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Obama calls for a national health plan, mandatory coverage for children
Proposals also include making national health coverage more accessible and transparent.
 Barack Obama Image: Obama for America |
The centerpiece of Democratic presidential candidate Sen. Barack Obama’s health care platform is the creation of a national health plan and a new agency to help individuals purchase private health plans.
“We now face an opportunity – and an obligation – to turn the page on the failed politics of yesterday’s health care debates,” Sen. Obama said in a speech posted on his Web site. “My plan begins by covering every American.”
Sen. Obama’s health care platform also includes keen oversight of the health insurance industry, prescription drug reforms, cost-saving strategies, increased medical research and disease prevention.
Thomas Gustafson, PhD, senior policy adviser at the Washington, D.C., law firm Arnold & Porter LLP, described the Obama health care plan as an ambitious but incremental blueprint for health care reform.
“Sen. Obama’s plan is a carefully constructed agenda of discrete policy initiatives aimed at many of the problems of America’s health care,” Dr. Gustafson said in an e-mail interview. “It involves a number of more-or-less incremental changes, building on existing structures and improving them. While it is less sweeping than some previous attempts at reform, such as that of the early Clinton administration, overall its claims are still very ambitious. One may fairly question whether all parts of the plan would be likely to be enacted as Sen. Obama proposes them. However, his incremental strategy can give a decent chance of improving our health care system.”
Universal health coverage
To cover the uninsured, Sen. Obama’s proposal calls for a national health plan with benefits that are similar to those available to members of Congress, according to the Obama Web site.
Workers would be allowed to keep their employer-provided coverage, the campaign said.
“If you already have health insurance, the only thing that is going to change for you under this plan is the amount of money you will spend on premiums,” Sen. Obama said in a video posted on the Web site. “That will be less than you are spending now.”
The national health plan would include subsidies for individuals and families who do not qualify for Medicaid or the State Children’s Health Insurance Program (SCHIP). The income-based subsidy would help subscribers buy into the national public plan or purchase private plans.
A National Health Insurance Exchange would help individuals who want to purchase private insurance plans. Participants in the exchange would be able to change jobs with no risk of losing their coverage. Those who sign up for the national health plan or private insurance would not be rejected because of pre-existing conditions or other restrictions, according to the Web site.
Also, employers that already offer health coverage would pay lower premiums because the health care costs of the uninsured would not be passed to those who have insurance.
The Obama plan includes mandatory health coverage for all children and calls for allowing young adults to continue coverage on their parents’ health plans through age 25. Parents would receive assistance in signing newborns up for employee-sponsored coverage, Medicaid, SCHIP or any other program that is established, the Obama site said.
An Obama administration would expand eligibility requirements for the Medicaid and SCHIP programs.
Federal income tax cuts for Americans earning more than $250,000 per year are scheduled to expire, providing revenue that would cover the national health plan. Savings throughout the health care system would provide additional funding for the plan, according to the Obama site.
Insurance reform
The National Health Insurance Exchange would also act as a watchdog group that creates rules and standards for participating insurance and makes coverage more accessible and affordable. Insurers would be required to justify above-average premium increases. The exchange would publicize differences between insurance plans, according to the Obama Web site.
Employers that do not offer or make a significant contribution to employees’ health coverage would be required to contribute a percentage of paid wages toward the costs of the national health care plan. Small businesses would be exempt from this requirement and receive a refundable tax credit of up to 50% on premiums paid by those businesses for their employees.
“This new credit will provide a strong incentive to small businesses to offer high quality health care to their workers and help improve the competitiveness of America’s small businesses,” according to the Web site.
Cost-saving and efficient
Proposed cost-saving measures include requiring health care providers that participate in the national health plan, Medicare or federal employee health plans to use proven disease management programs, the campaign said.
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To improve health care quality, the Obama plan would require providers to report preventable medical errors. An independent institute would be established to provide physicians and patients with information on the effectiveness of various treatment options.
Other cost-saving proposals include rewarding physicians participating in federal programs for meeting outcome-based performance benchmarks, according to the Obama campaign.
To make health care more cost- efficient, the Obama plan calls for the investment of $10 billion annually over 5 years to spur the implementation of secure, standards-based electronic health records and other health information technology.
On prescription drugs, the Obama plan calls for allowing Americans to purchase drugs from other developed nations provided those products are deemed safe and prices are lower outside the United States. Also, the plan calls for increasing the use of generic drugs in federal health care programs.
Other initiatives
Other health care initiatives proposed in the Obama plan include increased funding for medical research, medical education and training in health-related fields. The plan also calls for improving mental health care, preventing lead poisoning, reducing mercury poisoning and increasing funding for autism research, according to the Obama campaign.
The plan calls for requiring child care facilities to reduce lead levels within 5 years. Sen. Obama supports more than $1 billion in federal funding for autism research, the Obama campaign said.
Sen. Obama pledged to ensure that disabled Americans receive Medicare and Medicaid benefits “in a low-cost, effective and timely manner.”
He and Sen. Ken Salazar, D-Colo., urged the Department of Health and Human Services to provide clear information on the Medicare prescription drug benefit and to ensure that Medicare recipients are protected from fraudulent marketing schemes, according to the Obama Web site.
For more information:
- Thomas Gustafson, PhD, can be reached at Arnold & Porter LLP, 555 Twelfth St. NW, Washington DC 20004-1206; 202-942-6570; e-mail: Tom.Gustafson@aporter.com.
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