Massachusetts Health Insurance Law Focus Of Debate Among Candidates

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Therecently implemented Massachusetts health insurance law, which requires allstate residents to obtain coverage, "is now at the center ofdisputes" in the Democratic and Republican presidential campaigns, the Washington Post reports. The law, signed last yearby Republican candidate and former Massachusetts Gov. Mitt Romney, requires allstate residents to obtain health insurance this year or face possible taxpenalties after Jan. 1, 2008, with subsidies for lower-income residents.

Democratic candidates Sen. Hillary Rodham Clinton (N.Y.) and former Sen. JohnEdwards (N.C.) have announced proposals to expand health insurance to all U.S.residents that would include an individual mandate. Democratic candidate Sen. BarackObama (Ill.)has announced a proposal to expand health insurance to all residents that wouldnot include an individual mandate. However, the debate on individual mandatesamong Democratic candidates "is in some ways overstated" because allof their health care proposals "are likely to be changed dramatically byCongress" and because the plans announced by Clinton and Edwards do notinclude enforcement mechanisms, according to the Post.

Among Republican candidates, the debate on individual mandates "is turnedon its head," the Post reports. Romney, "while defendinghis plan in Massachusetts,"has attributed the "more ambitious aspects" of the law to Democrats,and his presidential health care proposal would not include an individualmandate. Republican candidate and former Sen. Fred Thompson (Tenn.) hascriticized individual mandates as a "tax penalty," and Republicancandidate and former New York City Mayor Rudy Giuliani said that suchrequirements would move "you in the direction of socialized medicine"(Bacon, Washington Post, 11/18).

Study of Proposals

Health care proposalsannounced by Democratic candidates include potential benefits and risks forhealth insurers because they would increase the number of U.S. residents withprivate health insurance, as well as the role of the federal government in themarket, according to a PricewaterhouseCoopers HealthResearch Institutestudy scheduled for release this week, the Wall Street Journalreports. The study found that the health care proposals announced by Clinton,Edwards and Obama would increase annual spending by about $100 billionannually, in large part to help more residents purchase private healthinsurance.

Benjamin Isgur, assistant director of the institute, said, "Here's thepotential for a whole new pool of lives for them to cover, with payment behindit."

However, the proposals also include potential risks for health insurers, the"biggest of which might be a proposal ... that would set up aMedicare-like health plan that would compete with private insurers,"according to the Journal.

In addition, under the proposals, the federal government could account for halfof health care spending by 2011, six years earlier than currently estimated. Accordingto the study, "Tipping past the halfway mark has broad implications forthe industry, which will increasingly depend on government payment, which tendsto be less than commercial payment" (Meckler, Wall Street Journal,11/19).

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Additional Developments

Summaries of several recentdevelopments in the presidential campaign related to health care appear below.

  • Edwards: Edwards last week in Milford, N.H., discussed his health care proposal and his differences with Clinton on the issue, the Pittsburgh Post-Gazette reports. Edwards said of health care reform efforts led by Clinton in the 1990s, "We had a Democratic president, a Democratic House and a Democratic Senate in 1993. We tried to pass universal health care. The drug companies, the insurance companies and the lobbyists killed it" (Sherman, Pittsburgh Post-Gazette, 11/18).

  • Giuliani: Giuliani has criticized Democratic candidates for their support of "socialized medicine" and has "vigorously opposed expanding government health insurance for children," but his "current market-based proposals on health care ... have him campaigning against his own record in some ways," the New York Times reports. During his first term as New York City mayor, Giuliani took action to reduce the role of government in health care. However, after his recovery from prostate cancer during his second term, Giuliani began "one of the most aggressive efforts in the country to enroll children and adults in public health programs like Medicaid and Child Health Plus," the Times reports. As part of the effort, Giuliani promised to "root out the uninsured as he had rooted out criminals," according to the Times (Kershaw, New York Times, 11/17).

  • Sen. John McCain (R-Ariz.): McCain on Saturday in Canaan, Vt., expressed support for the legalization of prescription drug reimportation from Canada and other nations with adequate safety standards, the AP/St. Petersburg Times reports. McCain said, "Drug companies and the lobbyists they pay in Washington want to keep your drug prices high. Obviously, I want them to be affordable." In addition, he said, "If we are going to control health care costs, we need to control the rising costs of pharmaceuticals" (AP/St. Petersburg Times, 11/18).

  • Romney: Romney on Friday in Nevada discussed the Massachusetts health insurance law at the Las Vegas Chamber of Commerce roundtable, the AP/Ft. Worth Star-Telegram reports. Romney said that the law seeks to require state residents who can afford health insurance to purchase coverage, with subsidies for lower-income residents. He added, "My plan said this: Now that we got the rates down so they're more affordable ... either buy a health care policy or pay your own way at the hospital. But no more showing up expecting free care from the government or from the hospital" (Ritter, AP/Ft. Worth Star-Telegram, 11/17).

  • Thompson: Thompson on Sunday in an interview with ABC's "This Week" said he supported efforts by the parents of Terri Schiavo to "keep that child alive" during a legal dispute over the issue in 2005, USA Today reports. Thompson, who last week received the endorsement of the National Right to Life Committee, said, "How can anyone come to the conclusion that there is a benefit of the doubt not to choose life for a loved one?" (Wolf, USA Today, 11/19).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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