Hillary mailer accuses Obama of "demagoquery," Kennedy responds and a fact check on SCHIP

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Sun Feb-17-08 06:10 PM
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Hillary mailer accuses Obama of "demagoquery," Kennedy responds and a fact check on SCHIP

Obama Campaign Blasts Wisconsin Clinton Health Insurance Mailing

Calls the recycled Clinton charges �false, negative.�

Mail piece cites NY Times� Krugman slamming Obama.

Sen. Kennedy on Obama media call: �I was shocked and surprised that Sen. Clinton would put that pamphlet out.� Calls it a �great disservice� and a �distortion,� with an intention of �fear mongering.�

Gov. Doyle on Obama media call: �I�m also very troubled by this mailer�it represents how Sen. Clinton has conducted herself in Wisconsin.�

Clinton�s Wolfson replies on his media call: Says he respects Sen. Kennedy, Gov. Doyle but �The record on this issue is very clear�our plan will cover everyone, his plan will not.�

Plus: Bill Clinton presses wife�s health care plan in Toledo, Ohio.

Hillary is accusing Obama of demagoguery? Wow, she has become Rove!

On a second page it reads, "Barack Obama's plan says NO WE CAN'T, leaving 15 million people without coverage." It goes on to list bullet points claiming that the plan "wastes billions" and would cost Americans $1,700 per person." Obama has long claimed that his plan would cut costs more than any other's and would cut costs for individuals. But Clinton has seized on his plan's lack of a mandate to say he's not really offering universal health coverage.

The mailing also quotes a line from New York Times' columnist Paul Krugman -- a fierce critic of Obama -- saying that the candidate's claim that he is passing universal health care is "unscrupulous demagoguery from the candidate himself."

Sen. Ted Kennedy, responding to the mailing told reporters in a conference call that he had been fighting for universal health care for 38 years and would not have endorsed Obama if he didn't believe that he wasn't for it or couldn't pass it.

Kennedy also introduced a new line of attack on Clinton, saying that neither she nor her husband were initially for the S-Chip program which he introduced in the Senate with Republican Orrin Hatch after the failure of Clinton's health care plan in 1994.

Kennedy also told reporters that the Clinton campaign was resorting to the same kind of "fear mongering" that had scuttled her own health care plan in 1994 and called for the debate to remain positive.

But he had no answer for why the Obama campaign had also gone negative in their ads about health care and engaged in what some claimed was "fear mongering" as well, by dropping a mailer that had an eerie resemblance to the Harry and Louise ads that were released by drug companies to discredit the Clinton plan in the early 1990s. The ad released by the Obama campaign told them that the Clinton campaign would force them to pay for healthcare.

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Obama's claim is verifiable. Hillary has said that she would consider: "Going after people's wages" (video)

CLINTON: George, we will have an enforcement mechanism. Whether it's that or it's some other mechanism through the tax system or automatic enrollments.

But you're missing, I believe, the key point. If you don't start with universal health care, and I have very aggressive cost controls and quality improvements, and my health care tax credits plus the premium cap that I am the only person to put in to a health care plan to say, your income will be adjusted so that a small percentage will be always the limit of what you have to pay for premiums.

If you don't do what I am saying we do, we will never even attempt to get to universal health care. And the reason why I think there are a number of mechanisms, going after people's wages, automatic enrollment, when you are at the place of employment, you will be automatically enrolled, whatever the mechanism is is not as important as, number one, the fundamental commitment to universal health care, the appreciation that, with health care tax credits and with a premium cap, it will be affordable for everyone.

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Back to Sen. Kennedy's criticism of Hillary's tactics, ouch! There was a time when Kennedy gave Hillary credit for her efforts to get SCHIP passed. Hillary for her part describes this effort as one of her crowning accomplishments in her 35 years experience. From Hillary's campaign site:

She was instrumental in designing and championing the State Children's Health Insurance Program, which has provided millions of children with health insurance. She battled the big drug companies to force them to test their drugs for children and to make sure all kids get the immunizations they need through the Vaccines for Children Program.

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Clinton claims credit for child program

By BETH FOUHY, Associated Press Writer Sat Oct 6, 7:09 AM ET

NEW YORK - When she talks about health care reform on the campaign trail, Democrat Hillary Rodham Clinton points to a multibillion-dollar health insurance program for children as one of her signature accomplishments.

