Which Democrat's Health Plan

By LAURA MECKLER
December 5, 2007; Page A8

While the leading Democratic presidential candidates agree on most policy issues, a sharp dispute has emerged: Who would do more to provide health coverage for the uninsured?

Sens. Hillary Clinton and Barack Obama have been engaged in a bitter back-and-forth over whose health plan covers more people. Former Sen. John Edwards has jumped in, saying his plan is the best of all.
• The Players: Hillary Clinton, Barack Obama and John Edwards all claim to have universal health-care proposals.
• The Background: Clinton and Edwards, but not Obama, would require all Americans to have insurance.
• The Bottom Line: Mandates may be needed to get everyone insured, but it's unclear if these plans provide enough subsidies to make the mandates affordable.

The argument concerns whether the government should require all Americans to get insurance. Mrs. Clinton and Mr. Edwards would require people to get insurance, either through work, a government program or new health marketplaces that all three candidates promise to set up. Mr. Obama would only require that children be insured.

Other elements of their plans are similar, including subsidies to help lower-income and even middle-income families pay premiums, and various proposals to cut the cost of health care. The candidates say they would pay for their plans by rolling back President Bush's tax cuts for upper-income earners and by savings in health spending through various measures.

None of the Republican candidates has proposed a universal health plan. But with the race tight and health care the No. 1 domestic issue for Democrats, the differences among Democrats have become a point of continuing tension.

Mrs. Clinton charges that Mr. Obama's plan would leave 15 million people without insurance. Outside experts agree that number is in the ballpark. If people aren't required by law to buy insurance, many won't. There are millions of children, for instance, who remain uninsured, even though they qualify for free or subsidized government programs.

In addition, all three candidates want to bar insurance companies from rejecting sick people or charging them more. But it is hard to require companies to insure expensive sick people if they aren't guaranteed that cheap healthy people will balance them out.

On the campaign trail, Mrs. Clinton has attacked Mr. Obama for his plan, saying it betrays the Democratic principle of universal coverage. Her campaign has demanded that he take down an advertisement that claims his plan "covers everyone."

Mr. Obama has replied that her attacks are more about politics than substance; they didn't come, he noted, until she lost ground in the polls. But his advisers don't dispute her central charge. Rather, they claim Mrs. Clinton's plan would also leave millions without coverage.

Obama adviser Austan Goolsbee argues that if Mrs. Clinton's health plan is enacted, she will have to waive the mandate for millions of people. That is because, he says, there isn't enough money for subsidies to make health insurance affordable enough for people to buy it.

"You can't put in a mandate until health care is affordable," he says. He predicted that a Hillary Clinton administration would wind up exempting 20% of the uninsured, or about 10 million people. That is the percentage of uninsured adults who were exempted in Massachusetts, the only state to try an individual mandate.

That view may not be true. Ken Thorpe, a health-policy expert at Emory University who has advised all three major Democrats, said he ran cost estimates for the Clinton plan at the Clinton campaign's request, and found there should be enough money to make insurance affordable for all. He said he ran three scenarios with varying levels of subsidies -- from $100 billion a year to $120 billion a year. The campaign chose one in the middle: $110 billion.

If it turns out that isn't enough money to make health premiums affordable, Mrs. Clinton would have to spend more on subsidies, one of her health-care advisers said.

But, the adviser said, it is wrong to assume that 20% of Americans will be exempted. It is impossible to say for certain, because the campaign has not explained how large the subsidies will be or who will qualify for them.

The Obama plan does some other things to get people insurance. It allows adults up to age 25 to stay on their parents' insurance even if they aren't in school. And it attempts to lower the cost of insurance overall through a reinsurance plan, whereby the federal government would cover some expenses of some of the most costly patients.

Outside experts note that the Clinton and Obama plans propose spending about the same amount of money, while Mr. Obama uses some of his to pay for the reinsurance plan -- an initiative that could cost tens of billions of dollars. That should help lower premiums across the board, but it means there would be less available for direct subsidies.

Amid the Clinton-Obama dispute, Mr. Edwards, who was the first to propose a universal coverage plan, has tried to jump into the debate. He notes that he has been much more specific than Mrs. Clinton has about how he will enforce the mandate. Indeed, Mrs. Clinton has suggested some options but has not made as clear a statement about enforcement.

Under the Edwards plan, people will have to prove their have insurance when they file their taxes, and the government will seek to collect back premiums, with interest, for those who refuse to get it.

None of the candidates want to talk about the fact that even if their plans worked out exactly as designed, none would cover all 47 million uninsured people in the U.S. That's because several million of the uninsured -- estimates put it up to seven million -- are illegal immigrants, and none of the front-runners include them in their programs.

Write to Laura Meckler at laura.meckler@wsj.com

Huckabee "I drink a different kind of Jesus juice,"

LITTLE ROCK, ARK. -- In 2005, a Republican state senator named Jim Holt introduced a bill to deny public benefits to Arkansas' soaring population of illegal immigrants. Holt, a Southern Baptist minister, figured it was a rock-solid conservative idea -- a matter, he said, "of right and wrong."

