Five of the leading Democratic presidential candidates have outlined proposals for making health insurance more affordable--or for providing coverage for the 12 million small-business employees who currently go without. Here's a guide to who's suggesting what:
The plan: Creating the Universal Health Benefits Program, which would offer the same coverage as the Federal Employees Health Benefits Program (FEHBP)--the Cadillac of health plans that covers members of Congress and federal employees. People who are already covered under Medicaid or Medicare would not have access, but many uninsured would. To keep premiums steady, Dean would fund a "reinsurance trust."
Pros and cons: It covers everyone, but it is essentially universal health care and likely the most expensive proposal.
The plan: Providing federal funds for states to create purchasing pools for companies with 50 or fewer employees. Tax credits would be offered to small firms with low-income work forces.
Pros and cons: Allowing states to tailor programs to their own specific business community has its advantages, but it could result in a patchwork of regulations, which could cause problems for businesses that operate in more than one state. And do cash-strapped state governments have the resources to administer yet another federally mandated program?
The plan: Offering a 60% tax credit for the full premium cost of health insurance for employers of all sizes, whether a company offers health insurance or not.
Pros and cons: The plan helps companies that already offer insurance to maintain benefits in the face of rising costs. But it also will force employers who don't offer benefits to do so--and they wouldn't be able to use the credit to cover any added administrative costs.
The plan: Expanding Medicaid coverage to the working poor--people who make too much money to qualify for Medicaid now but can't afford coverage on their own.
Pros and cons: The virtue of Graham's plan is that it takes the health care system we have in place and leverages it. But the problem is, it probably won't help small employers who face huge premiums because of sick employees.
The plan: Providing businesses with tax credits like Gephardt, and letting them buy into FEHBP, like Dean. Kerry would create a separate pool for the hoi polloi--which makes his plan viable politically, since the Feds are unlikely to take steps that would endanger their own coverage.
Pros and cons: It specifically assists small-company workers with high health care costs, but if employers with sicker workers flock to the FEHBP, it will end up being very expensive.