The program, enacted in 1997, has provided $24 billion over 10 years to states to cover more than 6 million children whose families earn too much to be eligible for Medicaid but cannot afford private health insurance.

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FACT CHECK:

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On Dec. 9, 1996, senior White House health adviser Chris Jennings sent a memo to the first lady outlining several options � and recommending ways for her to increase her visibility on the issue.

With his wife's backing, President Clinton announced a plan to expand health coverage to as many as 5 million children in his 1997 State of the Union address. "The children's health program wouldn't be in existence today if we didn't have Hillary pushing for it from the other end of Pennsylvania Avenue," Kennedy told

President Clinton signed the bill in August 1997.

While Kennedy is widely viewed as the driving force behind the program, by all accounts the former first lady's pressure was crucial.

"She wasn't a legislator, she didn't write the law, and she wasn't the president, so she didn't make the decisions," says Nick Littlefield, then a senior health adviser to Kennedy. "But we relied on her, worked with her and she was pivotal in encouraging the White House to do it."

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Kennedy's comment, appears to contradict his then senior health adviser, but in reality this is simply one instance of the media taking a comment out of context, which was Hillary's "pressure" convinced Bill to not veto it.

ACCURACY Mrs. Clinton�s work on health care is well known and not in dispute. Aides to Senator Edward M. Kennedy, Democrat of Massachusetts, have credited her with persuading a wavering President Bill Clinton to support the creation of the State Children�s Health Insurance Program in 1997. (Though one can attribute to typical campaign hyperbole this spot�s implication that she was somehow a lone voice for universal coverage; most of the Democratic field was for it in 1992.) And as a senator she has worked on providing special health services and benefits for emergency workers at ground zero.

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The history of SCHIP:

104th CONGRESS

2d Session

S. 2186

To provide access to health care insurance coverage for children.

IN THE SENATE OF THE UNITED STATES

October 1, 1996

Mr. KERRY (for himself and Mr. KENNEDY) introduced the following bill; which was read twice and referred to the Committee on Labor and Human Resources

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Senator Kerry was there at the beginning of the fight to provide the largest investment in children�s health care since the creation of Medicaid. His 1996 bill, the �Healthy Children, Family Assistance Health Insurance Program,� was the precursor to the successful SCHIP program, which became law in 1997 and provides funding to cover 5 million children.

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STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS (Senate - October 01, 1996)

Mr. KERRY. Mr. President, I am proud to introduce legislation today, joined by my friend, colleague, and esteemed senior Senator, Ted Kennedy, to help ensure that the 10 million uninsured children in this country get the health care they need and their parents get the peace of mind they deserve.

Mr. President, the fact is that most of these 10 million uninsured children have parents who work--90 percent of these uninsured children have parents who work, according to the General Accounting Office . And three out of five of these children have parents who work fulltime during the entire year.

Unfortunately, the problem of uninsured children is getting worse, not better--each year, more than 1 million additional children lose private insurance. No parent should have to choose between medicine for a sick child and food for the family. The thought of a mother and father, working hard to make ends meet, waking up in the middle of the night with a child in pain, and waiting to see if the pain passes because they cannot afford to go to the hospital, is a stark image of a national tragedy. Mr. President, American children without health care are alone in the world--we are the only Western industrialized nation that does not provide health care for every child.

I am proposing today with Senator Kennedy a voluntary subsidy program to help working families to purchase private health insurance for their children. Only families with incomes too high to qualify for Medicaid would be eligible to receive these vouchers. Participation in the voucher program would be voluntary. The premium subsidy would be provided on a sliding scale with families earning 185 percent or less of the poverty line receiving the full subsidy; the subsidy would phase down so that families earning more than 300 percent of the poverty line would not receive a subsidy. Cost-sharing would be limited but everyone would pay something. The proposal includes a comprehensive benefits package with a full range of the essential services needed by children. The total cost of the plan is $24 billion over 5 years and is paid for by a combination of cuts in corporate welfare and a tobacco tax increase. Although it is apparent there is no chance the plan will be enacted this year, with Congress now in its final hour before adjourning prior to the election, we are introducing it as a bill today because we want to place this issue prominently on the national agenda during the next few months preceding convening of the 105th Congress.

