Hillary Clinton on Health Care Reform: Part II

“We’re going to have universal health care when I’m president — there’s no doubt about that. We’re going to get it done,” said presidential candidate Senator Hillary Clinton in Iowa on March 26th.  Whether this prediction comes true depends on a lot of things, most important among them: will she ever be the president and will she have the political clout to get meaningful reform enacted? As discussed in my last post, her track record on this isn’t so good.

What would Clinton health care reforms look like in a Hillary Clinton administration? She hasn’t yet provided a lot of details, but in the past week she’s at least begun to provide their outline.

Speaking at a Las Vegas candidates forum on March 25th, Clinton noted “fixing” health care would be an incremental process taking two terms of her presidency. “We all are going to try to start as soon as possible.  We can move quickly, but make no mistake, it’s going to be a series of steps.”

Clinton favors “guarantee issue” provisions, which requires insurers to accept all applicants regardless of their health conditions. At least that’s what she implied in Las Vegas. According to the Las Vegas Review Journal, Clinton claimed “Insurance companies make money by spending a lot of money and employing a lot of people to try to avoid insuring you ….” The Review Journal further reports her as calling for “an end to ‘insurance discrimination’ against people with pre-existing medical conditions.”

Let’s hope she’s not considering her home state of New York’s approach to guarantee issue, which is pretty much a disaster. As previously posted in this blog, the New York approach costs its citizens thousands of dollars each year. Consider: the average annual premium for a single New Yorker is $3,743 compared to $1,885 in California. For a family, the average annual premium in New York is $9,696 while a California family pays, on average, $3,972 per year. Given this, one hopes Clinton is considering a more nuanced approach to guarantee issue.

Unlike some of her challengers for the Democratic Party presidential nomination, Clinton seems to reject a single payer system. Here’s a portion of the transcript from the Iowa town hall meeting:  “I think we have to have a uniquely American solution to health care because we’re a different kind of country than anybody else.

“I think we will move toward requiring employers to participate the way Massachusetts does or the way California is considering. … And if you don’t insure your employees you’re going to have to pay some kind of per-employee amount so that everybody can be given insurance.” (Here’s the full transcript of the town hall meeting as posted by ABC News. The health care reform discussion begins on page 2 of the transcript).

While not supporting a single payer approach, Clinton does see the government as being an insurer of last resort for consumers who don’t get coverage from other sources such as their employers. And she would require individuals to buy coverage, presumably through this state program, with costs being borne by employers who don’t purchase coverage. As she notes, this mirrors the health care reform proposals enacted in Massachusetts by then Governor Mitt Romney and proposed in California by Governor Arnold Schwarzenegger.

Clinton is staking out a middle ground on health care reform. She’s going to get tough on insurance companies, but continue to rely on employer sponsored coverage. She’s supporting a government health plan for more Americans, but it won’t be completely government run. This may surprise some, and it should serve as fair warning for all. Remember: even if her presidential bid fails, Senator Clinton will be a powerful voice in the U.S. Senate on any health care reforms the new president has to offer.