Edwards Weighs In on Uninsured

MANCHESTER, N.H. â€”  Sen. John Edwards (D-N.C.) on Monday offered a plan that seeks to provide universal health care for children -- but would require many parents of kids without coverage to contribute part of the cost.

Positioning himself near the center of the crowded Democratic presidential field, Edwards released a health-care blueprint that was more narrowly targeted and less expensive than plans released so far by his rivals. Edwards’ proposal also asks more of the uninsured themselves.

“We have a responsibility to make sure every family can afford health insurance, and every parent has a responsibility to make sure their children have it,� Edwards said in a speech at a community health center here.

Edwards’ plan would cover 21.7 million Americans -- just more than half of all those without health insurance -- and cost the government $590 billion over the next decade, according to an analysis by Kenneth Thorpe, a professor at Emory University in Atlanta. An analysis commissioned by the Edwards campaign reached similar conclusions.

By contrast, plans by Sen. John F. Kerry (D-Mass.), former Vermont Gov. Howard Dean and Rep. Richard A. Gephardt (D-Mo.) would cover more of the uninsured but at significantly higher cost. Edwards said his plan, with its smaller price tag and more precise focus on children, was more “achievable ... and [fiscally] responsible� than his opponents’ plans.

Edwards is searching for a spark to ignite his presidential campaign. Although he ranks second to Kerry in overall fund-raising this year, he did much better in the first quarter than in the second. He remains stuck in the low single digits in polling in Iowa and New Hampshire, the opening contests in the nomination race.

Edwards is courting voters in both states. He’s holding a dozen town hall meetings around New Hampshire this summer, including one Monday in Laconia. His schedule includes visits to 34 Iowa towns in July and August.

His speech Monday continued his effort to present himself as a fiscally responsible populist focused on the needs of working families. Both in substance and message, his health-care plan echoed the “personal responsibility� theme that Bill Clinton stressed in his 1992 campaign.

While the plans offered so far by other Democrats focus on providing new government benefits to the uninsured, Edwards placed at least as much emphasis on the obligations of parents toward their children.

“The only way we can tackle this problem is to ask for responsibility from everyone,� he said.

His call for parents to provide coverage for their children through age 20 is likely to be his plan’s most controversial aspect.

Edwards said he would pay for his plan by repealing portions of the President Bush-backed tax cuts benefiting the top-income earners, cutting corporate subsidies and reducing the federal workforce, outside of defense and homeland security, by 10% over the next decade.

Thorpe calculates Gephardt’s plan, built on a tax break to encourage employers to provide insurance, would cover about 30.4 million people, at a 10-year cost of $2.5 trillion.

The Dean and Kerry proposals hinge mostly on expanding existing public programs. Thorpe estimates Dean’s plan would cover almost 31 million of the uninsured, at a 10-year cost of $932 billion. Kerry’s plan, according to Thorpe, would cover 26.7 million and cost $895 billion over 10 years.

Under Edwards’ plan, Washington would provide all parents with children 20 and younger tax breaks to help cover the cost of insuring their children.

Parents whose employer-provided insurance already covers their children would face no additional costs; rather, those parents would receive a tax credit to help offset the cost of the premiums they pay for their children. For a family of four with an annual household income of about $60,000, that credit would be worth about $300 a year for the two children. Except for the largest families, the tax credits would phase out for those earning more than $75,000.

Parents whose children are not already covered would also receive a subsidy to help them buy coverage -- either through their employers or the Children’s Health Insurance Program (CHIP), a state-federal partnership that provides coverage for kids in working poor families.

That coverage would be available without cost for the poorest families and at a cost of $10 a month or less for working-poor families.

Middle-income families with uninsured children would face a bigger bite: Edwards’ staff estimates a family of four with an annual income of $60,000 would pay $30 a month to buy into CHIP for the two children. Payments would rise to a maximum of $80 a month for a family of any size earning $75,000 a year.

The payment requirements are a likely point of debate: Aides to Gephardt say he believes low-income families still would not be able to afford insurance under Edwards’ proposal.

Under Edwards’ plan, children without coverage would be automatically enrolled in an insurance plan at school or when claimed on their parents’ tax returns. That approach should guarantee insurance for virtually all of the 8.6 million Americans under 18 now without it, calculated Thorpe.

Thorpe projected that the Kerry and Dean plans would cover about 90% of uninsured children and that Gephardt’s would probably capture a slightly smaller share. But their plans would cover more of the uninsured than Edwards’ because they include more sweeping subsidies for uninsured adults.