Gore Pledges Action on Health Insurance : Campaign: He vows to close gaps and cover every child in America by end of first presidential term. He speaks twice in O.C. today.

Building on the incremental solutions pushed by President Clinton since the failure of his vaunted health care overhaul, Vice President Al Gore vowed Tuesday to insure every child in America and to fill the health insurance gaps straddled by their parents, all by the end of a first presidential term in 2005.

The vice president said he would expand an existing federal-state program that helps provide health insurance and offer it to children whose parents make about $41,000 to support a family of four. That amount is 250% of the federal poverty level, up from program’s current income target of 200% of the poverty level, or about $33,000 for a family of four.

That program--the Children’s Health Insurance Program, created in 1997--uses federal and state money to help insure children. Members pay according to income and family size, and most are signed up through health maintenance organizations. Nationwide, about one child in 10 does not have health insurance.

Gore’s proposal also would allow the uninsured parents of children who qualify for the Children’s Health Insurance Program--or for Medicaid, insurance for the indigent--to buy insurance at reduced rates, thus lessening the numbers of uninsured working parents.

Backs Medicare Expansion Plan

He also backed a proposal already advanced by Clinton that would enable Americans ages 55 to 65 to buy into Medicare, in effect expanding access to one of the fastest-growing segments of the uninsured population.

“Taken together, these steps will make health care affordable for millions of Americans who can’t afford it today,” Gore told an audience assembled at Childrens Hospital in Los Angeles. “They will move us toward the day when every American has access to affordable, quality coverage.”

Gore was silent on the question of how he would finance a program that could easily reach into the multibillion-dollar range. Spokesman Chris Lehane said that would be detailed later.

“It’s all going to be done in the context of a balanced budget,” Lehane said.

The broad plan Gore outlined Tuesday offered something for nearly everyone: Small business owners would win greater access to cheaper pools of insurance, and the self-employed or those without insurance at work would get the same tax break as businesses on health insurance costs. The disabled would be able to keep Medicaid or Medicare coverage when they return to work--instead of losing them and being denied private coverage because of preexisting conditions.

Health care advocates and policymakers had mixed reactions to Gore’s proposals, although most lauded him for tackling what many believe to be the largest health care problem facing the country, the 43 million Americans not covered by indigent care, private insurance or employer health plans.

“The biggest gap in coverage is adults and this is an efficient way to begin to reach them,” said Judy Feder, dean of policy studies at Georgetown University and a contributor to Clinton’s failed 1993-94 health care reform plan.

E. Richard Brown, director of the UCLA Center for Health Policy Research and a professor at the UCLA School of Public Health, said that while helpful, Gore’s program would not solve the problems of most uninsured Americans.

California’s Legislature recently killed three bills that would have expanded eligibility for government insurance programs to those at 300% of the poverty level--far above Gore’s proposal--and would have applied to parents as well as children, as Gore’s would. Even then, only 2 million of the 7 million uninsured Californians would have been eligible, Brown said.

“It sounds like a number of interesting and useful small pieces which will help states expand [coverage] if they want to,” Brown said. “But it still will leave probably the largest segment of the uninsured population out in the cold.”

The bigger problem is adults who make too much money to qualify for assistance programs but cannot afford premiums for private insurance. While Gore dealt with that issue by offering individuals a 25% tax credit for health insurance costs, Brown said that most people cannot come up with the up-front money.

Gore advisors acknowledged that the plan unveiled Tuesday is somewhat limited, saying it would help about 11 million to 15 million people, some of whom are already eligible for the existing Children’s Health Insurance Program.

The impact in the states would be mixed, according to health care analysts. California, where access to health care has recently been broadened, would feel less impact than most.

This state expects to cover children in families at 250% of the poverty level--Gore’s proposal--by next month. The children’s program here goes under the name of Healthy Families.

Surpasses Other Candidates on Details

In terms of details, Gore easily advanced beyond the rest of the presidential candidates, who largely have spoken sympathetically about the plight of the uninsured but left specifics for later.

His Democratic primary opponent, former New Jersey Sen. Bill Bradley, has said only that he would press for universal health care. He said Tuesday that he would soon offer proposals that make clear “that the vice president and I have a different approach to the fundamental health care issues facing America.”

Scott McClellan, a spokesman for Texas Gov. George W. Bush, criticized Gore’s proposal as “the kind of big government solution” that Gore and Clinton “consistently embrace.”

Gore’s plan is a model of the centrist approach that Clinton endorsed after his more radical health care plan was blasted by nearly all sides in 1993-94.

Gore took pains to avoid comparisons with Clinton’s doomed effort, which was quarterbacked by First Lady Hillary Rodham Clinton.

Neither was mentioned by name, but Gore clearly alluded to the fiasco. “This is a fundamentally different approach,” said Gore, not saying to what he was comparing his effort.

Gore is scheduled to address the American Legion Convention at the Anaheim Convention Center at 9 a.m. today, then will attend an Orange County Democratic Foundation luncheon at the Disneyland Hotel.