Arkansas' governor at the time was also a professed conservative, and also a Southern Baptist minister. But Mike Huckabee had only scorn for his fellow Republican's proposal.

Huckabee called the bill "race-baiting" and "demagoguery," and argued that the denial of health services could harm innocent children. The bill, Huckabee said, did not conform with his take on Christian values.

"I drink a different kind of Jesus juice," Huckabee said.

Today, Huckabee is seeking the Republican nomination for president, and voters nationwide are getting to know a different kind of candidate: He is the Southern preacher who favors droll wit over brimstone sermonizing, a rock 'n' roll bass player who believes in creationism, with an Oprah-ready story about a 110-pound weight loss that probably saved his life.

Here in Arkansas, where Huckabee ruled as governor for 10 1/2 years, voters grew accustomed to a different brand of Republican -- a governor with an idiosyncratic agenda that was sometimes difficult to categorize, but always driven, Huckabee insists, by his Southern Baptist faith. That faith influenced major policy decisions that could be deemed moderate, if not liberal, including a significant environmental initiative and a vastly expanded healthcare plan for low-income children.

Though Huckabee took strong stands against abortion and same-sex marriage, his record on taxes -- a key pillar of Republican orthodoxy -- was distinctly heterodox. He supported tax hikes on cigarettes, gasoline, groceries, sales and income. A video circulating on YouTube -- and played, in part, on the CNN-YouTube Republican debate Wednesday -- shows Huckabee addressing the Arkansas Legislature in 2003 and suggesting that he would be open to raising a broad range of taxes.

Initiatives like the children's health plan tapped a deep vein of populism, helping Huckabee win two gubernatorial elections. But his record on taxes and immigration alienated some Arkansas Republicans, who are watching with trepidation as Huckabee's prospects soar in the GOP primary race for president.

The most recent Des Moines Register poll, published today, showed Huckabee overtaking former Massachusetts Gov. Mitt Romney. (Huckabee's 29%-to-24% lead in the Register's poll is within the margin of error, but it's a huge advance from his tie for sixth place in the same poll in the spring.) Other surveys showed him gaining ground against former New York Mayor Rudolph W. Giuliani in Florida.

Holt, the former state senator, has a warning for conservatives around the country who think they have found their candidate.

"I think if they knew [his record] it would totally de-energize them," he said. " . . . His policies are just wrong."

In a phone interview, Huckabee, 52, asserted that he left Arkansas a stronger state when term limits forced him out of office in January -- with improved highways, more accountable schools, low unemployment, and an $800-million budget surplus. He also stood by his conservative credentials.

"I'd put mine against anybody's on that Republican stage," he said.

His achievements were won in the face of an often-vigorous Democratic opposition that controlled the Legislature throughout his governorship. At times it seemed he was "getting it from both sides," said Ann Clemmer, a Republican and Huckabee supporter who teaches political science at the University of Arkansas at Little Rock. "I think he did a lot just on his own -- really on his own counsel. And in that regard I think you have to say he was a leader."

Huckabee hails from President Clinton's hometown of Hope, and his political career has played out in Clinton's shadow. In 1993, voters narrowly elected Huckabee to replace Democratic Lt. Gov. Jim Guy Tucker, who succeeded to the governorship when Clinton was elected president. Huckabee became governor three years later, when Tucker resigned after being found guilty of two felonies as part of the Whitewater investigation involving the business dealings of Bill and Hillary Clinton and others.

To observers like Rex Nelson, a former political editor of the Arkansas Democrat-Gazette, Huckabee represented a welcome change.

"I think everybody wanted some calm, some stability," said Nelson, who signed on as Huckabee's press secretary in 1996 and served for nine years.

Arkansans eventually turned their attention away from Whitewater and the Clintons, and toward the teetotaling preacher who had once led Baptist congregations in Pine Bluff and Texarkana. Then, as now, Huckabee put his religious convictions front and center. Early on, he developed a mode of governing that seemed to be both expedient and from the heart.

Political consultant Dick Morris, who also worked for Bill Clinton, advised Huckabee in his first race for lieutenant governor. He told Huckabee that to succeed in Arkansas, he should avoid acting like a "country club" Republican who only represented the rich.

Morris also recalled saying to Huckabee: "I assume you're against parole for violent criminals, because you're a conservative." Huckabee told Morris that he would hold open the possibility of parole because he believed, in some cases, in the power of forgiveness, Morris said.

Democrates at the Heartland Presidential Forum

The people got more microphone time than the politicians.

Five Democratic presidential candidates who spoke at the Heartland Presidential Forum Saturday in Des Moines could do little more than nod and listen as person after person – mostly out-of-state residents – shared emotional stories of perceived injustice.

