"Today, the Democrats have two distinct plans on the table for achieving healthcare for all Americans: Congressman Gephardt's and mine," Dean said. "I look forward to the time when all Democrats in the race have put their plans before the American people."
The issue of healthcare coverage, particularly among the elderly, likely will take center stage among the domestic issues during 2004 presidential campaign. The White House and congressional lawmakers have struggled with how to provide coverage for the millions of uninsured individuals and give Medicare recipients a prescription drug benefit to offset the skyrocketing costs of medications.
Dean is the second Democratic candidate to trot out a plan for revamping the nation's healthcare insurance industry.
Gephardt released a proposal shortly before the Democratic debate in South Carolina two weeks ago. Sen. John Kerry, D-Mass., is expected to unveil his own plan on Thursday.
Sen. Joseph Lieberman, D-Conn. is set to reveal a healthcare initiative on May 21 in Washington. Unlike Kerry, Dean and Gephardt, a Lieberman aide said the senator will talk only about a key component of his plan that will focus on "research and curing diseases."
Gephardt criticized the Dean proposal as undermining the present employer-based health insurance system. He said it would offer employers incentives to drop coverage, and stressed that it would not do anything to reduce healthcare costs for state and local governments.
"We can no longer afford incremental steps or policies that nibble around the edges. To effectively resolve this crisis we must treat the whole problem and not the symptoms," Gephardt said.
"So far, my proposal is the only one comprehensive enough to extend true universal coverage to all 60 million of those Americans. Governor Dean's plan does not," he said.
The Congressional Budget Office in a report released Monday found that 71 percent of all uninsured non-elderly adults were without health insurance because of the high cost. It found that 61.6 percent cited a lack of access to employer-sponsored insurance.
Dean cautioned that the distinction in the upcoming election will not be in the details of the Democratic plans, but rather "it's the distinction between Democrats -- who view this as a moral imperative -- and President Bush, who for over two years has failed to address this issue."
Dean, a physician, laid out a proposal similar to a plan implemented in his home state, the Vermont Health Access Plan. Dean's proposal comes two weeks after Gephardt delivered his vision for a universal healthcare plan that would cover nearly all Americans.
Dean said Tuesday that universal access is fundamental but is not enough on its own. He said he appreciated Bush setting aside $400 billion for a Medicare prescription drug benefit, but vowed, if elected president, to veto any prescription drug plan that requires patients to give up the right to choose their own doctors and get the medications they need.
The two plans vary vastly in cost. The respective campaigns report the Gephardt plan would cost an estimated $700 billion over three years while the Dean proposal would total about $88 billion a year.
Federal officials estimate that there are approximately 41 million uninsured Americans in the United States. Gephardt said his plan would cover 97 percent of the nation's uninsured while Dean's proposal would provide coverage for 11.5 million more children and young adults and 5.5 million adults.
Dean's plan would extend Medicaid or the Children's Health Insurance Program to every child and young adult under age 25, and require employer health plans to extend coverage to dependents up to age 25. It would expand coverage to working families who earn up to 185 percent of the federal poverty level. It would allow those with incomes above that level to buy into a health plan similar to that which government workers have.
Gephardt plans to extend CHIP and Medicaid coverage to the parents of eligible children coupled with an effort to enroll uninsured, CHIP-eligible youngsters.
Employers under the Gephardt plan would receive a 60 percent tax credit on healthcare premiums for their workers and reimburse state and local governments for the cost of providing health insurance for their employees. Dean's plan would provide tax credits for small businesses to buy coverage for their workers.
In an effort to assist low-wage workers with the cost of premiums, Gephardt's plan adds a 25 percent refundable tax credit to workers whose income is up to 100 percent of the poverty level.
Under Dean's proposal, the federal government would pick up 70 percent of COBRA premiums, but require employers to pay the cost of extending coverage for additional two months. The Consolidated Omnibus Budget Reconciliation Act, or COBRA, is the law that allows terminated employees or those who lose coverage because of reduced work hours to buy coverage for themselves and their families for limited periods of time.
The aim of the Gephardt plan, unlike Dean's, also is to help stimulate the economic growth though the use of tax credits, pumping some $280 billion in the economy over the first three years. The Gephardt campaign said its proposal would provide a tax credit of $316 billion in three years to businesses that currently provide coverage.
It would create jobs by increasing the gross national product by at least 1 percent annually, reducing the cost of health benefits to employers. The savings would result in higher wages and better benefits for workers, they said. The increased salaries would generate payroll tax revenue.
Gephardt's plan was criticized two week ago by his Democratic challengers as taking money from people who need it most and giving it to corporations. Sen. John Edwards, D-N.C., said during the Democratic debate held two weeks ago that the healthcare crisis in America couldn't be dealt with unless lawmakers have the backbone to take on corporations. Gephardt defended his plan as a way to stimulate the economy unlike Bush's 10-year, $1.35 trillion tax cut that he said has failed.
"The Bush tax cuts have failed. They are not making this economy better, they are not helping people get jobs, they are not covering anybody with health insurance," Gephardt said.
Sen. Joseph Lieberman, D-Conn., said during the same event that he was not willing to pay for Gephardt's plan, saying that it doesn't leave any money to invest in education, finding cures for disease, homeland security or international security.
Ron Pollack, executive director of Families USA, a non-profit group dedicated to securing affordable healthcare for Americans, said what is interesting about the Democrats plans so far is the significant similarities. Pollack said that they build on the existing healthcare structure, use public programs such as Medicaid and CHIP, and seek to include all Americans.
"They are in vivid contrast to the Bush administration," Pollack said, saying the president has paid "less than benign attention" to the issue. Pollack said Dean's proposal mirrors what is in Vermont and could work on a national level. However, he said that while Vermont has an excellent track record insuring children, the state does not have the best record for covering everyone.
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