Mr. President, I want to discuss 2 of the 10 million compelling reasons to provide basic health insurance to children who are not covered now.

One of the first reasons is a 13-year-old student in Lynn, MA, named Costa Billias. He played football at Breed Junior High and loved the game, but said, `For the past 2 years I gave my best to football, but my mom explained that we were not insured and if I got hurt we would lose our house and everything we own to pay the hospital.' He quit the team, but he cannot

quit life. If he gets hurt doing something else, his family still stands to lose everything. In addition, I think it is wrong that Costa Billias is being denied the opportunity to play football again.

One more of the 10 million reasons we must pass this bill is the Pierce family. Jim and Sylvia Pierce were married in 1980 and live in Everett, MA. Jim was a plumber and they had three children, Leonard, Brianna, and Alyssa. In October 1993, Sylvia was pregnant with her fourth child when Jim was tragically killed on his way home from the store. In that one horrible minute her life changed forever. She not only lost her husband, but, pregnant and alone, she lost her health insurance as well. Her survivor's benefits made her income too high to qualify for long-term Medicaid, and too low to pay the $400 a month it would take to extend her husband's health plan. Sylvia said, `I've always taken good care of my children. I feed them well; I take them to the doctors immediately when they need it. All of a sudden I couldn't do that anymore.

Mr. President, in addition to the moral imperative, the scientific evidence is overwhelming that lack of health coverage is bad for children, delaying medical care or making it impossible to get. A recent study in JAMA found that children with health coverage gaps were more likely to lack a continuing and regular source of health care--even when factors such as family income, chronic illness, and family mobility were factored out. Numerous studies by university researchers and by government agencies show that the uninsured are less likely to receive preventive care (such as immunizations for children), more likely to go to emergency rooms for their care, more likely to be hospitalized for conditions that could have been avoided with proper preventive care, and more likely to have longer hospital stays than individuals with health insurance coverage.

Mr. President, every hour we wait to take this step, another 114 children lose private health insurance. Every 30 seconds we wait, another child loses private health insurance. America's children cannot wait any longer. Families without insurance are forced to pay the full cost of medical services--an impossible burden for struggling families, one that often takes a back seat to putting food on the table and a roof over the children's heads.

Mr. President, this plan is an important, incremental step toward guaranteeing health coverage for all Americans. I urge my colleagues to support it.

Mr. KENNEDY. Mr. President, it is an honor to join Senator John Kerry in introducing this visionary and practical program. Senator Kerry has been a consistent leader in the Senate in fighting for children, for health care, and for working families. This initiative sets a benchmark for the next Congress and the American people. It is a proposal that is a reflection of true family values.

Every American child deserves a healthy start in life, but too many don't receive it. Seventeen industrialized countries do better at preventing infant mortality than we do. A quarter of American children do not receive basic childhood vaccines. Every day, 636 babies are born to mothers who receive inadequate prenatal care, 56 babies die before they are a month old, and 110 babies die before they are a year old.

Access to affordable health care is one of the greatest problems children face. Ten-and-a-half million children under the age of 19 have no health insurance--one in every seven American children. If it were not for the expansions of Medicaid over the past 5 years, the number would be seven million higher. Under Republican proposals to cut Medicaid, four million children would lose their coverage. Employer-based insurance coverage is eroding. Too many pregnant women--more than 400,000 a year--are uninsured, and lack access to critical prenatal care.

Almost all uninsured children are members of working families. Their parents work hard--40 hours a week, 52 weeks a year. But all their hard work does not buy their children the protection they deserve. Every family should have the right to health security for their children. No parents should fear that the loss of a job or their employer's failure to provide coverage will put their children out of reach of the health care they need.

Health insurance coverage for every child is a needed step in the fight to guarantee health care for every family. The cost is affordable. The benefits are great. The opportunities for bipartisanship are substantial.

The legislation we are introducing today is a simple, practical proposal. It imposes no new government mandates on the States or the private sector. It does not substitute for family responsibility. It fosters it, instead, by assuring that every family has the help it needs to purchase affordable health insurance for their children.

