Presidential Candidates' Health Care Reform Proposals

1. Presidential Candidates' Health Care Reform Proposals Karen Davis President, The Commonwealth Fund AcademyHealth 2008 National Health Policy Conference February 4, 2008 kd@cmwf.org www.commonwealthfund.org

2. When You Are Deciding Whom to Vote For In Next Year’s Presidential Election, How Important Will the Candidate’s Views on Health Care Reform Be? Percent of adults who say candidates’ views on health reform will be very/somewhat important 94 87 86 83 Source: S. R. Collins and J. L. Kriss, The Public's Views on Health Care Reform in the 2008 Presidential Election, The Commonwealth Fund, January 2008

3. Health Insurance Reform and the Presidential Candidates: Three Distinct Approaches • Expanded coverage through individual insurance market with tax incentives, changes to employer benefit tax exemption, and deregulation of state markets (Giuliani, Huckabee, McCain, Romney) • Universal coverage through mixed private–public group insurance with shared responsibility for financing (Clinton, Edwards, Obama) • Universal coverage through a public insurance program like Medicare (Kucinich) Source: S. R. Collins and J. L. Kriss, Envisioning the Future: The 2008 Presidential Candidates' Health Reform Proposals, The Commonwealth Fund, January 2008.

4. Where Leading Candidates Stand on Health Care Reform Features Source: S. R. Collins and J. L. Kriss, Envisioning the Future: The 2008 Presidential Candidates' Health Reform Proposals, The Commonwealth Fund, January 2008.

5. Public Support for the Proposal That Employers Should Either Provide Health Insurance to Their Employees or Contribute to a Fund That Would Help Cover Workers Without Health Insurance Percent of adults who say that employers should either provide health insurance or contribute to a fund Source: S. R. Collins and J. L. Kriss, The Public's Views on Health Care Reform in the 2008 Presidential Election, The Commonwealth Fund, January 2008

6. Public Support for a Health Reform Proposal That Requires That Everyone Have Health Insurance, With Government Helping Those Who Cannot Afford It Percent of adults who strongly/somewhat favor a requirement that everyone have health insurance 80 68 68 52 Source: S. R. Collins and J. L. Kriss, The Public's Views on Health Care Reform in the 2008 Presidential Election, The Commonwealth Fund, January 2008

7. Support for Features of Presidential Candidates’ Health Care Reform Proposals “To what extent do you favor or oppose the following features of the presidential candidates’ health care reform proposals?” Implement market regulations against risk selection 86 Mandate health insurance with premium subsidies for low and moderate income 83 Include a public plan option like Medicare in new group insurance “connector” 79 Expand Medicaid and SCHIP to include adults at poverty level or above 78 71 Employer pay-or-play mandate Set a minimum floor on insurance company medical-loss ratios 62 Allow individuals, small businesses, and associations to buy private insurance across state lines 62 Administer an individual mandate and income related premium assistance through the tax code 52 Eliminate the employer benefit tax exemption and replace it with standard income tax deduction or tax 45 Source: Commonwealth Fund Health Care Opinion Leaders Survey, January 2008.

8. Health Care Opinion Leaders Call for Allowing Public Plans Like Medicare to Compete with Private Insurance “Do you think health care reform should…? Please select all that apply” Percent Source: Shea, K., S. Collins and K. Davis, Health Care Opinion Leaders’ Views on the Presidential Candidates’ Health Reform Plans, Commonwealth Fund, January 2008.

9. Seven in Ten Health Care Opinion Leaders Think the Next President Should Simultaneously Pursue Universal Coverage and Improve Quality, Efficiency and Cost Control “Most candidates’ plans also include provisions that would improve quality, efficiency, and cost control as well as increase coverage. In your view, which of the following provisions should the next president focus on?” Not sure 3% Address quality, efficiency and costs first and then work on achieving universal coverage 12% Universal coverage at the same time as policies to improve quality, efficiency and costs 70% Universal coverage first, and then address quality, efficiency and costs 14% Source: Shea, K., S. Collins and K. Davis, Health Care Opinion Leaders’ Views on the Presidential Candidates’ Health Reform Plans, Commonwealth Fund, January 2008.

10. Panel • Gregg Bloche, Obama for America • Chris Jennings, Hillary for President • Tom Miller, John McCain 2008