Clinton Discusses Enforcement Mechanism For Health Insurance Mandate

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Democraticpresidential candidate Sen. Hillary Rodham Clinton (N.Y.) on Sunday during anappearance on ABC's This Week with George Stephanopoulos" discussed her proposal torequire all U.S. residents to obtain health insurance and "inched closer... to explaining how she would enforce" the requirement but"declined to specify -- as she has throughout the campaign -- how shewould penalize those who refuse," the New York Times reports. Asked whether she wouldgarnish wages to enforce the mandate, Clintonsaid that "we will have an enforcement mechanism, whether it's that orit's some other mechanism through the tax system or automatic enrollments"(Sack, New York Times, 2/4). Clintonexplained she believes "there are a number of mechanisms" that couldwork including "going after people's wages." Clinton also said that the enforcementmechanism would apply only to residents who can afford health insurance butrefuse to purchase coverage, adding that, with her proposals for subsidies,"it will be affordable for everyone" (Babington, AP/Houston Chronicle, 2/3).

She also said that the focus on an enforcement mechanism took attention fromdifferences in her health care proposal and the plan announced by rival Sen. BarackObama (Ill.).His proposal would require health insurance only for children and would leavesome residents without coverage, she said.

Bill Burton, a spokesperson for Obama, said that Clinton "again refused to directlyanswer the question" about the enforcement mechanism. He added, "America needs aleader they can trust, not someone who will avoid hard questions."

Obama Campaign Mailer

The Obama campaign lastweek distributed a mailer that said, "Hillary's health care plan forceseveryone to buy insurance, even if you can't afford it ... and you pay apenalty if you don't" (New York Times, 2/4).

Neera Tanden, policy director for the Clintoncampaign, said that the Clintonhealth care proposal includes subsidies to help residents cover the cost ofhealth insurance, as well as provisions to reduce the cost of coverage.According to Tanden, Obama "betrays the cause of universal healthcare." She added, "For a potential Democratic nominee to be attackinguniversal health care is quite stunning" (Fouhy, Associated Press, 2/1).

The Clintoncampaign also criticized the mailer for the use of images that resemble thoseused in the "Harry and Louise" television advertisements aired by American's Health Insurance Plans in the 1990s to help defeat her health careproposal. Len Nichols of the New AmericaFoundation said,"I am personally outraged at the picture used in this mailing," whichhe called a "Harry and Louise evocation" (Smith, "BenSmith" blog, The Politico, 2/1). A link to a portion of themailer is available online at politico.com.

David Axelrod, chief strategist for the Obama campaign, defended the mailer. Headded that the Clintoncampaign has "spent a lot of money in this campaign to distort our healthcare plan" (Zeleny/Healy, New YorkTimes, 2/2).

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Burton alsonoted comments by Sen. Ted Kennedy (D-Mass.), who endorsed Obama last week."It's the passion of my life, universal comprehensive health care, and Iwouldn't support Barack Obama unless I was absolutely convinced that he was foruniversal comprehensive health care as well," Kennedy said. "I'vetried for 38 years to get the universal comprehensive health care. I'vesupported 12 different proposals to try to get there. Elect Barack Obama and wewill get there" (Associated Press, 2/1).

Also, according to the New York Times, "A group of doctorsand health policy analysts, including a number of Obama advisers, pointed outin a letter released Thursday that Massachusetts, the only state with aninsurance mandate, has thus far failed to enroll nearly half of its uninsureddespite imposing a modest first-year tax penalty of $219 (the fine increasessignificantly this year)." A copy of the letter is available online athuffingtonpost.com.

Clinton would not "allow exemptions fromthe insurance mandate, as Massachusettsdoes," according to the Times (New York Times,2/4).

Clinton Addresses Health Care at CampaignEvents

Clinton on Saturday during an event at the California State University-Los Angeles that targeted Hispanic voters said,"My opponent will not commit to universal health care." She added,"I do not believe we should nominate any Democrat who will not proudlystand here today, tomorrow and the next day and say universal health care isthe goal" (Sweet, Chicago Sun-Times, 2/3).

Later on Saturday, Clinton during an event in Tucson, Ariz., said, "Hedoesn't have a universal health care plan, and I think as a Democrat, if we'regoing to run against the Republicans, let's run on our principles." Sheadded, "Unless we get everybody covered with insurance, we'll never beable to improve health care, reduce costs. We'll never be able to rein in theinsurance companies because they'll always be able to cherry-pick" healthyresidents and reject those with pre-existing conditions (Scarpinato, Arizona Daily Star, 2/3).

Voter Survey

Sixty percent of Democraticvoters and 40% of Republican voters believe that the presidential candidateshave not adequately discussed health care issues in their campaigns, accordingto a recent survey conducted by the Susan G. Komenfor the Cure Advocacy Alliance.

The survey found that about 40% of voters said that they are not satisfied withthe health care proposals from the candidates. In addition, 62% of voters citedbreast cancer as the most important health issue for women, followed by heart disease,and ovarian and cervical cancers, according to the survey. The survey alsofound that 71% of Democratic voters and 46% of Republican voters would supporta federal tax increase to expand access to breast cancer tests and treatmentfor all women (Grimaldi, CQ HealthBeat, 2/1).

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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