Our plan will establish no massive new Federal bureaucracy. Basic guidelines and financing would come from the Federal Government, but the plan would be implemented and administered by States.

The program will make a major difference in the lives of millions of families, but its basic principles are not novel or untested. Fourteen States already have similar programs in place and running. Earlier their year, for example, Massachusetts enacted a program very similar to our proposal.

Under our plan, the Federal Government will assist all families with incomes under 300 percent of poverty to purchase health insurance for their children, if they do not already receive coverage under an existing public program. Families with incomes under 185 percent of poverty will receive a full subsidy. Families with incomes between 185 percent of and 300 percent of poverty will receive assistance on a sliding scale. Between 80 and 90 percent of all uninsured children live in families with incomes below 300 percent of poverty. Even uninsured families with higher incomes might buy coverage for their children if policies designed for children were available. Families with income under 150 percent of poverty will also receive assistance with the cost of copayments and deductibles. Similar assistance will be provided to uninsured pregnant women.

The program will be administered by States under Federal guidelines. In general, States will contract with private insurance companies to offer children's coverage to any family that wants it. Lower income families will receive assistance with the cost of coverage, but coverage will be available to all families at all income levels. Basic rules will guarantee that coverage is adequate and tailored to the special needs of children, especially the need for comprehensive preventive care.

This plan does not guarantee that every child will have insurance coverage, but it gives the opportunity to every family to cover their children at a cost the family can probably afford. It will be a giant step toward the day when every member of every American family has true health security.

The cost of a similar program has been estimated at $24 billion over 5 years. We propose to finance our plan by a combination of tobacco tax increases and closing corporate tax loopholes. The Nation currently spends close to $1 trillion per year on health care. The additional cost of this proposal is substantial, but it is a needed step toward healthier lives for millions of American children and peace of mind for their parents.

In this Congress, we made substantial progress toward improving the health care system. We turned back extreme proposals to slash Medicare and Medicaid. Working together in a bipartisan way, we were able to pass the Kassebaum-Kennedy Health Insurance Reform Act, take a significant first step toward mental health parity, and protect mothers and infants from premature discharge from the hospital. Every Democratic and Republican health plan in the previous Congress endorsed the idea of subsidizing private insurance coverage for children. This proposal should be a bipartisan health priority for the next Congress. I believe it is an idea whose time has finally come.

It was a tough legislative fight, even in a state known for generous public services, with the proponents overcoming a veto by Gov. William F. Weld, who opposed any new taxes.

Now the state's United States Senators, Edward M. Kennedy and John Kerry, want to take the Massachusetts approach national, with a tax increase on cigarettes that could reach 75 cents a pack or more. They contend that smokers and the tobacco industry can afford the cost of health insurance for the 10 million children who now have none, and that teen-age smoking will be discouraged in the process.

Senator Kennedy said early in February that uninsured children were rarely treated for chronic problems like earaches and asthma.

''We should make sure the sons and daughters of working families get a healthy start,'' he said. ''The best way to fund this is a tax on tobacco, which causes five million premature deaths a year and weighs down our whole health system.''

Their approach is one of several being talked about in Congress, where the President's proposal to expand coverage gradually so that half of the 10 million children not covered now will be insured by 2000 has been widely criticized, especially by Democrats, as inadequate.

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A few months later, Daschle introduced a plan Jan. 21, 1997, which Kerry co-sponsored: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=105_cong_bills&docid=f:s13is.txt.pdf">PDF

Democrats to Seek Expansion of Health Coverage for Children

By Spencer Rich
Washington Post Staff Writer
Sunday, December 8, 1996; Page A19

The proposals, being drafted by Senate Minority Leader Thomas A. Daschle (S.D.), House Minority Leader Richard A. Gephardt (Mo.) and other key Democrats, essentially could create a new class of federal social support. Some of the initiatives would offer a tax credit to help a family buy their children a health care policy, while others would offer a direct federal subsidy of some type.

Although the details are still being worked out, most of the measures focus on children in families that fall between the cracks: They're not poor enough to qualify for Medicaid but not affluent enough to pay for private insurance entirely out of their own pocket.

