Sen. Hillary Rodham Clinton unveiled a plan on Monday to guarantee health insurance to all Americans, but in a way carefully designed to avoid nearly every major political flaw in her failed proposal of 1993–94.
In the new plan, Clinton promised to cover everyone without big new bureaucracies, without a complicated reorganization of one-seventh of the U.S. economy and without affecting Americans who are insured and happy with their coverage — all features that helped doom the Clinton administration’s plan 14 years ago.
In what her advisers hoped would be the final stage of a long political rehabilitation on the issue, Clinton told her audience here that she had been scarred by the old battle but had gained some valuable lessons.
“I learned that people who are satisfied with their current coverage want assurances that they can keep it,” Clinton said. “Part of our health care system is the best in the world, and we should build on it; part of the system is broken, and we should fix it.”
Like the plans put forth by her two main Democratic rivals, former Sen. John Edwards of North Carolina and Sen. Barack Obama of Illinois, the new Clinton plan would try to strengthen and build on the existing, employer-based system, through which most Americans under 65 already receive their coverage. Clinton would create new options for buying private or public insurance at affordable rates, require everyone to obtain insurance, and provide subsidies to small businesses and individuals who cannot afford it.
The plan, with a estimated cost of $110 billion a year, would be financed largely by rolling back President Bush’s tax cuts for Americans making over $250,000 a year and by projected savings in the health care system.
The title of Clinton’s proposal sums up her carefully calibrated new approach: “The American Health Choices Plan.” It was clearly aimed at the middle-class Americans who feared that her last health plan would limit their choices, force them into health maintenance organizations and subject them to new government bureaucracies deciding what their benefits could be — fears stoked by a devastating campaign by the insurance industry.
Clinton’s Republican rivals instantly denounced her new proposal as another exercise in “Hillarycare,” with Mitt Romney declaring that she “takes her inspiration from European bureaucracies” and “fundamentally does not believe in markets and in the states.” Romney, who as governor of Massachusetts himself signed into law a measure requiring all residents of his state to sign up for health insurance, and other Republican candidates acknowledge problems in the health care system but would rely more than Clinton and the other Democrats on the market, the states and tax credits to resolve them.
But a variety of health policy analysts said the change between Clinton 1 and Clinton 2 was striking. The first plan, for example, required people and employers to join new “regional alliances” to purchase their coverage.