Senator Mike Enzi, R-Wyoming
10 Steps to Transform Health Care in America
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Plan StatusProposed Act under review.
Number of People Covered
All Americans.
Estimated Cost
Not addressed.
Payment Scheme
Market-based plan combined with subsidies and tax credits to give all Americans access to a qualified core plan (QCP). |
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Plan in Brief
- This Wyoming senator is prominent in health care reform initiatives as a sponsor or cosponsor of numerous health care proposals.
- Enzi has proposed his “10 Steps to Transform Health Care” via a bill (S. 1783) introduced in the Senate in July 2007./span>
- Individual mandate—those who do not purchase coverage will be enrolled in a state program by default.
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Pete Stark
Representing California's Thirteenth District, AmeriCare
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Plan StatusProposed Act under review.
Number of People Covered
All Americans.
Estimated Cost
Not addressed.
Payment Scheme
Combines AmeriCare, which is modeled on Medicare, with employer-based insurance. The AmeriCare trust fund will be built on premiums and used to fund the program. |
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Plan in Brief
- This California congressman is prominent in health care reform initiatives as a sponsor or cosponsor of numerous health care proposals.
- The AmeriCare Health Care Act of 2007 (H.R. 1841) was introduced in March 2007 and remains in committee.
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Universal Health Care Vouchers
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Plan StatusPublished.Number of People CoveredAll Americans.
Estimated Cost$828 billion (not including the Medicare population).
Payment Scheme A value-added tax would fund health care vouchers.
Each American would receive a voucher to use to purchase a basic health care coverage package from private providers. |
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Plan in Brief
- Ezekiel J. Emanuel, M.D., Ph.D., is chair of the National Institutes of Health’s Department of Bioethics. Victor R. Fuchs, M.A., Ph.D., is Henry J. Kaiser Jr. Professor Emeritus at Stanford University in departments of economics and health research and policy.
- Emanuel and Fuchs say that inefficiencies in the health care system and growing costs will thwart most proposals to revamp the system because those proposals fail to provide the right incentives and infrastructure for cost-effective care.
- The plan calls for universal, guaranteed issue coverage funded by a tax and for the elimination of approaches and programs that add to administrative costs (e.g., employer-based coverage, means testing).
- Emanuel and Fuchs state that this plan is more politically feasible than other proposals because it balances individual choice and egalitarianism—two essential features of the American national character.
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President George W. Bush, Administration
Achievements/Goals
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Plan StatusChanges enacted by Bush Administration and some proposals.Number of People CoveredDoes not aim for universal coverage.Estimated CostU.S. health care costs have continued to rise steeply, reaching approximately $2.1 trillion in 2006. The cost of the Medicare prescription drug program alone is estimated to be $1.2 trillion over ten years. Payment Scheme Bush favors expansion of individually purchased private insurance over public programs. |
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Plan in Brief
- Medicare prescription drug benefit introduced.
- Health Savings Accounts introduced.
- Proposed law allowing states to redirect federal funds for uncompensated health services toward private insurance subsidies (currently done through waivers).
- Deficit Reduction Act (DRA) gave states more flexibility to tailor their Medicaid programs.
- Expanded "cash and counseling" programs giving more control over personal and custodial care funds to individuals on Medicaid.
- Proposed a standard health deduction – i.e., individual tax "break" (not yet in place).
- Latest budget would trim Medicare and Medicaid but slightly expand State Children’s Health Insurance Program (SCHIP).
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Ron Wyden
US Senator (D-Oregon), Health Americans Act |
Plan StatusThe Healthy Americans Act, S334 was introduced in January 2007 and has 12 co-sponsors.Number of People CoveredAll Americans ~300 million; Near-universal coverage.Estimated CostNot specified.
Payment Scheme Individuals would buy insurance directly from private insurers. |
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Plan in Brief
- Universal health coverage with largely a private delivery system and a requirement that people go out and purchase it.
- Cut the link between health insurance and employment
- Employers required to “cash out” existing health plans and raise wages by that amount.
- Workers would then be required to buy health insurance for themselves from a pool of private plans.
- Focus on preventive care
- Provides insurance that is portable and extends beyond employment.
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Others 
