Covering The Candidates

December 20, 2007
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No Republican presidential candidate requires individuals to obtain health insurance or mandates that employers offer their workers a plan in their proposals, while most Democrats running for the land's highest office call for at least one of those to happen.

Two Democratic candidates offer coverage for everyone, while no Republican does.

Republicans focus almost exclusively on making tax changes and other alterations to enhance the private insurance market, while most Democrats would expand a public plan or create a new one.

These are just a few of the general differences across parties that the candidates have in their health care proposals and there are more differences among candidates within parties.

What follows is a snapshot of each presidential candidate's plan to expand access and coverage to more Americans, and whether each would require individuals to buy coverage or employers to offer coverage under their plan.

Biden, Joe (Democrat): Expand Medicaid and SCHIP programs. Create new options to buy into coverage through Medicare and a new program that mirrors the Federal Employees Health Benefits Program (FEHBP). Provide subsidies to low-income individuals and create a Federal reinsurance system for catastrophic costs to lower health insurance premiums.

No requirement to obtain or offer coverage.

Clinton, Hillary (Democrat): Have private and public plan options made available to individuals through a new Health Choices Menu operated through the FEHBP. Coverage through employers and public programs like Medicare continues.

Individuals must have coverage. Large employers must provide an employee plan or contribute to cost of coverage. Most small employers not required to provide or contribute to employee coverage, but will be provided incentives to do so.

Dodd, Chris (Democrat): Create a new program, Universal Health Mart, based on and parallel to the FEHBP. Subsidize premiums for individuals and businesses that can't afford payments. Those under 100 percent of poverty could enroll in Medicaid. Medicare remains the same.

Individuals must obtain coverage. Those who can't afford to are enrolled into the UHM. Employers that don't provide coverage would contribute to the UHM.

Edwards, John (Democrat): Create Health Markets, nonprofit purchasing pools that offer competing public and private plans. Establish a tax credit to help subsidize the cost of insurance purchased from Health Markets. Expand public insurance to cover more children and low-income adults.

Individuals "expected" to obtain coverage once cost becomes "affordable." Employers to provide or help fund coverage.

Gravel, Mike (Democrat): Create a universal health care program with vouchers issued to individuals by the federal government. Vouchers based on person's projected health care needs.  Phase out Medicare and Medicaid over time.

All persons would receive a voucher for their chosen plans. Employers not required to offer coverage.

Giuliani, Rudy (Republican): Give persons without employer coverage a tax deduction and low-income families a tax credit to subsidize premiums. Tax changes intended to shift millions from employer-based plans to individual insurance. No expansion of public plans.

No requirement to obtain or offer coverage.

Huckabee, Mike (Republican): Use tax deductions and credits to encourage people to buy private health insurance. Encourage the market to solve problems of cost and access. Opposed to universal federal coverage.

No requirement to obtain or offer coverage.

Hunter, Duncan (Republican): Increase competition in the private market by letting individuals buy coverage from any insurance company in the country.

No requirement to obtain or offer coverage.

Kucinich, Dennis (Democrat): Replace all existing private and public plans with a new, comprehensive universal public plan. Plan includes dental and long-tern care coverage. No deductibles or other forms of cost-sharing imposed. Supports HR-676.

All U.S. residents automatically enrolled in plan.

McCain, John (Republican): Remove the tax treatment of employer-sponsored plans and provide a tax credit to individuals ($2,500) and families ($5,000) to buy coverage. Promote competition among providers. Contain costs through payment charges to providers, tort reform and other measures.

No requirement to obtain or provide coverage

Obama, Barack (Democrat): Create a new public plan. Expand Medicaid and SCHIP. Create the National Health Insurance Exchange to enroll those without coverage into the new public plan or approved private plans.

All children must have coverage. Employers must offer "meaningful" coverage or contribute a portion of payroll to new public plan.

Paul, Ron (Republican): Provide tax deductions for all un-reimbursed medical expenses and insurance premiums.

No requirement to obtain or provide coverage.

Richardson, Bill (Democrat): Maintain existing coverage. Expand Medicaid and SCHIP. Create new coverage options that could be purchased through FEHBP and Medicare.

Eventually everyone would be required to have coverage. Employers required to provide insurance or help finance coverage for employees.

Romney, Mitt (Republican): Expand and deregulate the private market. Change the tax treatment of health insurance to provide subsidizes to low-income uninsured families. Promote state-based innovation.

No requirement to obtain or provide coverage.

Tancredo, Tom (Republican): Use market-based solution to expand coverage and to address other health care problems.

No requirement to obtain or provide coverage.

Thompson, Fred (Republican): Increase competition and consumer choice. Streamline regulations. Supports tax incentives to encourage individuals to buy coverage.

No requirement to obtain or provide coverage. HQX

Source: Henry J. Kaiser Family Foundation, 2008 Presidential Candidate Health Care Proposals

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