Edwards Seeks Mandatory Coverage

Published September 1, 2003

Presidential candidate Senator John Edwards (D-North Carolina) unveiled on July 28 a $53 billion health care reform plan he says will provide health coverage for uninsured U.S. residents. Edwards’ proposal would require parents to provide health coverage for children through age 21.

Mandatory Coverage of Dependents

The Edwards proposal provides for tax credits to help families purchase coverage for their children through employer-sponsored health insurance plans or the State Children’s Health Insurance Program (SCHIP).

According to Edwards, under his plan parents in families of four with annual incomes less than $60,000 would have to pay no more than $1 per day for health coverage for their children. Parents in families of four with annual incomes less than $36,000 would pay no more than 30 cents per day.

Edwards said his proposal would allow parents to enroll their children in health insurance programs at hospitals after birth, on the first day of school, and on tax returns. Parents who failed to enroll their children in a health insurance program would receive an “initial warning.” If parents failed to respond by getting health insurance for their children, the federal government would enroll the children in “the appropriate program” and effectively bill the family through taxes.

“Children don’t raise themselves,” Edwards said. “That’s what parents do. Parents must take responsibility to enroll their child in a health care plan, and America will make sure they can afford it.”

Twila Brase, a registered nurse and president of the Minneapolis, Minnesota-based Citizens Council on Health Care (CCHC), took exception to the Senator’s approach. “Senator Edwards contradicts himself. He says raising children is the parent’s responsibility, but his proposal declares child-rearing to be the government’s responsibility.

“This should concern parents everywhere,” she continued. “If government can require parents to buy insurance, what’s to keep government from developing a full set of required parental duties?”

Uninsured Adults Also Addressed

Edwards said his plan for addressing the nation’s uninsured problem also would allow adults age 55 and older, and their spouses even if younger, to purchase health coverage through Medicare.

Insurance companies also would be required to subsidize coverage for workers with employer-provided coverage who become unemployed.

Edwards said his proposal would provide health coverage to an estimated 12 million uninsured residents younger than age 21 and to 8 million uninsured adults.

Paying the Price

Edwards said he would repeal tax cuts enacted by President George W. Bush and reduce the size of the federal government to cover the cost of his proposal.

Requesting anonymity, a spokesperson for the Edwards for President campaign told Health Care News the proposal includes provisions they say would reduce federal health care expenditures by an estimated $17 billion per year by limiting prescription drug advertising.

Further savings from the development of electronic medical records and payment systems and reductions in the number of medical malpractice lawsuits filed would, Edwards asserts, help pay for the plan, but no details have been offered.


Chris Conover, a professor at Duke University who specializes in health care for low-income patients, questioned the cost-effectiveness of the Edwards proposal. He noted health care costs for children are lower than costs for adults, who require more treatment.

“I understand politically the appeal of covering kids,” said Conover, “but from the raw, bang-for-the-buck point of view, it’s not the most logical place to start filling in the gaps of coverage.”

“We have Medicaid for poor children and S-CHIP for low-income children,” added Merrill Matthews Jr., Ph.D., director of the Council for Affordable Health Insurance. “Now Sen. Edwards wants to tax middle-class taxpayers to create a government program for middle-class children. And if the parents choose not to take the program, they will get taxed yet again as punishment. All the while, the media will complain that middle-income families don’t have enough money to buy health insurance.”

According to the Raleigh News & Observer, officials in the Edwards campaign expected the proposal to attract criticism as an “intrusion in parenting decisions.”

CCHC’s Brase certainly feels that way. “Mandates force citizens to buy products they may not want, no matter how high the price. Higher prices then invite government intervention and intrusion.

“It’s up to health insurers to make a product that consumers want,” Brase said. “And until government gets out of the way, insurers won’t even try.”

Conrad F. Meier is managing editor of Health Care News. His email address is [email protected].

For more information …

about the Citizens Council on Health Care, visit its Web site at http://www.cchc-mn.org/. For more information about the Council for Affordable Health Insurance, go to http://www.cahi.org.