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Dean unveils national health insurance plan

Democratic presidential hopeful is also a doctor

From Phil Hirschkorn
CNN New York Bureau

Democratic presidential candidate Howard Dean speaking to supporters in New Hampshire last week.
Democratic presidential candidate Howard Dean speaking to supporters in New Hampshire last week.

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NEW YORK (CNN) -- Calling it a "moral imperative," the only doctor in the 2004 presidential race Tuesday unveiled his prescription for delivering health insurance to 41 million Americans now without it.

Former Vermont Gov. Howard Dean, who has made universal health insurance a centerpiece of his candidacy for the Democratic presidential nomination, outlined a plan whereby nobody would have to change doctors or health insurance companies, if they didn't want to, and with few mandates for businesses.

He detailed his plan in a speech Tuesday at Columbia University, where he took classes before enrolling at the Albert Einstein College of Medicine in New York.

"The United States is the only industrialized nation in the world that does not have health insurance for all its citizens," Dean said. "We have fallen 50 years behind in this country, behind the social standards of what we consider to be the civilized world."

Dean projected his health care plan would cost the government $88 billion annually in new funding that he claimed could be covered by rolling back President Bush's tax cuts.

The most far reaching and expensive component of Dean's plan is to expand eligibility for the federal Children's Health Insurance Program, known as CHIP, to all children and young adults under age 25 who are from lower income families -- those earning under 300 percent of the federal poverty level, or around $54,000 a year for a family of four.

The program would also be open to adults ages 25 to 64 with incomes up to 185 percent of the poverty level, or about $35,000 for a family of four.

Dean said the CHIP expansion alone would serve an estimated 23 million uninsured Americans and would be administered by states with support from federal funds.

In another component of his plan, Dean said he would offer other uninsured individuals ages 25 to 64 a chance to buy into the existing health plan for federal employees, including members of Congress.

Dean said this reform would cover 5.5 million Americans, as insurance companies that provide coverage to federal workers would be required to offer the same benefits and affordable premiums to other Americans.

Small business with fewer than 50 employees would also be eligible for the program, extending coverage to another 700,000 Americans, Dean said.

To boost enrollment in the appropriate program, Dean would automatically enroll uninsured taxpayers unless they chose to opt out. Costs would be limited to 7.5 percent of an individual's income.

"This covers every hardworking person who is scraping by at the bottom of the middle class hoping not to sink any further," Dean said.

Workers between jobs

For working Americans between jobs, Dean would require their former employers to pay their share of the health insurance premiums for two months after the employee left.

Afterwards, Dean would have the federal government pay 70 percent of the premium for continuing insurance coverage under the existing program called COBRA.

To push all companies to provide employees with health insurance, Dean said he would eliminate certain tax deductions to companies that don't.

"If you operate a business that can afford to pay your executives large salaries and provide them with generous bonuses and benefits, then you ought to be prepared to pay for health insurance for your employees," Dean said.

Dean said his health insurance plan was designed so he could get it passed in Congress, avoiding the fate of former President Clinton's original health care plan.

"All we do is make it easier for people to buy health insurance. We don't control the health insurance market," Dean told reporters after his remarks. "Nobody has to change their insurance company or their doctor if they don't want to in this plan, and that's what people objected to in the '90s."

Dean said his plan drew on his experience as governor, when he halved Vermont's uninsured rate from 17 percent to 8 percent.

He also said his plan would be only one-third as expensive as the one offered by rival candidate Dick Gephardt, the former House of Representatives majority leader from Missouri.

"We can do this if we take the majority of the Bush tax cuts," Dean said. "If you ask most Americans: would they like to get rid of the president's tax cut? The answer is going to be: "No." But if you give Americans a choice between the president's tax cut and having health insurance that can never be taken away, the vast majority of Americans are going to pick health insurance."

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