U.S. must expand health insurance to "people who need it," but critics maintain that lack of regulations on insurers could leave many without affordable coverage, the Boston Globe reports. As a result, "McCain's aides have been scrambling to come up with ways to satisfy those who want more coverage without violating what they call McCain's conservative principles on the issue," according to the Globe.

McCain has said that he seeks to reduce the role of government in health care and opposes increased regulation of health insurers. His health care proposal would eliminate a tax break for employees who receive health insurance from employers and replace it with a tax credit of up to $5,000 per family for the purchase private coverage. In addition, the proposal would promote reduced costs and increased competition among health insurers. McCain has said that the proposal would strengthen the private health insurance market and make coverage more affordable for many low-income families.

The proposal would not mandate that health insurers accept applicants with pre-existing medical conditions, a requirement that McCain has said would "be mandating what the free enterprise system does." According to critics, without such a requirement, millions of residents would not have access to affordable health insurance. Jonathan Gruber, a professor of economics at Massachusetts Institute of Technology, said that the proposal is "fine except for the poor and the sick."

A kaisernetwork.org webcast of a forum featuring McCain discussing his health care proposal is available online.

Response
In response to such concerns, McCain has said that he might help residents with pre-existing medical conditions through a "special provision including additional trust funds for Medicaid payments" or "high-risk pools." McCain aides also have said that he might attempt to use savings in Medicaid to finance additional tax credits for residents with pre-existing medical conditions. However, the "amount of the credit hasn't been determined, the possibility of extracting enough savings from Medicaid is debatable, and it is unclear whether a credit would be enough to persuade an insurance company to accept a person who would be likely to have large medical expenses," the Globe reports.

Thomas Miller, a McCain adviser and resident fellow at the American Enterprise Institute, said, "These are real questions, and I think there will be answers, and there better be, but they are not there yet," adding, "A lot more remains to be hammered out." Douglas Holtz-Eakin, chief policy adviser for McCain, said, "We'll put out more details. As we do, it will be clearer to people" (Kranish, Boston Globe, 4/3).

Opinion Piece
Democratic presidential candidates Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) are "intersecting" in their "appeal to Sen. Ron Wyden (R-Ore.)," who has "slowly gathered" bipartisan support for a bill (S 334) that would "restructure U.S. health coverage and extend it to all Americans," Oregonian Associate Editor David Sarasohn writes in an opinion piece.

According to Sarasohn, the legislation, called the Healthy Americans Act, "refocuses public and private insurance spending to individuals" and "obliges them to buy coverage." The bill is "not quite like Clinton's or Obama's" health care proposals, which would "leave more of the current system in place," but "enough of an overlap" exists for "people to insist they're all in this together," Sarasohn writes.

He adds that an expansion of health insurance to all residents "has been the great white whale of the Democratic Party: occasionally sighted, always escaping" and "likely to do great damage to anyone who comes too close." Both "Clinton and Wyden have stalked it for awhile," and, because the "debate has changed" in recent years, a "different outcome" might result, Sarasohn concludes (Sarasohn, Oregonian, 4/2).