Health Care Proposal Aims to Offer Insurance for All

Two key lawmakers on Thursday unveiled a $24-billion-a-year plan to contain soaring health care costs and provide basic medical insurance to the estimated 33 million Americans who now lack it.

The legislation, sponsored by Rep. Henry A. Waxman (D-Los Angeles) and Sen. John D. (Jay) Rockefeller IV (D-W.Va.), embraces far-reaching recommendations made last year by a bipartisan commission named after the late Rep. Claude Pepper (D-Fla.).

The two lawmakers said they eventually will introduce a second bill dealing with a related, even more-expensive problem--insurance to cover long-term health care. That could cost an additional $43 billion a year, if the legislation also follows the Pepper Commission blueprint.

The Waxman-Rockefeller measure to guarantee basic health benefits for everyone faces tough obstacles, including expected resistance from the Bush Administration and small business and the prospect that a tax increase might be needed to help pay for the plan.

But the move by two leading liberals on health policy, coming soon after the conservative American Medical Assn. presented a comprehensive reform plan, should give fresh momentum to the long search for solutions to the billowing health care problem.

Waxman, chairman of the House Energy and Commerce subcommittee on health and the environment, said he hopes the new proposals will spur President Bush to present a plan of his own.

“The biggest gap in our ability to move legislation into law is the failure of the Bush Administration to be engaged on the issue, to even recognize that there’s a problem,” Waxman said at a joint news conference with Rockefeller.

Rockefeller, who chaired the Pepper Commission and heads the Senate Finance subcommittee on long-term health care, said his proposal on basic insurance coverage seeks to correct the failings of the present system while also building on it.

He warned that if federal officials, the insurance industry, employers and health providers cannot agree on something close to his commission’s plan, an angry public will rise up and demand a national health insurance system costing more than $220 billion a year.

Rockefeller said he has “no philosophical disagreement” with such a federally operated system. But, he added, the 33 million people who are now uninsured should not have to wait a decade for relief.

The core of the Waxman-Rockefeller bill is a “pay-or-play” requirement for employers. Businesses either would have to purchase basic health coverage for workers from a reformed private insurance market or they would have to pay into a public insurance pool that provides coverage.

Individuals and families who are not in the work force would be able to enroll directly in the pool, which would be financed by both private and public funds. The pool also would replace the present Medicaid system, helping low-income people meet premium and cost-sharing expenses.

To help small businesses provide basic coverage, the legislation would offer federal subsidies and tear down barriers that have prevented restaurants, coal mines and other concerns from obtaining insurance.

“It is time now, folks, to stand up to the insurance industry and to say that enough is enough--our people deserve health insurance,” said Rockefeller, the heir to an oil fortune who is exploring a run for President in part on populist themes.

The legislation aims to control rising medical costs by permitting all private payers, including employers and health insurers, to use Medicare payment rates in purchasing hospital and physician services.

Waxman called for financing the $24-billion-a-year federal tab with a surtax on personal and corporate income taxes. Rockefeller said he would provide the Senate Finance Committee with a list of six funding options.

“This bill will cost money,” Waxman acknowledged, “but it’s money well spent if it provides protection for the millions of working people who are now without insurance. . . . We also must recognize that there is a very high price for doing nothing and for failing to control health costs.”