A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Hillary's Health Plan

Hillary's Health Plan

September 19, 2007

So it's out, Hillary Clinton's plan to expand access to health insurance to cover nearly everyone. Key parts:

1. Require all residents to obtain health insurance;
2. Require large employers to contribute toward the cost of health insurance for employees and provide tax subsidies to small businesses to help cover the cost of coverage for workers;
3. Provide tax breaks to ensure that health insurance premium payments do not exceed a certain percentage of household income;
4. Mandate that health insurers cannot deny coverage to applicants because of pre-existing medical conditions; and
5. Allow residents without health insurance or with inadequate coverage to participate in a program similar to Medicare or the Federal Employees Health Benefits Program; and
6. Expand Medicaid to cover low-income adults without children

Thoughts/reactions:

First, she's clearly learned and internalized some key lessons from the 1993-94 reform fiasco. Whether people think she's learned the "right" or "wrong" lessons is grist for everyone's mill. But her key learning is -- don't mess with everyone's care, just with those who need help.

Second, this looks as close to Massachusetts and Edwards as one could possibly engineer. Irony upon irony -- at odds with Mitt Romney over his own legacy, and that's just for starters.

Third, if Dems win the White House and pick up real numbers in the House and Senate, the combination of Clinton/Edwards/Obama plans define the initial contours of the Democratic health care agenda, like it or not.

Fourth, does it strike anyone as just a teensy bit premature to embrace a national individual mandate when it has yet to be really put to the test in Massachusetts? We're OK defending it, but it's an experiment, make no mistake, and it's still early.

Fifth, bravo to Mrs. Clinton for taking on the insurance industry and the disgusting practice of medical underwriting and cherry picking. This is a fight worth making. And this the main reason for including an Individual Mandate, to eliminate the industry's chief argument for medical underwriting.

Sixth, hard to see any sign of single payer legs in this race. Dennis Kucinich is as far as it goes.

Chapter 58 has legs, long national legs. No wonder people from every point of view want to weigh in on it at every chance.
John McDonough