Bush reaches out on health; Broad initiative would subsidize insurance for poor


WASHINGTON -- In the latest effort to broaden the appeal of his presidential candidacy, George W. Bush offered a major proposal yesterday to provide health insurance subsidies and housing aid for the working poor.

The Republican governor announced his "New Prosperity Initiative," at an estimated cost of $42 billion over five years, during a campaign stop in Ohio, one of a handful of moderate Midwestern states that could decide the presidential race.

The scope of his health care proposal, by far the most expensive part of the plan, surprised some analysts, who had expected a more limited offering. Others dismissed it as inadequate.

Bush's initiative, which follows tax cut and education proposals for the poor, is part of a major effort to reach out to independent swing voters and impart a more centrist tone to his campaign. The goal, aides said, is to portray the Texan as "a different kind of Republican."

Bush quoted Booker T. Washington and Abraham Lincoln as he outlined his plan at a church-based anti-poverty center on the west side of Cleveland. He made explicit reference to those his plan would target: blue-collar families, recent immigrants, former welfare recipients and others bypassed by the economic boom.

"Our economy must also honor and reward the hard work of factory and field, of waiting tables and driving cabs," Bush said. "It is easy to be secluded in success, in gated communities and separate schools. Yet, our growing nation must not be allowed to grow apart."

Bush said every working family in America must have access to health insurance but emphasized that he would rely on private insurance, not government programs, to reach that goal.

Tax credits

The centerpiece of his plan is a subsidy to help working poor families pay their private heath insurance premiums.

Bush would provide tax credits of up to $2,000 per family and $1,000 per individual to cover up to 90 percent of the cost of private health insurance among those earning $30,000 or less and individuals earning $15,000 or less. The amount of the subsidy would decrease as incomes rise, phasing out above $60,000 a year.

Bush would encourage small businesses to lower their health care costs by purchasing insurance from coverage pools operated by trade associations such as the Chamber of Commerce.

The Bush health plan would benefit wealthier taxpayers by changing the Flexible Savings Account program for medical and child care costs to allow workers to roll over up to $500 of unused funds into the next year. Under the current program, any money that isn't spent by the end of the year is forfeited to the government.

The Bush plan also calls for expansion of laws governing Medical Savings Accounts, an idea popular among conservatives. To encourage upward mobility, the Texan wants to allow low-income families that receive rental assistance from the federal government under the Section 8 plan to use up to a year's worth of that money to subsidize down payments and monthly mortgages.

He also would encourage savings under a plan that would provide tax credits to financial institutions that match deposits of up to $300 per year for those making less than 60 percent of the median income in their community.

Bush aides said the plan would be paid for out of the projected federal budget surplus.

The Gore campaign responded by criticizing Bush's record on health care in Texas and claiming that his proposed tax cut would eat up the entire surplus.

Bush "hasn't made health care a priority in Texas, and his tax cut won't allow him to do so as president," said Gore campaign spokesman Doug Hattaway.

As governor, Bush never made a major speech on health care and his administration was slow to embrace a federal program to expand government health insurance for children, the Gore campaign said. Texas ranks near the bottom nationally in the percentage of children covered by health insurance.

Unexpected scope

But some independent analysts were impressed by the scope of the health care plan offered by Bush, who had been largely silent on the subject up to now.

"I think it is significant that he is offering a large plan. People didn't expect it," said Robert Blendon of the Harvard University School of Public Health.

However, Blendon and others questioned whether most poor families would be able to afford private insurance, even with the Bush subsidy. They noted that the average private health plan for a family costs more than $5,000 a year, more than twice the $2,000 subsidy that Bush would provide.

"This is health care on the cheap," said David Cutler, a health care economist who advised former Democratic presidential candidate Bill Bradley.

Because only those who aren't covered by government or employer health insurance would be eligible, the plan could encourage businesses to drop health care coverage, raising the cost to the taxpayers, several analysts said.

Bush aides said that up to 18 million Americans would be eligible for assistance under the plan. However, a similar plan, introduced this year in Congress, would help only about 3.2 million of the uninsured, according to its bipartisan sponsors, while an additional 5 million low-income Americans who now pay for their own insurance would get some relief.

The plan is the first attempt by Bush to address the problem of the 44 million Americans who lack health insurance. It gives the governor a proposal that he can offer as a counter to Gore's, which has also been criticized as too modest.

Gore has proposed an extension of current government health programs for the poor to include families earning up to $41,000 a year, or 2 1/2 times the poverty level. The Gore plan would cover 12 million of the uninsured, at a cost of $146 billion over 10 years.

Neither the Gore plan nor the Bush plan approaches the sweep of health care proposals made in the early 1990s, a time of much tighter budgets.

In 1992, President Bush offered a plan similar to the one his son announced yesterday. It would have provided subsidies of at least $5,000, in current dollars, to help the poorest families pay for private insurance and would have cost close to $50 billion a year in current dollars.

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