TOPICS > Health

Teaming Up?

January 20, 2000 at 12:00 AM EDT

MARGARET WARNER: Extending health insurance to the nation’s 44 million uninsured got a boost yesterday from two players who have hardly been allies in the past. First, President Clinton proposed spending $110 billion over ten years to expand the children’s health insurance program, known as CHIP, to cover more poor children; insure the parents of poor children now covered by CHIP or Medicaid; give workers between 55 and 65 a 25% tax credit to buy into Medicare; and give out-of-work Americans a tax credit to pay for coverage in their former employer’s health care plan through the so-called COBRA program. The president was asked about the prospects.

REPORTER: What makes you think that you can get a more expansive health care program through Congress this year than you were able to get through last year?

PRESIDENT CLINTON: I believe if you just look at what’s going on in the election season this year, the public cares a lot about health care, and they’re talking a lot about it. And all these people, without regard to their party, who come here in Congress, they’ve been home talking to the people they represent, they’ve been listening to this. They know what their folks are up against, they know what kind of problems people face with long-term care.

MARGARET WARNER: Also yesterday, the Health Insurance Association of America, the trade group that helped defeat President Clinton’s 1993 health care plan, issued another in its series of “Harry and Louise” television ads, with a very different twist.

MAN IN AD: News on the Web?

WOMAN IN AD: 44 million Americans without health insurance.

MAN IN AD: That’s huge, an epidemic.

WOMAN IN AD: That only coverage can cure.

MAN IN AD: We can’t leave working families and kids without insurance.

WOMAN IN AD: Well, someone actually has a workable plan, called InsureUSA. It has tax relief for workers and small businesses, and special help for the working poor.

MAN IN AD: But not government-run health care.

WOMAN IN AD: I’m e-mailing this to the candidates.

MAN IN AD: Send them a message.

SPOKESPERSON: Coverage is the cure for millions of Americans. Log on to help.

MARGARET WARNER: The President was asked about this new development.

REPORTER: You think Harry and Louise may support you this time?

PRESIDENT CLINTON: Well, I hope so. You know, they’ve been acting like they want to support me, and I’d like to get together with Harry and Louise. I thought they were pretty effective last time, and we ought to be on the same side. I’d love it if Harry and Louise would sidle right on in here and say this is the greatest idea since sliced bread, and we could go forward together. It would be great.

MARGARET WARNER: For more, we’re joined by, Ron Pollack, executive director of Families USA, a consumer health advocacy group; and Chip Kahn, president of the Health Insurance Association of America, the insurance industry trade group whose ad we just saw. So, Chip Kahn, are we going to see Harry and Louis showing up in the Oval Office to endorse this plan?

CHIP KAHN: Well, we really think the President is moving in the right direction. We’re appreciative of his plan that recognizes that the current system ought to be built on that employers and the public sector are doing the right thing now and we should build on programs that work. And we think particularly his focus on needy people, particularly those parents of children who qualify for other programs, is a great start. We have some issues with the Medicare side of it. We think we can help people between 55 and 65 in ways other than expanding Medicare. But on the whole we think the president is moving in the right direction. We’re excited about him opening up to this new initiative.

MARGARET WARNER: Ron Pollack, your group has, in the past, advocated far more sweeping change. Does this proposal measure up?

RON POLLACK: Well, incrementalism is not a four-letter word. So I think if we move in the right direction and cover people who are uninsured, particularly the people who need it the most, that’s very helpful. Now, the parents of children who are eligible for CHIP and Medicaid, that’s a group that’s been left out in the cold. So, when the President put that issue on the table, covering these parents through Medicaid and CHIP, I think he did a great service.

MARGARET WARNER: Chip Kahn, to many veterans… I think many veterans of the health care wars are really stunned by this new Harry and Louis ad. I mean, it certainly endorses at least the President’s goals. I know you have your own proposal but why the turn-around?

CHIP KAHN: Well, our industry has always been for covering more Americans. We do best in an environment in which everybody has access to coverage. So this is really for us nothing new. In the past we had concerns about the way the President wanted to do it, and that’s why in ’93 and ’94 Harry and Louise asked all those nasty questions about the President’s plan. But for us this is part of a continuum. We are really appreciative that the president is recognizing that we need to build on the system we have now. We think if we build on the employer-based system, employers providing coverage, finding…helping employers who have low-wage workers provide coverage and if we can build on this child health program that really works and include, as Ron said, those adults who are parents that the President is talking about and we hope we can find ways to provide some coverage for those poor adults who aren’t parents but who need coverage. That’s how we’ll help the 55 to 65-year-olds we believe.

MARGARET WARNER: But to many people, Ron Pollack, looking at this, the two you would look like pretty strange bedfellows. I mean, how do you explain the shift? Are you each moving more toward the other, or is one moving more? Explain this.

