Wyden-Bennett vs. McCain on health care

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With all the talk here and on Swampland over the past couple of days about John McCain’s health-care plan, it’s worth remembering that there’s already a bipartisan bill in Congress that would do pretty much what McCain says he wants to do as far as taking health insurance out of the hands of employers, yet actually addresses many of the hard questions about making coverage universal and keeping costs down that McCain so far has not.

That would be the Healthy Americans Act, sponsored in the Senate by Oregon Democrat Ron Wyden and Utah Republican Bob Bennett (although it’s really Wyden’s baby). And today the Congressional Budget Office and Joint Committee on Taxation came out with an analysis that says the bill would, over time, “tend to become more than self-financing and thereby would reduce future budget deficits or increase future surpluses.” Bloggeth Ezra Klein: “In other words, we can cover the 47 million uninsured without spending more money. As a talking point, this is huge.”

Both Wyden-Bennett and McCain would remove the existing tax subsidy for employer-provided health insurance–in which companies get to deduct the cost of that insurance from their income taxes, but employees aren’t taxed on the value of the health insurance they receive–with an across the board break for individual taxpayers. In McCain’s case it’s a $5,000-per-family tax credit; with Wyden-Bennett it’s a $15,210 per family (of three) tax deduction that begins to phase out at an annual income of $125,000 for joint returns or $62,500 for individuals.

But while McCain pretty much stops there and leaves the rest to the market (apart from some not-very-well-developed thoughts about special programs for the hard-to-insure), Wyden-Bennett includes subsidies for the lower-middle class, new state Health Help Agencies to coordinate the purchase of insurance, a universal coverage requirement, and a tax on employers to help pay for it all. It’s all so health-wonkish I can barely bear it, but it’s clearly a far more thought-out plan than McCain’s–and is both more sweeping and farther along the road to becoming reality than Clinton’s or Obama’s. So, uh, maybe it is what we all ought to be discussing.

I’m not saying it hasn’t been discussed at all. Joe Klein gushed about it in the pages of Time last summer. Ruth Marcus wrote a column about it in February. The CBO report is getting a smattering of coverage. But nothing like the McCain plan. Funny that, huh?

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