Highlights of Clinton's Health-Care Reform Plan

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The following is based on a draft of the President's plan dated Sept. 7

Federal grants to states to increase the number of school clinics and broaden the scope of their services. Emphasis would be placed on regions that currently lack adequate health services.

OVERVIEW

Guaranteed health coverage for all Americans by the end of 1997.

Employers would be required to pay 80 percent of the cost of employees’ coverage.

Doctors, hospitals, and clinics would be expected to organize themselves into “health-care networks’’ that would compete to provide services and keep costs low.

States would create “regional health-care alliances’'--independent state agencies or nonprofit corporations whose members would include most businesses, school districts and other government agencies, the self-employed, and others. Most Americans would obtain health coverage through their regional alliances. The alliances would negotiate the cost of services with health-care networks and insurers. They would approve the creation of the networks, monitor their quality and cost-effectiveness, and report their findings to the public. Each alliance would offer at least one “fee for service’’ plan. Companies employing 5,000 or more workers could choose to create their own “corporate alliances.’'

A National Health Board appointed by the President would monitor the regional alliances and set systemwide regulations.

No one would be denied coverage due to a pre-existing condition.

People who changed jobs would retain their coverage.

Employers could not drop coverage for employees’ dependents due to cost.

Every health-care network would be required to offer a standard benefits package at the same cost to everyone.

STANDARD BENEFITS PACKAGE

Most services now covered under traditional private health plans.

Immunizations for infants for eight diseases.

Family-planning and pregnancy-related services.

Preventive dental services and eye exams for children under 18.

Health-education classes, including stress management and nutritional counseling.

Mental-health services, including treatment for drug and alcohol abuse.

FUNDING

The Administration estimates it will cost $700 billion over five years to launch the program.
Costs partially offset by controls on Medicaid and Medicare expenditures.
Higher taxes proposed on tobacco.

SCHOOL CLINICS

Federal grants to states to increase the number of school clinics and broaden the scope of their services. Emphasis would be placed on regions that currently lack adequate health services.
Among other things, clinics could offer mental-health and family-planning services and immunizations.
Services provided through school clinics would be automatically covered under all health-care plans.

HEALTH EDUCATION

Federal grants to states for school-based health-education programs for adolescents and adults. Emphasis would be placed on sex-education and AIDS-prevention programs and other efforts to reduce high-risk behavior.

MEDICAID

The federal government would pay premiums for poor and disabled persons who are unemployed.
Funding could be used to pay for services at school-based clinics.

RURAL HEALTH

Federal funding to help establish health-care networks in rural communities.
Development of new “academic health centers’’ to support rural health-education efforts.

STUDENT COVERAGE

Dependent students in boarding schools or at college would be covered under their parents’ plans, or could join regional health alliances where they attend school.

A version of this article appeared in the September 29, 1993 edition of Education Week as Highlights of Clinton’s Health-Care Reform Plan