And the audience of 3,600 did not hesitate to express emotion. As they listened to descriptions of loss of health insurance, the stench of a nearby factory farm, or a family split up by immigration officials, the crowd frequently yelled out: “That ain’t right!” and booed.

Hillary Clinton, a U.S. senator from New York, felt the glare of their displeasure after Billy Lawless, a Chicago immigrations rights organizer, asked her if she’d commit to giving undocumented workers a path to citizenship in her first 100 days as president.

Clinton, who spoke via telephone after weather prevented her flight to Iowa, said immigration reform is a top priority.

But Lawless pressed her, asking if she’d do it in the first 100 days.

Clinton said it’s up to Congress to pass such reform, but as president she would do as much as possible.

The crowd booed, apparently upset that she wouldn’t commit to a 100-days promise.

Chris Dodd, a U.S. senator from Connecticut, was the next candidate to get that question, and he quickly answered: “Absolutely, absolutely.”

“One of the great sources of our wealth and strength of our country has been the diversity of our people,” Dodd said. “We’ve never done anything worthwhile as a nation when we’ve done it out of fear and hate.”

Saturday’s crowd was hardly just caucus-eligible Iowans. People were bused in from Missouri, Kansas, Illinois and Minnesota, and organizers said people from 33 states were represented as part of a kick-off to the Campaign for Community Values.

The forum was hosted by Iowa Citizens for Community Improvement and Campaign for Community Values, a movement that includes about 100 community organizations.

Only one Republican responded to the invitation – businessman John Cox - but the hosts’ lawyers advised against a solo member of one party because it would appear to be an endorsement.

Also in attendance were former North Carolina senator John Edwards, Illinois senator Barack Obama and Dennis Kucinich, a representative from Ohio.

Here's some of what they had to say:

EDWARDS: He listened to Virgene Martin of Bridgewater’s story about 400 people banding together to fight a factory farm. They failed, and the hog operation is now located next to Martin’s own family farm.

“What’s happening is these big corporate farming operations, and big multi-national corporations that are taking over farming in America, these corporate predatory lending operations, these big drug companies, big insurance companies, big oil companies, big banks, big gas companies we see what they’re doing to destroy our land,” Edwards said. “We see what they’re doing to destroy our people and take away our assets. How long are we going to let these people run the United States of America?”

Edwards, a former trial lawyer, said he beat those big corporations in the courtroom, “and I’ll beat ‘em again.”

KUCINICH: Irlanda Helgen of Marshalltown got teary-eyed telling Kucinich about a father of five children whose wife left for work one day and never came back because of an immigration raid.

“There are no illegal human beings,” Kucinich said in English and Spanish.

Deb Thomas of Wyoming told Kucinich that oil and gas companies that use hazardous chemicals in drilling are turning communities “into toxic wastelands.”

“We understand why we’re in Iraq, in a word,” Kucinich said and held out the microphone to capture the audience shout the word “Oil.”

Kucinich gave a fiery answer about his plan to move the country away from reliance on coal. He talked about a “full employment economy,” where everyone has a job, as well as health care for all, and education for all, from age 3 through college.

And he got wild applause when he said: “We must give those who come to this country a path to legalization.”

CLINTON: Patricia Divine Wilder of the town of Walla Walla in Washington state said she’s a small business owner who can’t afford health insurance. Her 36-year-old nephew also had no insurance, and by the time he went to the doctor for pain in his back and shoulders, his cancer was incurable.

“James died,” Wilder said, then paused to cry.

“Take your time,” Clinton said softly.

“James died,” Wilder continued, “just six weeks later."

“We have to have a better government safety net,” Clinton said, then gave a summary of her health care reform plan.

DODD: Emira Palacios, of Wichita, Kansas, told Dodd she came to the United States 22 years ago as an undocumented worker. She has spent over $15,000 during the process of becoming a citizen, and she and her 18-year old son will vote for first time in the next election.

“Take your time now,” Dodd said when Palacios became too emotional to speak.

Dodd said the country has to “have secure borders, obviously.”

Later, a moderator cut him off when his answer crossed the two-minute limit.

“I get more time here than I get at those debates, though, I can tell you that,” Dodd said, chuckling.

OBAMA: Deidra Lewis of Massachusetts said her daughter woke up with a burning feeling in her eyes one day. Lewis had to cut back her work hours to deal with her daughter’s rare eye disease. In January, she lost her health insurance.

But she enrolled in the State Children’s Health Insurance Program, and the public program made the difference between a child going blind or keeping her eyesight.

“Can you look into Alexsiana’s eyes and tell me don’t all God’s children deserve medical care?” she asked Obama.

Obama said yes. Alexsiana crossed the stage to hug him. The audience couldn’t hear what he whispered in her ear.

Obama vowed to have a plan in place for health insurance for all Americans by the end of his first term as president.

After a string of stories told by people from the Bronx, Cleveland, Mississippi, South Carolina and California, Debra Carr told Obama she is from Des Moines.

Obama immediately said: “I want you to caucus for me.”