McCain’s Healthcare Plan: ‘Guaranteed’ Empty Rhetoric»

Yesterday, former Hewlett Packard CEO and McCain campaign surrogate Carly Fiorina had an enlightening interview with BlogHer touching on John McCain’s healthcare plan.

We’re all familiar with the rhetoric that is McCain’s proposal. When asked exactly how McCain would ensure that people, particularly children, were able to get healthcare, she had an answer we’ve never heard before: “guaranteed access.” Fiorina said:

[T]he combination of guaranteed access, tax credits, and a set of health care and health insurance options that are more affordable and more accessible will ensure that children have access to both health insurance and health care.

Listen to it:

Fiorina’s answer came in a question about children’s health care — namely, how would McCain ensure that parents use his tax break to pay for their children’s health insurance rather? Fiorina replied with particularly peculiar circular logic: McCain’s plan has “guaranteed access.”

Yet there’s nothing “guaranteed” about McCain’s health care plan. First, it would make it difficult, if not impossible, for people with preexisting conditions — including Sen. McCain himself, a cancer survivor — to obtain health insurance. Second, it would dismantle the system through which the vast majority of working Americans — and their families — get health coverage today, by ending employer-based insurance.

In fact, McCain’s vote against expanding SCHIP ensured that more children would be denied the very “guarantee access” the program promises. BlogHer should have asked McCain how he would guarantee access for uninsured American children whose parents are forced to decide between purchasing a private health insurance plan and paying off an inflated mortgage that keeps their child out of a homeless shelter.

Sorry, Carly. “Guaranteed access” is nothing more than empty health care rhetoric, like the rest of McCain’s health care plan.

Why McCain Scare Tactics On Health Care Are Dead Wrong»

Our guest blogger is Tom Daschle, former Senate Majority Leader and a Distinguished Senior Fellow at the Center for American Progress Action Fund.

Last week, Senator John McCain finally addressed an issue that progressive candidates have been advocating since the beginning of the election: comprehensive health care reform. But rather than offer real solutions to our health care crisis, Senator McCain has re-hashed failed Bush policies and embraced the tired rhetoric of the conservative right. Senator McCain has tried to brand progressive efforts to reform the health care system as nothing more than socialized medicine or “nationalized health care.” Senator McCain’s assertions are not only misleading, they are factually wrong.

Contrary to Senator McCain’s belief, providing universal health coverage does not require the nationalization of our health care system. Indeed, last month, an informative Frontline documentary examined several capitalist democracies with universal coverage systems that are not run by the government. Many of the issues raised in the documentary confirm my own conclusions that better quality care can — and is — being provided for less money in countries around the world.

While Senator McCain spends his time trying to debunk progressive efforts to provide affordable health care coverage to every American, our health care system continues to erode. This week, the Save the Children foundation released a report that ranked the United States 22nd in the world on women’s health, 28th on mothers’ health, and 33rd on children’s health – behind Poland, Slovakia and Latvia. Senator McCain and President Bush can take full credit for our dismal ranking on children’s health: both are outspoken opponents of the critically needed extension and expansion of the State Children’s Health Insurance Program.

Americans should be concerned about is that Senator McCain continues to promote failed Bush health care policies that would dismantle the employer-based health insurance system and shift people to the discriminatory individual insurance market. Health care reform is a priority of the American people, and progressives will work hard to make it reality.

For more, check out Center for American Progress’ new report: “The Specter of Socialized Medicine: What Is It and Is It Invading Our Country?”

Actually, Cato, McCain’s Health Care Plan Really Is That Bad»

An analysis of John McCain’s health care plan by Cato Institute’s Michael F. Cannon argues that “Sen. McCain’s plan is a lot better than his critics suggest.” We disagree. Here’s why:

Cannon argues that, contrary to Elizabeth Edwards’ claim that McCain’s embrace of the private market wouldn’t secure coverage for people with pre-existing conditions, “the individual market covers lots of people with high-cost medical conditions — so long as they purchased the insurance when they were healthy.” Not only that, but “those high-cost patients do not pay premiums that correspond to their health risk, and their coverage does not disappear when they change jobs.”

But Cannon, in his enthusiasm to defend McCain, overlooks some important facts:

McCain’s Plan Would Weaken The Ability Of Sick People To Keep Their Private Insurance: The main reason (not mentioned by Cannon) that some people who develop health problems can renew their health insurance without seeing higher premiums is federal regulation through the Health Insurance Portability and Accountability Act (HIPAA). States have improved on these regulations, offering more protections to sick consumers of private health insurance, but John McCain, in his push for an unregulated national market, would undermine these additional protections.

