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Al Gore speaks in Los Angeles, California.  September 7, 1999

Today Al Gore unveiled his new health care vision for the 21st century to expand health care coverage for those who do not have it and improve it for those who do. He focused on his new plan to expand access to affordable health insurance for every child by 2005 and make health coverage more affordable for millions of adults.

As he detailed this plan, he outlined five bold steps to improve every aspect of the health care system. They are: (1) assuring rights for patients by passing legislation to keep medical records private and a strong enforceable Patients’ Bill of Rights that gives patients critical protections, such as access to specialists, access to emergency room services and making health plans accountable for harming patients; (2) modernizing health care by focusing on prevention, individual responsibility, and new technologies to improve and measure quality; (3) building on the progress and possibilities of new research while protecting against the perils, such as genetic discrimination; (4) addressing the nations’ unprecedented challenges due to the aging of the baby boomers by strengthening and modernizing Medicare, including providing a prescription drug benefit, and by proposing initiatives to support families with long-term care needs; and (5) working towards the goal of assuring all Americans have access to quality health care coverage.

Today, at the Children’s Hospital of Los Angeles, Al Gore outlined his new plan to expand health care coverage for America’s families. It has seven major elements:

    (1) Ensuring That All Children Have Access to Affordable Health Insurance by 2005. The over 11 million children who are uninsured are less likely to be immunized, get regular checkups, and tend to fall behind in school. In 1997, the Clinton-Gore Administration fought for and enacted the Children’s Health Insurance Program (CHIP) – the largest investment in children’s health in a generation -- to expand coverage to children in families with too much income for Medicaid but too little to afford private insurance. However, in some states nearly 25 percent of children are still uninsured and even where there have been program expansions, enrollment has been woefully inadequate.

    Today, Al Gore is proposing to build on this initiative and assure that all American children have access to affordable health insurance by 2005. To reach this goal and help ensure that all children are signed up for health insurance, he is proposing three steps:

      · Expanding CHIP to children up to 250 percent of poverty (about $41,000 for a family of four) to increase the number of uninsured children eligible for the program. The current program allows states to cover children in families with up to 200 percent of poverty. There are nearly one million uninsured children in families with income between 200 and 250 percent of poverty. States expanding eligibility for children to those in families with income up to 250 percent of poverty would receive an increase in their CHIP allotment, based on the number of uninsured children in the expanded population. They would receive the same enhanced match that has led all fifty states to apply to participate in the CHIP program.

      · Allowing children above 250 percent of poverty who do not have coverage to buy into CHIP or Medicaid. Over two million uninsured children are in families with income above 250 percent of poverty. This would provide a new option for children not eligible for CHIP, Medicaid or employer-based insurance. Families would pay the full premium, but the premium itself will be more affordable than most individual insurance options. In addition, families could use the new 25 percent tax credit (described below) toward this coverage.

      · Ensuring that children eligible for CHIP or Medicaid are enrolled. Over seven million children are in families that are eligible for CHIP or Medicaid. To help ensure that children eligible for these free and low-cost health insurance programs get enrolled, this policy would (1) provide financial bonuses to states that meet enrollment targets, which would be phased in by 2005; (2) reduced states’ CHIP enhanced matching rate if they do not meet these targets; and (3) develop a school-based strategy for enrollment. Together, these policies would guarantee universal access to affordable children’s health insurance by 2005.

    (2) Expanding Health Care Coverage for Working Parents. CHIP was created because of the high number of working families whose children were uninsured. Unfortunately, most of these children (over 85 percent) come from families where the parents are uninsured themselves. To help the 7 million uninsured parents of Medicaid or CHIP-eligible children, Al Gore would expand CHIP to parents. States could access higher Federal matching payments (same as CHIP) to cover the parents of children already enrolling in Medicaid and CHIP. This efficiently and effectively offers a large proportion of the uninsured an affordable health insurance option and helps create a health care system that rewards families. States could set the upper-income eligibility level where they wished but would have to cover all parents below the income limits (i.e. states could not favor higher over lower-income parents). This proposal will also help assure that more uninsured children enroll because families are more likely to take advantage of new health care programs if the coverage is available for every family member.

    (3) Providing Affordable Health Care Options for Americans Ages 55 to 65. Americans ages 55 to 65 are the fastest growing group of uninsured in the country, with more than 3 million currently without health insurance, over 60 percent of whom are women. Many of these uninsured Americans have been dropped by their employers or had coverage through a spouse and have difficulty buying into the individual insurance market because of poorer health conditions. Al Gore supports and will continue to advocate the Clinton-Gore Administration’s proposal to allow vulnerable Americans ages 55 to 65 to access affordable health care options by buying into Medicare. These Americans would also be eligible for the 25 percent tax credit (see below).

    (4) Assuring People With Disabilities Can Keep Their Health Care Coverage When They Return to Work. For people with disabilities accessing affordable health insurance is the greatest barrier to returning to work. Under current law, people with disabilities are often forced to drop health care coverage because they get a job that makes them ineligible for Medicaid or Medicare because of their income or ability to work. This means that many people with disabilities are put in the untenable position of choosing between health care coverage and work. Al Gore supports and will continue to advocate the Administration proposal to pass legislation to allow people with disabilities new health care options when they return to work by allowing them to buy into Medicare or Medicaid.

    (5) Making Health Insurance More Affordable and More Accessible for Small Businesses. The proportion of small businesses offering insurance declined from 59 to 54 percent between 1996 and 1998 alone. Small businesses typically pay higher premiums for benefits, and administrative costs may consume as much as 40 percent of premium dollars. As President, Al Gore would make health insurance more affordable and accessible for small businesses by proposing a 25 percent tax credit for premium costs for each employee of a small business that decides to join a purchasing coalitions (where businesses join together to negotiate for affordable health insurance options for employees). The proposal would also encourage such coalitions to develop by both allowing foundations to make charitable contributions for their start-up and providing states with seed-money to establish these coalitions. This would provide more affordable, private health insurance to the working uninsured in firms with fewer than 50 employees and would be available to employers who provide insurance as well as to those who do not.

    (6) Assuring Tax Equity Through a New Tax Credit for Individual Health Insurance. While people receiving health insurance through their employers receive tax breaks, those without access to job-based health insurance receive no tax benefits. To fix this inequity, Al Gore is proposing a 25 percent refundable tax credit for people lacking access to employer-based health insurance who purchase coverage in the individual market. The principle behind this tax credit is similar to the principle behind the recent law that expanded health insurance deductibility for the self-employed. Al Gore would also work to improve the individual insurance market to help make it a more affordable, accessible option for Americans.

    (7) Maintaining and Strengthening Health Care Delivery Systems Serving the Uninsured. Al Gore will strengthen community health centers, public hospitals, academic medical centers, and other safety net providers that treat millions of Americans. Strengthening these centers would allows them to develop comprehensive systems of care, develop links financial and telecommunication systems, and fill the service gaps that exist in many communities, especially in the areas of primary health care, mental health services, and substance abuse services. As part of strengthening these care systems, Al Gore will improve treatment mental health services for those Americans eligible for Medicaid.



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