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Bradley proposal insures all kids

Bill Bradley's $65-billion-a-year plan would pay all or part of premiums for lower-income children and adults.

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By TIM NICKENS Times Political Editor

© St. Petersburg Times, published September 29, 1999

For months, Bill Bradley promised he would offer big ideas as a candidate for president.

On Tuesday, the Democrat delivered one.

The former New Jersey senator unveiled a universal health care proposal that would require health coverage for every child, subsidize premiums for millions of Americans and offers a prescription drug benefit for Medicare recipients.

There is even something for people who have health insurance. Bradley would offer everyone a tax break on their insurance premiums, regardless of whether they joined a new plan or stayed with their existing coverage.

The estimated cost is as eye-catching as the plan. The annual $65-billion price tag, which Bradley would cover with about half of the federal budget surplus, is about 1.3 times the size of the annual budget for the state of Florida.

But Bradley said the country cannot afford to ignore the 43.4-million Americans without health insurance.

"When it comes to America's health," Bradley said in a televised speech from Los Angeles, "this is not the time to be timid. It requires bold action and a national commitment, from the president on down, to make certain that every American has what should be a basic birth right."

By offering a proposal that would surpass even Medicare in its sweep, Bradley has guaranteed that health care will be a major topic in the 2000 election. Some national polls list health care behind only education among voters' top concerns.

Vice President Al Gore offered a more modest plan earlier this month that would eventually provide all children health coverage by 2005. Republicans such as front-runner George W. Bush, Steve Forbes and John McCain have recommended expanding the use of existing medical savings accounts.

Health care also should resonate as an election-year hot-button in Florida, which routinely ranks among the top 10 states in the number of uninsured. About 2.8-million Floridians do not have health insurance, including more than 800,000 children.

"There seems to be a bidding war over who can take care of more kids," said Jack Levine, president of the non-profit Center for Florida's Children in Tallahassee. "I like it."

While 11-million children nationwide are uninsured now, Bradley's proposal would require all children to be covered by health insurance from birth to age 19. They could either be enrolled in their parents' existing plan, or in new federally approved private plans.

Children in low- or middle-income families, with annual incomes of up to $49,200 for a family of four, would have part or all of their premiums paid by the government. Health insurance premiums for everyone would not be counted as taxable income.

For adults, there also would be a system to subsidize premiums for low- and middle-income workers. Anyone who chose not to continue their current private coverage could enroll in private plans now available to members of Congress and 9-million federal employees.

"It's always been somewhat confusing to me why Congress was not willing to share what it had with the rest of the American people," said John Clarkson, dean of the University of Miami medical school, who reviewed a copy of Bradley's proposal that was sent by the campaign.

The result of Bradley's proposal would be that Medicaid, the health care program for the poor paid for with both state and federal dollars, essentially would be replaced.

For seniors who are at least 65 years old and receive Medicare, there would be an optional prescription drug benefit with a $500 deductible. The Clinton administration also has sought a prescription drug benefit, but Republicans in Congress have argued it would be too expensive.

Bradley's proposal gives the federal government a larger role in expanding health coverage than the vice president's. Gore would send states more money to provide subsidized coverage for children, and families who earned above the income limits could buy into the state plans.

But Bradley would not create a new government-dictated insurance program or replace existing private insurance plans like the Clinton administration's ill-fated 1993 universal health care proposal. The Clinton plan, developed in private meetings led by first lady Hillary Rodham Clinton, died a year later as the "Harry and Louise" television ads aired by the health insurance industry raised Americans' fears that their existing health care plans were threatened.

The producer of those ads, the Health Insurance Association of America, praised Bradley's plan Thursday as "realistic and thoughtful."

Gore's campaign called Bradley's plan unrealistic and too expensive. Bradley called Gore's approach timid and noted it has no cost estimate while his would not touch the surplus dedicated to Social Security.

Steve Pajcic, a Jacksonville lawyer and Bradley's point man in Florida, said Bradley's proposal would eat far less of the budget surplus than the tax cuts proposed by Republicans in Congress.

"What should we do? Should we eliminate the inheritance tax for wealthy Americans, or should we offer health insurance to all children and make it available to all Americans?" Pajcic asked. "That's what elections ought to be about."

The overall impact of the Bradley proposal on Florida is not yet clear.

Under Govs. Lawton Chiles and Jeb Bush in the '90s, the state has made gradual progress in reducing the number of uninsured children. Levine estimates the number could drop to 500,000 in the coming months through initiatives backed by Bush and the Legislature.

"State by state, progress is being made," he said, "but there is no reason in the universe this should not be federally led."

Bradley's proposal aims to do that. But his plan also would trade health care costs between the federal and state governments in ways that could cost Florida money.

States no longer would be responsible for paying their share of the cost of providing health insurance for the poor, which would save Florida several billion dollars.

But states would assume responsibility for long-term care in nursing homes and other institutions. Most nursing home days are paid for with Medicaid money, and Florida has the highest portion of elderly residents in the country.

William Haley, director of geriatric programs at the University of South Florida, said Bradley's campaign generally assured him states such as Florida would not be penalized.

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