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But many more ambitious plans are in the works. Among the most detailed thus far is a proposal being drafted by Sens. Edward M. Kennedy (D-Mass.) and John F. Kerry (D-Mass.) that would provide grants to the states to help families afford health insurance for their children.

The plan would target families in that no man's land � that is, those who are not poor enough to be eligible for Medicaid but who don't get insurance on the job and can't afford to pay for it themselves. Under the Kennedy-Kerry plan, families would be paid a federal subsidy that would gradually decrease as their income went up.

Kennedy was determined to get the legislation passed and worked to bring Republicans on board.

But even with the success of the Kassebaum-Kennedy bill, the best that Mr. Kennedy and other supporters of child health insurance had expected at the start of the 105th Congress was that they could put the issue back on the political map.

Not long before last fall's elections, Mr. Kennedy and John F. Kerry, the junior Democratic Senator from Massachusetts, introduced a bill that proposed paying for health insurance for uninsured children through a tobacco tax, a law that was already in place in their state.

Throughout the fall and into the end of 1996, Mr. Kennedy notified a string of Republican senators in an effort to bring them aboard, among them John H. Chafee of Rhode Island, Mike DeWine of Ohio, John McCain of Arizona and Arlen Specter of Pennsylvania.

The common link among those Republicans, a Democratic aide said, was that ''they had voted against the tobacco lobby in the past and they were open to children's health insurance.''

Mr. Kennedy ultimately teamed with Mr. Hatch, a conservative with whom the liberal from Massachusetts had worked closely in the past and whose Mormon beliefs had made him an ardent foe of tobacco and supporter of children's legislation.

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CONCURRENT RESOLUTION ON THE BUDGET (Senate - May 21, 1997)

Mr. KERRY. Mr. President, I thank the Senator from New Jersey.

I am proud to rise to join Senator Hatch and Senator Kennedy as a cosponsor of this, and to thank them for their leadership on it. Let me say first of all, that it is absolutely disingenuous to suggest to the U.S. Senate that this amendment ought to be voted against or is subject to criticism because it reduces the tax cut by $30 billion.

Every U.S. Senator knows, by virtue of our experience here and the practice on the budget, that we are not allowed to specify the specific source of revenue. But every Senator also knows what the source of revenue would be if we decided to pass this legislation. There is no question about it.

There is no other place that the Finance Committee would go as a consequence of an overwhelming vote of the Senate to say that we should provide this care with the understanding of the sponsors and of all of those proposing that there is one source that we are directing our attention to for the revenue. So that is an entire smokescreen. No Senator can hide their vote behind that kind of smokescreen today.

Second, it is absolutely false to suggest that the $16 billion in the agreement is going to provide health care to even the 5 million children that it claims to, let alone the 10 million children we know do not have coverage today. The math is ascertainable. And the math will tell you that you are only going to cover about 3.7 million children with the amount of money allocated.

The fact is, that last year when Senator Kennedy and I and Senator Rockefeller and others introduced legislation to provide health care for children, we thought we had an approach. And Senator Hatch and others could not find agreement with it. And there have been some changes since then. But let me tell you, Mr. President, what else has happened since then.

There are 750,000 additional children who have lost their private health insurance in this country in that year that we have not seen fit to do what Senator Kennedy and Senator Hatch are asking us to do today--750,000 additional kids.

One kid every 35 seconds has lost their health insurance in this country. And the fact is, that most of those 10 million kids are the sons and daughters of parents who are working. Ninety percent of them are working. And the vast majority, about 68 or 69 percent, both parents are working and are working full time.

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I think Senator Hatch and Senator Kennedy are absolutely correct when they say this is one of the most important votes we will cast. This does not blow apart any agreement. Do not let any smokescreen to that effect cloud a vote here. This agreement can hold together because this amendment provides for revenue and it provides for making up the difference of what is taken away. In the end, this agreement could go forward, and America's children would benefit as a consequence of that.

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All of those children , Mr. President, every one of them, and 5 million more, will have health insurance thanks to our insistence and the leadership of Senator Kennedy that we deliver the largest investment in the health of our children since the enactment of Medicaid, a generation ago.

