Bradley Proposes $65-Billion Lifelong Health Care Plan

Bill Bradley unveiled a far-reaching $65-billion health care plan Tuesday that would require parents to insure all children at birth and abolish Medicaid, making the federal government, and not the states, responsible for the health care of America’s poorest residents.

Bradley’s plan--a year in the making--envisions birth-to-death health care coverage in three stages: guaranteeing care for every child in America, subsidizing care for working poor adults and helping senior citizens who have catastrophic and chronic illnesses pay for prescription drugs. And he would do it, he said, without creating huge new bureaucracies.

“In 1994 President Clinton sought to provide health insurance for all Americans. That attempt failed,” Bradley said in a 30-minute address to 500 students and supporters at Los Angeles Valley College in Van Nuys. “It is time to try again--but in a different way.”

Bradley’s health care reform plan represents the Democratic presidential candidate’s first effort to clothe his broad campaign promises with details. But the plans still are sketchy; they will continue to evolve, the former New Jersey senator said.

The plan, which he figures will extend benefits to 95% of the 45 million Americans without medical coverage today, would be paid for with surpluses from the federal budget and would not dip into funds for Social Security. But where the money would come from in the event of an economic downtown is unclear.

All Americans deserve “the helping hands to a productive life, whether they are the hands of family members or the hands of that extended family of all Americans helping each other,” Bradley said. “You can call that extended family government if you like, but government is, after all, just the people.”

And how would he enforce his requirement that all parents enroll their children in some form of medical insurance until age 18? He doesn’t know yet. Noting that “we can’t drive a new car home from an auto dealership without signing up for insurance,” Bradley said that we must “trust in the basic goodness of the American people” to provide care for their children when they are given the means.

In its basic political strategy, the Bradley plan is similar to a health care blueprint unveiled by Vice President Al Gore at Childrens Hospital in Los Angeles during a campaign swing earlier this month. But Bradley makes a more expansive commitment to providing access to the uninsured--raising questions about both price tag and political feasibility.

Dr. Alan Garber, director of the Center for Health Policy at Stanford University and a Bradley supporter, called the plan an effort “to strike a balance between what’s ideal and what’s achievable.”

But Gore aides immediately charged that Bradley will not find enough money in the federal surplus to cover the plan’s cost without slashing domestic spending or cutting into the money Clinton wants to set aside to stabilize Medicare, which provides medical benefits for Americans 65 and older.

“At that rate of extra spending, you can’t guarantee Medicare solvency,” said Elaine Kamarck, Gore’s chief issues advisor.

Bradley conceded that $65 billion is a lot of money, but he also took an oblique slap at Gore, who has proposed what Bradley called a “definitely timid” health care plan. Nor has Gore revealed its costs. “A campaign proposal without a price tag,” he said, “is just another politician’s promise.” At that, the audience broke out in applause.

Unlike Clinton’s failed plan to overhaul the health care system, neither Gore nor Bradley would require employers to provide coverage to their employees, nor would they impose any new federal cost constraints on the health care industry.

As a result, the small business and health insurance groups that helped defeat the Clinton plan would have much less incentive to oppose these proposals.

Under the Bradley plan, the government would pay the full premium to the health care plan selected by parents of children in households with incomes under $32,800 for a family of four.

Partial premium subsidies would be provided for children in households with incomes up to $49,200.

To increase access to health care for adults, Bradley would allow all Americans to participate in the Federal Employees Health Benefits Program, the same insurance program provided for members of Congress and 9 million federal workers.

Insurance for all adults in poverty and all current Medicaid participants would be fully subsidized. Those in households with incomes from $16,400 to $32,800 would receive partial subsidy. The federal government defines poverty as a family of four making less than $16,400.

In addition, taxpayers would get a break to make the insurance more affordable, because the Bradley plan would exclude premium payments from taxable income. The tax break would be similar to that available to workers who have employer-provided insurance.

Bradley campaign officials said that the Medicare prescription benefit for senior citizens, while optional, is far broader than that proposed by Clinton. Under the Bradley proposal, those who chose the coverage would pay a $500 deductible, a $25 monthly premium and 25% of the cost of the drugs, which would be generic medications whenever possible. There would be no cap on prescription spending.

Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, questioned whether the subsidies for low-income workers would encourage low-wage employers now providing health insurance to drop it--on the theory that the government can simply pick up the tab.

Rowland also worried that the absence of cost-containment provisions will lead to soaring federal costs as premiums rise over time. “When I look at it, it’s got a lot of promise, but it’s got a lot of problems, “ she said.

But some analysts gave Bradley high marks for forcing the issue of the uninsured back toward the center of the presidential debate--while pointing out that a plan this costly could be difficult to pass into law.

Ronald Pollack, executive director of the liberal advocacy group Families USA, notes that this political calculation marks the key difference between the Gore and Bradley proposals.

“The Bradley plan is designed to cover more people, and of course, that’s very good,” he said. “The Gore plan builds on existing programs and may be easier to enact into law. Philosophically, they are both very similar. . . . It’s a matter of scope and political practicability where they are competing with one another.”

In the last several weeks, Bradley has surged in a few states, notably New Hampshire and New York.

But he remains far behind Gore in California, where a Field poll taken last month showed the vice president leading by a nearly 3-to-1 margin. The poll also showed that Gore did slightly better than Bradley against Republican front-runner Texas Gov. George W. Bush in head-to-head matchups.

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Times staff writers Cathleen Decker and Massie Ritsch contributed to this story.