WASHINGTON -- Democratic White House hopeful Sen. Barack Obama (D-Ill.) unveiled his long-awaited health care plan on Tuesday, promising that everyone will be able to buy affordable health insurance and that people now covered will pay less. Employers would keep their insurance expenses down because the federal government would pay for the most costly cases.
Obama proposes mandating coverage of children but not adults, opening the question of whether his plan will lead to Obama keeping his first pledge, to sign a universal health care law by the end of his first term.
"We believe it to be a universal plan," said Obama health care advisor Austan Goolsbee, a University of Chicago economics professor. Goolsbee said the plan meets "the high unmet demand of people who want to buy health insurance."
Robert Blendon, professor of health policy and political analysis at Harvard's Kennedy School of Government, said the Obama package was a "near universal" plan. "He's in the ballpark."
Stephen Zuckerman, a health economist at the Urban Institute, said "no question this plan would expand coverage, but it won't lead to universal coverage." Neither Blendon nor Zuckerman are associated with a campaign.
Obama unveiled his plan at the University of Iowa in Iowa City. Now all three major Democratic 2008 contenders have put an overhaul of the health care system at the top of their domestic agendas.
Former Sen. John Edwards (D-N.C.) earlier put out an expansive plan mandating universal coverage.
Last week, Sen. Hillary Rodham Clinton (D-N.Y.) detailed her proposals for lowering health costs, with the universal health piece to come later.
Cost: $50 billion to $65 billion
The Edwards and Clinton camps issued statements that showed they were skeptical that Obama's plan fulfills his universal coverage pledge.
"Sen. Clinton believes that in addition to making health care more accessible, we have to achieve true universal health care so that every American has health care coverage," said her policy director, Neera Tanden.
Edwards spokesman Mark Kornblau said, "Any plan that does not cover all Americans is simply inadequate."
While in the Illinois state Senate, Obama was a sponsor of the Cardinal Bernardin Amendment, a guarantee that all Illinois residents had what he called in an IVI-IPO questionnaire the "right of health care coverage."
Central elements of Obama's programs are:
• Extensive health care cost savings, through expansion of information technology, reduced administrative overhead and more effectively caring for the most expensive patients, those who have chronic illnesses. Insurance companies would be forced to pass on these savings and reduce premiums.
• Creation of a National Health Insurance Exchange to oversee the private health insurance marketplace and sell insurance. Employers who do not make a "meaningful" payment toward health insurance will have to contribute to the national plan -- with certain small employers exempt.
• Coverage of children would be mandatory. Medicaid, the state-federal program for the needy, would be expanded with the federal government picking up costs. Employers would get federal reimbursements for care of catastrophically ill patients.
• The cost is estimated to be between $50 billion and $65 billion, to be paid with economies in the system and letting the Bush temporary tax cuts expire for those in the top brackets.