This plan invests an unprecedented $24 billion for uninsured children , and since it is funded by a tax on cigarettes, it is, in fact, a double health benefit. This plan serves as a financial barrier--a powerful disincentive for children to start smoking in the first place. It supplements, not supplants, current health care coverage. Our plan requires that States maintain their current Medicaid eligibility levels of spending to access Federal dollars to ensure that this investment is not used to replace public or private money that already covers children .

Mr. President, simply put, this is the embodiment of the Democratic principles I mentioned earlier. This victory for America's children and middle-income families is a victory for America itself. We will all benefit from a healthier generation of children .

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Here is the an assessment of the plans done at the time:

Incremental Approaches
To Covering Uninsured
Children: Design And
Policy Issues

An examination of the design issues, projected costs, and number
of children that would be covered under various insurance proposals.

by Kenneth E. Thorpe

PROLOGUE: Although global approaches to covering the uninsured have been rejected in recent years, policy interest in incremental approaches, such as health insurance initiatives for children, has been building. However, as Kenneth Thorpe, an authority in the areas of health care financing, insurance, and reform, explains here, there are many complex, politically sensitive issues thatmust be addressed in designing and implementing such a plan. The political context within which such a plan is presented also is essential. For example, the Senate recently rejected a proposal by Sens. Edward Kennedy (D-MA) and Orrin Hatch (R-UT) to raise cigarette taxes to fund an expansion of health care coverage for low-income children, not so much because of a lack of support, but rather because of warnings from Republican leaders and President Clinton that passage of the legislation would derail the bipartisan balanced budget plan. As an amendment to the budget plan, the Kennedy-Hatch proposal would effectively have decreased the size of the agreed-upon tax cut and increased the level of domestic spending.

Thorpe is a professor in the Department of Health Systems Management and director of the Institute for Health Services Research at Tulane University�s School of Public Health and Tropical Medicine, in New Orleans. He also has taught at the University of North Carolina, in Chapel Hill, and at the Harvard University School of Public Health. Most recently, Thorpe served as deputy assistant secretary for health policy in the U.S. Department of Health and Human Services. He holds a doctorate in policy analysis from the RAND Graduate School in Santa Monica, California.

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In 2004, Kenneth Thorpe did a thorough assessment of Kerry's healthcare plan The Impact of Sen. John Kerry's Health Care Proposal on Health Care Costs

Thorpe has done the same for the current Democratic candidates:

This time, the candidates are all "being very careful to say that, look, if you have health insurance today, you can keep it," said Kenneth Thorpe, a professor of health policy at Emory University. He has helped the top four Democrats crunch the numbers of their plans and was involved in Clinton's 1993 effort.

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Here is what Thorpe had to say about Obama's plan when he introduced it:

Obama unveils universal healthcare plan

By Jeffrey Young
Posted: 05/30/07

Most businesses would be required to offer coverage or pay into a fund for publicly subsidized benefits, and Obama would expand Medicaid and the State Children�s Health Insurance Program to cover more low-income people. Obama also proposed instituting new federal regulations of health insurance, including a prohibition against denying coverage because of preexisting conditions, and greater scrutiny of mergers between health insurers.

Emory University Professor Kenneth Thorpe analyzed the proposals and concluded that taxpayers would pick up a $50 billion annual tab.

According to Thorpe, the actual cost of the proposal would exceed $100 billion a year, but Obama�s campaign identified about $50 billion a year in budget offsets, including reduced payments to health plans providing benefits under the Medicare Advantage program and eliminating special payments to hospitals that treat large numbers of indigent patients.

Thorpe did not factor in new revenue from tax cuts that might be permitted to expire. That revenue, he said, could cover the remaining $50 billion a year, he said.

Obama�s plan appears to be somewhat less costly than Edwards�s, which Thorpe said would cost $100 billion to $150 billion a year. Thorpe added that Edwards did not specify any offsets. Edwards, however, has conceded that new tax revenue would likely be needed to pay for his plan.

�They�re all going to be three figures, over $100 billion,� Thorpe said of the various healthcare plans. Thorpe is analyzing numerous candidates� proposals, as he did for presidential candidates from both parties in 2000 and 2004.

Actual federal spending under the Obama plan could be higher than his estimate, Thorpe said. �That $50 billion is really assuming that everything is really up and fully implemented,� he said, and parts of the plan would take more than five years to put into place.

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