McCain’s Plan For The Uninsurable Is Woefully Inadequate: While only 5% of non-elderly Americans participate in the individual insurance market, 56 million chronically ill people are currently covered by employer-based health insurance plans, which can absorb the cost of these high-risk individuals because their pools are diversified. McCain would eliminate the tax incentive to keep these plans active, and nudge many of these folks into the private market where insurers would be reluctant to cover them. McCain’s answer? Dubious “high-risk” pools. Cato’s answer? Thoroughly debunked “Health Savings Accounts.”

There Are Better Alternatives That McCain Opposes: Cannon argues that McCain’s plan “provide more secure coverage of high-cost conditions than the current job-based system does” — but the way to provide the best security is a method which McCain adamantly opposes: offer a competing non-discriminatory, flexible alternative to employee based coverage by letting any American join a system like the one members of Congress use to get their insurance.

As the Des Moines register editorial board opined, McCain’s “dangerous experiment…should scare the heck out of the millions of Americans who rely on employer-based coverage.”

McCain’s ‘Main’ Health Care Concern Is Clearly Not ‘Cost’»

An LA Times piece today contrasts John McCain’s health care plan with the Democratic candidates’ plans by implying McCain is more concerned about health care “costs” while his opponents main concern is “coverage.”

But cost control and universal coverage are not mutually exclusive– they are inextricably connected. By neglecting the 47 million Americans without health insurance, McCain is neglecting one of the best ways to bring costs under control: universal coverage that reduces pricey, last-minute hospital visits by uninsured patients, lowers administrative costs, and encourages cost-effective preventive care.

Furthermore, McCain’s plan would increase the amount America’s families would spend on health care in a few key ways:

Eroding away the value of families’ health care tax benefit: McCain would eliminate the tax break for employee-based coverage, replacing it with a $2,500 tax credit for individuals ($5,000 for families) to help pay for private health insurance. Disturbingly, however, this credit will be pegged to general inflation instead of the price of premiums, the net effect being a “massive tax increase.“

Confusing cheaper coverage with lower costs: McCain wants to shift as many families as possible into an unregulated national insurance market where some people — particularly young, healthy people — may find coverage with enticingly low monthly premiums. But these attractive premiums would disguise, as Ezra Klein points out, “very high deductibles, lots of personal financial risk, and relatively sparse coverage.” After all, when insurance companies “cut costs,” they aim for one thing: denying as much coverage as possible.

Shifting struggling families into flawed, expensive “high-risk” pools: For unlucky families struggling with pre-existing conditions like cancer, heart disease or diabetes, McCain’s plan would offer a chance to buy into “high-risk pools.” Only trouble, these pools have many of the same draconian limitations as the unregulated private market: waiting periods, premiums that are out of reach for many families, substantial deductibles and co-pays, and limits on mental health and maternity care.

National Review Offers Weak Defense Of McCain Health Care Plan»

Our guest blogger is James Kvaal, Domestic Policy Advisor at the Center for American Progress Action Fund.

The National Review editors defend Sen. John McCain’s health care plan, disputing that it hurts people with existing illnesses. Today we learned that group includes Jay Cutler, who is healthy enough to be the starting quarterback for the Denver Broncos but also has diabetes.

So how will the McCain plan ensure that people with chronic illnesses can buy coverage? The National Review takes a pass on advocating the McCain campaign’s preferred solution, high-risk pools that subsidize last-resort insurance. Instead, it argues that people who buy their own insurance while healthy will no longer lose it when they change jobs.

Fair enough, but this line of reasoning leaves out the 56 million chronically ill people covered by their employers today. And while individual insurance is generally renewable, “premiums can still increase dramatically for people who develop health problems.” So buying insurance when you’re healthy doesn’t guarantee that you can keep it when you’re sick.

There is a better way to make sure that people can always buy the coverage they need: require insurers to sell to all comers at fair rates and create new subsidies to ensure that premiums are affordable.

McCain ‘Bold’ Solutions»

To top off his “Health Care Week” John McCain has released an ad entitled “Bold Solutions.” Watch it:

Here’s a little reminder of what those “bold solutions” entail:

• Boldly leave 56 million people with pre-existing conditions vulnerable in the private market
• Boldly threaten coverage for 158 million workers
• Boldly let insurance companies refuse coverage to folks with diabetes, heart disease, cancer, or dangerous jobs
• Boldly dole out a $2 billion tax cut for big insurance companies
• Boldly raise taxes on some families who buy health insurance
• Boldly propose a plan that costs $3.6 trillion over 10 years, over double what Clinton’s or Obama’s cost
• Boldly rely on expensive, debunked methods to only partially cover the poor and uninsured
• Boldly slash funding for hospitals that serve the uninsured without a plan for universal coverage
• Boldly deny coverage to a 9-year-old child with a cleft palate

McCain’s Health Plan, Like Bush’s, Slashes The Uninsured’s Hospital Safety Net»

Douglas Holtz-Eakin told the New York Times that, to attempt to cover people who fall through the (rather substantial) cracks in his health care plan, McCain would help pay for state “high-risk pools” by redirecting money “from existing federal programs that pay for uncompensated medical care, primarily in hospitals.”