RON POLLACK: Well, I’m not sure we’re bedfellows. We’re in the same room. We don’t talk about each other’s lineage anymore. I think that although we have profound differences on things like patients’ rights and a whole bunch of other things and we’ll continue to have those differences, on this issue of the uninsured, we’re seeing a dramatic and tragic growth in the number of people who are uninsured. And so many of them are people who simply can’t get coverage through the current means. If you are earning less than $7 an hour in wages, you’re less than one out of two likely to be able to get coverage from your employer. And you’re going to need financial help getting that coverage. So let’s build on Medicaid and CHIP, which work, and I think to the extent that Chip Kahn and the Health Insurance Association of America are willing to move in that direction, as we are, we can find common ground.

MARGARET WARNER: So, Chip Kahn, your group is willing to endorse this even though it’s really an expansion of government programs. I mean, CHIP and Medicaid are not private insurance programs.

CHIP KAHN: Well, at the end of the day, to help those people who lack the wherewithal to purchase the insurance, the kind of people that Ron is talking about, there have got to be bucks from some place. Actually if you look at the last knew years there’s been significant growth even for poor people from employer coverage.


CHIP KAHN: But the Medicaid program is covering less people every day. And, frankly, it’s going to take public programs to get the bucks to help those people find coverage.

MARGARET WARNER: But what I’m trying to understand is why would members of your group who are, after all, in the private insurance business, be for this, very simply?

CHIP KAHN: Well, we’re in the business of providing insurance. But we don’t mint money. And so to get these people help, there’s got to be some targeted assistance from the taxpayers to get them the money so they can purchase the coverage.

MARGARET WARNER: So, Ron Pollack, you heard the President, we heard the President also argue that he thought the political climate in the country and in Congress and politically had changed since the debacle for his plan in ’93, ’94. Do you see that? Do you think the climate has changed?

RON POLLACK: Oh, I think so. I think we’re seeing in each year in the past decade a substantial increase in the number of people who are uninsured. And this is despite the fact that the economy is in great shape. Unemployment is down. The deficit has been eliminated. We’ve got low inflation. So, imagine what happens if the economy turns sour. And I think what’s different, and the reason HIAA, and Families USA are in the same room together is I think we realize we can’t continue along this track. We just cannot have more and more people become uninsured. And, in the past, the way groups proceeded, they said, “here’s my plan and if you don’t like my plan, I’m leaving the table.” So they stuck with the status quo. Now I think groups are saying, “we really need to find common ground.”

MARGARET WARNER: So, Chip Kahn, before you had job, you were a very close advisor to the Republican leadership on the Hill. Do you think this new political climate is affecting Republicans as well as Democrats?

CHIP KAHN: I think it definitely will. I think there’s an interest on the public’s part in getting more people covered. It’s not the same anxiety about themselves for the middle class that they may have felt in ’92 before the ’93/’94 period but I think the concern is growing. And that’s why so many Republicans on Capitol Hill are talking about changing the tax law to try to help people. I hope that we can talk them into considering also as well as tax changes some of these improvements to the programs like the child health program because I think at the end of the day for the poorest Americans who don’t now qualify for other programs, that’s the only way to go.

MARGARET WARNER: So, in other words, you’re saying that your group has moved from the classic, what one might call the classic business position of let’s just do it all through the private sector to be willing to urge your allies in congress to do a combination?

CHIP KAHN: Yes, we can provide the coverage. And we would hope that as many of these people will be covered through the employer coverage or other private coverage as possible. But at the end of the day particularly for people in that low end, even if they’re working, they just lack the bucks to purchase health insurance. And we need to help them. That’s why we’re supporting these kinds of proposals — our own proposal which is so similar to the President’s.

MARGARET WARNER: Now, among Democrats, of course, Ron Pollack, as we see in the Bradley-Gore dispute on the campaign trail, there are Democrats who still want a big approach. Where do you think the political energy is on that side of the aisle?

RON POLLACK: Well, I think people still have a vision to get to universal coverage. I think all of us believe that. But I think people also recognize we’ve made lots of attempts to get there in one fell swoop. And maybe the voyage needs “a” step. And so what we’re trying to do is find common ground, build on what works. Medicaid covers 40 million Americans. CHIP is growing very nicely. And so, we want to build on what works. And we think that can take us in the right direction.

MARGARET WARNER: So, bottom line: Do you think we’ll see anything from Congress this year — lame-duck President in an election year?

RON POLLACK: Well, it’s always tough to get something passed in an election season, but I think we’ve got a really good shot. And we certainly, I think, have a very good shot of doing it in the following Congress.

MARGARET WARNER: Chip Kahn, prospects for this year?

CHIP KAHN: Well, I agree with Ron. I think it’s going to be a long row to hoe but if there’s a big tax bill, there’s a chance. Remember, the child health program was included in the Balanced Budget Act of ’97. So there’s a chance. But I believe that whether or not it happens this year, it will happen in the next two years, in 2001, and we’re working… we’ll work hard this year but we’re building towards next year. This is an important issue this the campaign, in the presidential campaign. And I believe we’re going to see a change here. We’re putting Harry and Louise out because we want to see that change as soon as possible.

MARGARET WARNER: All right. Well, thank you, Chip Kahn and Ron Pollack.