September 17, 2007

ClintonCare = CaliCare?

Hillary Clinton laid out her health care proposal today, and given her history with the issue, the plan will clearly draw some intense scrutiny in the days and weeks ahead. But the first thing I noticed was how similar it looked to the conceptual outline of a plan for California that could emerge from the negotiations between Gov. Arnold Schwarzenegger and the Democratic legislative leadership.

Clinton's plan includes an individual mandate, an employer mandate, a requirement that insurers sell policies to anyone who applies without regard to pre-existing conditions, community rating regulations, a new risk-sharing pool, subsidies and tax credits for the working poor and new taxes, in Clinton's case on people earning more than $250,000 a year. She even uses the phrase "shared responsibility" -- a favorite of the governor's -- to describe the financing of her plan.

Clinton is taking a risk in proposing the individual mandate, but she's also trying to sell the proposal as one that enhances choice for consumers by letting everybody buy into a pool that would offer the same benefits now available to federal employees. Consumers would choose from a menu of private plans with different benefit packages, providers and costs. She would also offer a publicly managed plan along the lines of what Medicare offers now, which she says would be cheaper because it would have lower administrative costs than private plans. Her proposal for a national pool, while optional for consumers, and her "Medicare for all" option clearly go further in terms of expanding government's role than anything contemplated in California -- other than SB 840, the single-payer model that Sen. Kuehl shelved in the Legislature this year.

Posted by dweintraub on September 17, 2007 1:23 PM