Bush Health Plan Called ‘Political Vehicle’

The medical plan President Bush will put forward today is intended by his political advisers as a fire wall to ward off rival Democratic proposals and has little chance of passage this year, White House and campaign officials say.

The package is meant almost entirely to serve political ends in an election year in which Bush already has sought to portray Democrats as bent on replacing the private health care system with an unwieldy government one.

As an indication of where the plan stands on Bush’s agenda, details of the proposal were kept out of Bush’s 1993 budget proposal so they could be introduced in Cleveland today with more fanfare but less formal White House commitment.

“I don’t think it’s a winning issue,” one senior Bush campaign official said, “but it gives us something to hold up against the Democrats and (their) national health (plan).”

A senior White House official emphasized that Bush is “serious” about his health care proposal but acknowledged that the Administration is unlikely to get it through Congress. “If we can’t,” the official said, “it’s a good political vehicle.”

Political insulation against far-reaching Democratic proposals for universal coverage has been a top Republican priority since last November, when Sen. Harris Wofford upset former Atty. Gen. Dick Thornburgh in Pennsylvania. In that special election the issue seemed to catch fire with voters.

The Bush package assembled since then marks a major departure from past Republican policy in its embrace of the principle that low-income and middle-income families without health insurance should get tax breaks to help them afford coverage.

The details of the plan also reflect what Administration officials have described as a deliberate effort to avoid antagonizing key blocs of support. The plan depends for financing on proposals unlikely to bear up under congressional scrutiny.

Rather than offend voters, for example, the White House appears to have scrapped an Office of Management and Budget proposal to limit the deductions high-income taxpayers with expensive health care plans could claim.

That proposal was regarded by the Administration’s health care experts as crucial to steering Americans toward less costly health care management plans. But it ran into strong opposition from officials concerned that it would unnecessarily anger likely Republican voters.

“It was good health care,” one senior Administration official said of the plan, “but there were lots of people who thought it was bad politics.”

Instead, to help needy families pay for health insurance, the White House plan would rely for most of its revenue on capping increases in payments for Medicare and Medicaid--a plan that congressional Democrats have rejected before. The proposal was designed, in part, to offend the fewest possible voters.

The main feature of the Bush proposal is tax credits of $3,750 for needy families and tax deductions of the same amount for middle-income taxpayers who must buy their own insurance.

Congressional sources said the White House, to avoid giving an impression that its plan would subsidize the insurance industry, would require insurers to offer two types of policies. Any company wanting to sell insurance would be required to offer both a standard policy and another type, aimed at the working poor, with minimal deductibles and co-payments.