Gore Assails Bush on Health Care, Seeking to Capitalize on Issue

It worked for him once and Vice President Al Gore hopes it will work again: Voter concerns about health care proved to be sufficiently potent to help him nail down the Democratic presidential nomination.

Now he is trying to use it to win the presidency.

Gore’s efforts have two components: to boost his own plan while drawing attention to the Republican failure to produce a health care plan as detailed as his.

“It’s kind of put-up-or-shut-up time,” the vice president said to reporters aboard Air Force Two on Monday evening, shortly after he talked to seniors in Florida about the issue. On Tuesday, speaking to young families seated on colorful blankets and lawn chairs at Rio Bravo Park here, Gore stepped up his pitch, calling on GOP rival George W. Bush to detail how he would provide health coverage for the 11 million children without it.

“What Gore is trying to do is show Bush hasn’t been that serious” because he has not yet offered a detailed health care plan, said Bob Blendon, a professor of health policy and political analysis at Harvard University. “The more the vice president talks about this, the more he reminds voters that he’s standing on an issue that they think he’s likely to be better on than Bush.”

Even though voters may not recall the details of the candidates’ programs, “what they focus on is whether the candidate is serious on the issue,” he added.

The Republican campaign has scoffed at Gore’s criticism that Bush is not committed to health care. But the Texas governor did offer a few new policy details this week, and he promised to announce a plan for adding a prescription drug benefit to Medicare by next week.

“Of course, it’s an important issue,” Bush told reporters Tuesday. “I’ve been talking about health care since the primaries. I’ve got a plan for the working uninsured. I’ve been talking about Medicare ever since I got started in the campaign, and I’m going to continue talking about Medicare. He may not like what he hears, but I’m talking about it.”

Gore’s attack on his opponent’s health care record and proposals has a familiar ring to it. He used it throughout the autumn and winter to dispatch his rival for the Democratic nomination, Bill Bradley.

The vice president built his attack against Bradley on the charge that the former New Jersey senator was trying to do too much too quickly and thus risking the same sort of health reform failure that doomed the Clinton administration’s early efforts. Now he is accusing Bush of doing too little and challenging him to do more.

“I came to the South Valley today to give you the specifics of my proposal to expand health care coverage to every child in America within this next presidential term and to expand coverage to the parents of those children up to 2 1/2 times the poverty rate,” the vice president told his audience here Tuesday.

He continued: “I hope that my opponent will also present to you specifics of how he would address the problem of children who do not have health coverage today. . . . There is still time, even before Labor Day, to offer these specifics.”

Neither the voting public’s interest in health care nor the issue’s political effectiveness against Bush can be overstated, in the view of Democratic strategists. Along with education, health care goes to the heart of the concerns raised by this year’s most sought-after voters: women lacking college educations who are struggling to hold families together. These women are often responsible for making sure the family’s education and health care needs are met.

And as a political issue, health care is effective because it is universal.

“Everybody knows this issue. You don’t have to teach anyone,” said one Democratic strategist in Washington. “Everyone over 50 understands this because they are either using prescription drugs or have parents in that age where they’re taking 19 different drugs for 14 ailments.”

As if to illustrate the point, there in Rio Bravo Park was Noah Austin, a toddler who broke his leg one week after his parents lost their health insurance. His care was provided by the Children’s Health Insurance Program, supported by both President Clinton and many Republicans in Congress, and which Gore would expand.

Throughout the campaign, the vice president has stressed the need to provide health insurance to all children, offering it as a first step in ensuring health care for all Americans.

“We need to cover every single child within this next presidential term,” he said. “Every single child in every family ought to have health care--good, high-quality health care. Every child.”

Gore’s campaign argues that Bush has yet to present a comprehensive, detailed program to cover poor children. Bush’s principal proposal has been for a tax credit that low-income families could use to help purchase health insurance. But Democrats and many independent analysts say it won’t provide benefits sufficient to cover the cost of even stripped-down plans now available.

“The issue here is much sharper than it was in the primary because the contrasts are much sharper,” the vice president’s spokesman, Chris Lehane, said. “Gore has a health care plan. The governor does not have a health care plan. Nada. Zip. Zero. Nothing.”

Gore’s model, the Children’s Health Insurance Program, which was established in 1997 after the failure of Clinton’s effort to overhaul the nation’s health care system, matches with federal money the funds provided by states to pay for health insurance for children in families with an annual income of up to 200% of the poverty level. Gore would raise that level to $250% of the poverty level, or about $41,000 for a four-person family. This would add nearly 1 million children to the program.

The vice president would also allow working families to buy into coverage under this plan or under Medicaid, expanding the coverage to an estimated 7 million working parents.

In addition, Gore would offer states bonus payments and other incentives to improve enrollment of children in the program. He would penalize them if they fall behind.

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Times staff writers Ronald Brownstein in Albuquerque and Maria L. La Ganga with Bush in Maine contributed to this story.