Translation: Holtz-Eakin wants to eliminate some portion of the $7.8 billion in federal support for “Disproportionate Share Hospitals,” or DSH, which serve especially high numbers of poor and uninsured patients. This money is “the largest source of federal support for uncompensated care for uninsured patients.”

States across the country have used DSH money to provide “essential funding to many safety net hospitals” and “maintain access to health services for low-income patients.” States are already fighting back against Bush’s proposed sweeping cuts to Medicaid and changes to health regulations that shift costs to state and local governments, and John McCain is offering more of the same.

As a study by the National Health Policy Forum concludes, “in the absence of a viable plan to broadly expand health insurance coverage, support for providers that serve low-income patients will become increasingly critical.” But John McCain’s plan would leave millions of Americans without health insurance, so his disregard for DSH funds is a bit disturbing. Read the rest of this entry »

McCain’s Health Care Spending Doubles Obama And Clinton»

The New York Times today did a good job pointing out that some people “could” pay more in taxes under the McCain plan. But the reality is that there is growing evidence that McCain has a massive new health tax as part of his plan, as this blog first discussed earlier. While the press typically portrays Democrats as the tax-and-spenders, McCain is on the verge of changing that paradigm with a plan that could have American’s spending $334 billion more in taxes over 10 years.

McCain’s advisors have confirmed that the spending under his tax credit plan is $3.6 trillion over 10 years, roughly the same amount that the Joint Committee on Taxation estimated would be spent by President Bush when he announced a similar policy. In the first year, the JCT estimated that the Bush policy would spend $220 billion in the first year.

This means the McCain’s spending on health reform is twice the price tag as Senators’ Clinton plan and Senator Obama’s. (Note: Senator Obama only describes his plan’s costs net of savings, but the Washington Post has published a cost estimate.)

Not only is the spending level very different between the Democrats and McCain, but the sources of funds vary as well. McCain would roll back the longstanding tax break for all 160 million Americans who obtain insurance through their employer. In contrast, the lower spending Democratic plans pay for health reform by rolling back President Bush’s tax cuts on the highest income Americans. Read the rest of this entry »

Is The McCain Health Care Plan A Massive Tax Increase?»

Our guest blogger is James Kvaal, Domestic Policy Advisor at the Center for American Progress Action Fund.

We’re halfway through health care week for the McCain campaign, with speeches in five states. But one critical question remains unanswered: how does the value of the credit change over time? If it grows slower than health care costs – as does the Bush plan it was modeled on – it would be a huge tax increase over time.

Sen. McCain has proposed a massive tax shift. He would end the tax break for health benefits that workers get from their jobs – a $3.6 trillion tax increase over the next decade. Then he’d redirect those resources into new tax credits worth $5,000 per family in the first year. The change would be a tax cut for some families and a tax increase for others.

The McCain campaign has not released a lot of details, particularly for such an important proposal. But we know more about the model for the McCain plan, a very similar Bush Administration proposal. (Bush’s proposal created tax deductions, but his aides said it was equivalent to a $4,500 credit for families. Adjust for rising health costs and you basically have McCain’s plan.)

The Bush plan capped the growth of credits at the rate of inflation (expected to be about 2 percent a year). That is much slower than current tax benefits, which grow with premiums (about 6 percent a year).

For Bush, capping the growth of tax benefits has two advantages. It makes the numbers work: the plan has a large initial cost that is slowly recouped over time as the tax cut turns into a tax increase. Second, as Ezra Klein notes, it drives families into cheaper coverage that will make them pay more for health care and therefore use less of it.

But this isn’t such a good deal for families. It’s more like a Trojan Horse: a tax increase disguised as an initial tax cut. The slower growth adds up to a 30 percent cut after 10 years and a 50 percent cut after 20 years.

So here’s my question: does the McCain proposal also limit health care cost growth? If so, it will soon become a massive cut in support for families’ health coverage costs.

UPDATE: In today’s New York Times, Kevin Sack and Michael Cooper observe that McCain’s plan “would have the effect of increasing tax payments for some workers.” Sack and Cooper note that even middle-income workers with conventional coverage could pay more over time, depending on how the tax credits are adjusted for inflation.

UPDATE II: Over at Swampland, Karen Tumulty confirms with Douglas Holtz-Eakin that the tax credit’s growth is limited to the inflation rate.