Family Forum / Parenting / Adoption / August 2004

Top post from pb... :

OT, J? I think not since the majority who post here are, as Marley calls
us, USians. Here's a little tidbit to add to yours...fits right into the
puzzle as you can see...

washingtonpost.com

Bush Health Care Plan Seems to Fall Short
Gap Grows Between Hard Data, Projections for Covering 10 Million Uninsured

By Ceci Connolly
Washington Post Staff Writer

Sunday, August 22, 2004; Page A04

If the Republican-controlled Congress enacted President Bush's entire
health care agenda, as many as 10 million people who lack health
insurance would be covered at a cost of $102 billion over the next
decade, according to his campaign aides.

But when the Bush-Cheney team was asked to provide documentation, the
hard data fell far short of the claims, a gap supported by several
independent analyses.

Projections by the Congressional Budget Office, the Treasury Department,
academics and the campaign's Web site suggest that under the best
circumstances,****Bush's plans for health care would extend coverage to
no more than 6 million people over the next decade and possibly as few
as 2 million.*****

"There's little reason to expect that there would be any reduction in
the overall numbers of Americans without health insurance," Brookings
Institution health policy expert Henry J. Aaron said. "We're swimming
against a rather swift current in our efforts to reduce the number of
uninsured, and the power of President Bush's proposals to move against
that current is, it seems to me, very, very limited."

In his bid for a second term, Bush is reprising much of the health care
agenda he ran on in 2000, including tax credits for individuals who
purchase insurance, and the formation of new, largely unregulated
purchasing pools for small businesses called association health plans.

His Democratic challenger, Sen. John F. Kerry (Mass.), has released a
health care agenda that is more ambitious and more expensive, with plans
to expand government health programs, offer tax credits similar to
Bush's and reimburse businesses for some of their most costly
catastrophic cases.

Forecasting the cost and impact of policy proposals is always
complicated, and both presidential campaigns try to spin the numbers to
their advantage. Kerry, for example, estimates his health care proposals
would cover 27 million people at a 10-year cost of $653 billion. But
that assumes $300 billion in "savings" that the Bush team says might
prove elusive. Without the savings, the cost of the Kerry package jumps
to nearly $1 billion.

Health experts inside and out of the administration say many of the
assertions Bush makes about his first-term health care record and his
health proposals for a second term are exaggerated, incomplete or
contrary to widely accepted analyses .

On the campaign trail, the president trumpets last year's enactment of a
Medicare prescription drug package as his signature health achievement.
In monetary terms, the new policy -- estimated to cost $564 billion over
10 years -- goes far beyond the $158 billion proposal candidate Bush ran
on in 2000.

"When we came to office, too many older Americans could not afford
prescription drugs. Medicare didn't pay for them," he said last month.
"Leaders in both political parties had promised prescription drug
coverage for years. We got it done. More than 4 million seniors have
signed up for drug discount cards that provide real savings."

Left unsaid is that 2.9 million of them had no choice; they were
enrolled automatically. And full implementation of the drug benefits
will not occur until 2006.

Since Bush took office, the number of Americans without health insurance
has climbed by 4 million, to nearly 44 million. On its Web site and at
news briefings, the Bush campaign says that through its actions
overseeing Medicaid and the Children's Health Insurance Program, the
administration has "expanded eligibility to more than 2.6 million people."

The statement gives the impression "they have extended coverage to 2.6
million more, and that is not really true," said Diane Rowland,
executive director of the Kaiser Commission on Medicaid and the
Uninsured. "In reality, only 200,000 of them got coverage" because of
Bush administration efforts.

Megan Hauck, deputy policy director for health care of the Bush
campaign, did not have figures but said she thought the Kaiser data were
"awfully low."

Total enrollment in the two government health programs did rise during
Bush's tenure -- by about 7.5 million. But for the vast majority,
coverage was required by law, not the result of any policy change.

"Part of the reason more people were covered is the economy got so bad
that people lost income," Rowland said. "There were more low-income
people under Bush than previously, so they became eligible for public
programs."

Although Hauck generally touts the campaign's projection that the Bush
proposals would expand coverage to 10 million Americans, she said it
could be as few as 6 million. Of the 10 million, half will use the
proposed $1,000 tax credit ($3,000 for families) to buy insurance. The
estimate comes from congressional testimony by a Treasury Department
official who speculated that the 10-year, $70 billion proposal could
result in coverage for 4 million to 5 million people.

One year earlier, the Bush budget set aside $89 billion for the same
credit, claiming it would cover 4 million. Analysts say it is impossible
to see how spending $20 billion less, at a time when premiums are much
higher, could achieve the same level of coverage.

If the tax credit were passed, Jonathan Gruber, an economist at the
Massachusetts Institute of Technology, predicts some businesses will
drop health insurance. If just 1 percent of people who currently receive
coverage from an employer bought individual insurance instead, the Bush
policy would result in 1.8 million newly insured, according to Gruber's
analysis.

The next-largest element in the Bush agenda is a proposal to allow small
businesses to band together to purchase insurance through new
association health plans. Hauck said 2 million people would be covered
if this were enacted. The figure came from a January 2000 CBO report in
which the nonpartisan agency said 10,000 to 2 million people might join
association health plans.

But in its July 2003 analysis of the Republican bill, the CBO concluded
that 600,000 Americans would likely buy into the pools, at a cost of
$254 million. Even the Bush campaign Web site reports that "600,000
would be newly insured," or 1.4 million fewer than Hauck's tally. And a
recent study by Mercer Risk, Finance and Insurance Consulting found the
proposal could result in a decline of 1 million insured, because
small-business insurance premiums would likely rise.

Finally, the Bush campaign projects that 3 million people would be
covered through new health savings accounts, which allow people to save
money tax-free for out-of-pocket medical expenses. The new accounts,
purchased in combination with high-deductible, catastrophic insurance,
were created as part of last year's Medicare prescription drug package.

Hauck said an "internal estimate" by the campaign indicates the
provision would extend insurance to 1.1 million people, though she could
not provide supporting material. The Joint Committee on Taxation
estimated the proposal would cost $6.7 billion, but officials there
declined to say how many people that figure was based on.

MIT's Gruber and Paul Ginsburg, president of the Center for Studying
Health System Change, said the impact would be minimal, because some
people likely to purchase the new accounts are currently insured.
Democrats say it is unfair for the Bush campaign to include the
provision at all, since it is current law, not a proposal.

Bush wants to expand use of health savings accounts by also making the
premiums tax-deductible, a proposal Gruber said would increase the
number of uninsured by 350,000.

But Hauck said the campaign assumes that making the premiums deductible
will result in coverage for an additional 1.9 million people. That
figure is based on an article by Dan Perrin and Richard Nadler at the
HSA Coalition, a group that has worked for the past decade to pass
medical savings account legislation, according to its Web site.

The coalition includes conservative members such as the Christian
Coalition, the 60 Plus Association and the Small Business Survival
Committee.

© 2004 The Washington Post Company