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Ex-Senate leaders unveil compromise plan for health care

WASHINGTON — Three former Senate majority leaders unveiled a bipartisan health care package Wednesday that would tax health benefits for some Americans and require insurance coverage for all.

The price tag for the plan, outlined by Democrat Tom Daschle and Republicans Bob Dole and Howard Baker, is estimated at $1.2 trillion over 10 years. After 10 years, the plan would pay for itself.

Until then, the overhaul would be financed by revamping health delivery and payment systems, slowing the growth in costs for Medicare and Medicaid, and fining large employers who don't offer insurance to their workers. To raise more revenue, their plan also would cap the tax-free status of employer-provided benefits at the value of Congress' health coverage and would tax benefits that are worth more.

"Health care reform and universal coverage is indeed something whose time has come," Baker said, adding that because they were no longer responsible for the politics of health care, their proposal was truly bipartisan. "We have no legislative writing authority, and that's an advantage in a way."

The group's plan isn't without controversy, though.

It would require individuals to carry coverage, limit out-of-pocket insurance premiums to 15 percent of income for a minimum benefits package and offer "enhanced protections" for Americans who are living on less than 400 percent of the federal poverty level. This year, the poverty threshold for a family of four is $22,050.

The plan also would call on states to create public insurance plans to compete with private insurers in a marketplace known as an "exchange."

The senators said they didn't agree on all parts of their proposal; Baker and Dole have a hard time accepting a public plan-like proposal and mandates. Dole called a proposal with a public plan "DOA," but the three men said that they had reached a consensus through conversation, presumably hoping to lead by example for current senators.

"If we can't compromise, how do we expect, how are we ever going to get a bill passed?" Dole asked. Daschle said that no one should expect unanimity from Democrats on any plan and that for any proposal to pass, a number of Republicans had to vote for it as well. Dole said that the package would need Republican votes to have credibility.

Daschle blamed the fracturing of the bipartisan effort on the public plan issue, but he said that he saw room for compromise.

"We've come too far and gained too much momentum for our efforts to fail over disagreement on one single issue," he said.

Daschle thinks there'll be compromise on the public plan issue in "the very near future." If it doesn't come from his group's idea for state marketplaces, it will come from other sources, he said.

The trio doesn't expect the Obama White House to endorse or accept its proposal, but it's time for everyone to start being open, Dole said.

"If we're getting serious about helping some poor child who's sick and needs attention, then somebody's going to have to give," he said. "And probably it's better if everyone puts money in the pot."

The leading Senate Finance Committee members, Sens. Max Baucus, D-Mont., and Charles Grassley, R-Iowa, issued statements commending the work of the three former senators.

Baucus said the plan would hold insurance companies' "feet to the fire." The proposed exchanges would "make it easier and less expensive for every American to purchase health insurance, and protects the idea of shared responsibility by employers, individuals and government. . . . And perhaps most importantly, the plan shows us a bipartisan consensus is within reach as we move toward our end goal of ensuring affordable, accessible care for every American," he said.

Grassley said the trio's blueprint should encourage compromise and show senators that bipartisanship was possible. "While I don't agree with every element of the proposal, I appreciate its contribution to the debate that's under way on how to improve the health care system by offering coverage to everyone, fixing the delivery system, getting control of spiraling costs and making sure reforms are offset and don't add to the federal budget deficit," he said.

(Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy-research organization that's not affiliated with Kaiser Permanente.)


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