Editorial: Health insurance for all

Wednesday, Nov. 15, 2006 | 7:10 a.m.

The health insurance industry has proposed expanding Medicaid and tax breaks as a way to guarantee health insurance coverage for all children in three years and ensure such coverage for most adults within 10 years.

A recent story by The New York Times says newly elected members of Congress who promised to help the uninsured are expected to support many of the provisions in a proposal that is certain to spark intense debate in Congress, which now is controlled by Democrats. Government figures show that 46.6 million Americans lacked health insurance last year, which is an increase of 6.8 million from 2000, the Times reports.

The health insurance industry's plan, projected to cost $300 billion over the next decade, calls for expanding Medicaid to cover all adults - single or married - whose annual incomes are below the federal poverty guideline. It also calls for the State Children's Health Insurance Program, which is jointly funded by federal and state governments, to cover all children in families with incomes that are less than twice the poverty level.

Congress, in turn, would be asked to create tax breaks for people who open health accounts that they would use to pay health insurance premiums. Congress also would be asked to create a tax credit for people who buy health insurance for their children.

The industry didn't offer any solutions as to how the government would pick up the $300 billion tab, nor did it offer information as to whether the plan would slow increases in health care costs.

But Massachusetts lawmakers recently passed a similar, bipartisan measure that uses a combination of incentives and penalties that, over the next three years, is to provide coverage for all of that state's uninsured residents. Poor residents could pay less than $3 a month for coverage. Solutions are possible.

The Bush administration's coziness with pharmaceutical companies and health insurers makes us somewhat skeptical of industry-proposed solutions to public health challenges. But the overall goal of this plan - to provide health insurance for children and adults who otherwise would be uninsured - sounds promising.

Industry, government officials and lawmakers have been at an impasse for too long when it comes to solving this problem. Nonetheless, this proposal raises many of the same unanswered questions that have sidetracked previous efforts to extend insurance coverage, such as how we are going to pay for it. It fails to impose penalties on employers who fail to offer health insurance and people who refuse to buy it. And it fails to guarantee that people who have pre-existing medical conditions will not be refused coverage.

These questions, and many more that certainly will arise in the future as the proposal is debated in Congress, will need to be satisfactorily answered.