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As leaves turn, health care debate blooms in Washington.

Senate Finance Committee Chairman Daniel Patrick Moynihan (D-N.Y.) last week pledged to reshape President Clinton's health care plan and to help pay for the plan in part by imposing a steep federal tax increase on handgun ammunition. Indicating he would hold the health care bill hostage to "taxing them [handguns] out of existence," Moynihan said his proposals would raise $200 million to help finance health care

Moynihan introduced legislation to increase the federal tax on handgun bullets from 11 to 50 percent in a hearing with U.S. Treasury Secretary Lloyd Bentsen testifying for the Clinton administration.

The six major health care alternatives demonstrate some of the perils in achieving consensus. The President's plan is by far the most, detailed, and the President, has asserted that he seeks a bipartisan consensus. So far only one Republican has co-sponsored his plan.

The principal Senate Republican alternative, sponsored by Sens. John Chafee (R-R.I.) and Robert Dole (R-Kan.) claims that, like the Clinton plan, it would provide universal access to health care. But it would impose an employee, rather than employer mandate: requiring employees rather than cities and other employers to provide coverage. The Chafee bill boasts 25 co-sponsors, all Republicans.

The principal Democratic alternative, sponsored by Rep. Jim McDermott (D-Wash.) in the House and Sen. Paul Wellstone (D-Minn.) in the Senate, would set up a so-called single payer system where the federal government, rather than cities and other individual employers, would pay for most health bills. That approach would be financed by increased federal individual and corporate taxes. That plan has attracted 89 Democratic co- sponsors in the House - fat more than the President's plan.

The principal House Republican alternative, offered by House Minority Leader Robert Michael (R-Ill.), mandates cities and other employers to offer insurance coverage for employees, but not to pay for it. That plan has more than 100 co-sponsors - all Republicans. Sen. Phil Gramm (R-Tex.) has offered a minority Senate Republican plan which has attracted 10 Senate Republican co-sponsors. This plan relies mostly on letting Americans set up tax-free accounts for medical care, but would not provide universal coverage.

Only one alternative, offered by Reps. Jim Cooper (D-Tenn.) and Fred Grandy (R-Iowa) in the House and Sen. Joe Lieberman (D-Conn.) in the Senate, has so far attracted any real bipartisan support. The Cooper-Grandy plan is a much less regulatory approach, relying on purchasing cooperatives to reduce insurance costs. Such pools would be mandatory for cities with fewer than 100 employees. The approach would not provide for universal coverage, but would replace Medicaid.
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Title Annotation:includes related information on various health care reform bills
Author:Shafroth, Frank
Publication:Nation's Cities Weekly
Date:Nov 8, 1993
Previous Article:Variety of mandate relief alternatives put forth in House and Senate.
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