Reform Proposals of Presidential Candidates
Senator Hillary Clinton
(D-New York)
www.hillaryclinton.com
The following is a summary of Senator Clinton's health care reform
proposals and priorities. Reprinted with permission from the Council
for Affordable Health Insurance.
Probably one of the most knowledgeable Democratic presidential
candidates with regard to health care reform, Hillary Clinton has
been slow to release her plan, no doubt in part because of all the
criticism she received in her earlier effort to reform the U.S. health
care system in 1993-4. On September 17 she unveiled her new proposal,
the “American Health Choices Plan.” According to The
Associated Press, Clinton says her plan would cost $110 billion
a year, and like some other Democratic candidates she proposes to
pay for her plan in part by eliminating “some of the Bush-era
tax cuts for people making more than $250,000 per year.” However,
even though there was a fair amount of media promotion for the release,
she did not reveal much more than had been previously reported. In
her plan she would:
-
Enact “universal coverage” by requiring
everyone to have health insurance coverage (known as an “individual
mandate”). They could get that coverage from the government
or their employer or by paying for it out of pocket.
-
Consider making employers automatically enroll employees
in health insurance and withhold part of their salaries to pay for
it.
-
Build on the existing employer-based health care
system. Employers could continue to provide health insurance coverage
to employees, and if they don’t they would be required to contribute
to a government-run pool (employer “play or pay”).
-
Provide a small business tax subsidy to help small
employers (perhaps with 25 employees or fewer) pay for health insurance
for their employees.
-
Prohibit health insurance companies from declining
an application, regardless of the applicant’s health condition
(i.e., guaranteed issue). That means prohibiting pre-existing condition
limitations.
-
Require minimum loss ratios for insurers (which
means insurers must pay out in claims a specific percentage of premiums
collected).
-
Prohibit insurers from charging large premium differentials
based on age, gender or occupation (known as “community rating”
or “modified community rating,” depending on how strict
the limitations are).
-
Expand Medicaid and the State Children’s Health
Insurance Plan (SCHIP).
-
Provide insurance alternatives for individuals who
do not have health insurance coverage, as well as a tax credit to
help pay the premium. Individuals may choose from two expanded versions
of existing government health care programs: Medicare and the Federal
Employees Health Benefits Program.
-
Emphasize computerized medical record-keeping.
-
Allow the federal government to negotiate prices
directly with pharmaceutical companies under the Medicare prescription
drug benefit (which probably means she wants the government to set
the price), and seek to eliminate inefficiencies and exorbitant
costs in the program.
-
Emphasize prevention of disease rather than cure
— particularly the need to address the obesity issue in this
country.
-
Improve quality by promoting physician-certification
programs.
-
Increase Medicare reimbursement rates for doctors.
-
Spend $300 million to expand nursing school enrollment
and establish mentoring programs to encourage more minorities to
enter nursing.
-
Provide patients with more treatment options.
-
Overhaul the current reimbursement system that she
says punishes doctors for spending more time with patients or those
who use a team approach and coordinated care.
-
Encourage state and local governments to enact smoking
bans in public areas.
-
Seek to reduce long-term care costs and regulate
the business practices of long-term care insurance carriers.
-
Increase federal regulation of health insurance
companies and encourage states to implement additional rules on
top of the federal rules.
-
Improve federal efforts to prevent the spread of
HIV/AIDS in the U.S. as well as worldwide. Provide at least $50
billion for HIV/AIDS programs worldwide by 2013 and $5.2 billion
for HIV/AIDS research at NIH.
