October 15, 2004
The number of Arizonans lacking health insurance came into focus during this week’s presidential debate in Tempe, but advocates involved in the issue disagree on whether the numbers cited by Sen. John Kerry accurately refl ect the state’s situation.
During Wednesday’s debate at Arizona State University, the Democratic nominee, highlighted Arizona’s number of uninsured — 950,000 people, according to his estimates — as an example of a gaping national problem that he plans to repair by making the federal government’s health care coverage available to all Americans.
That helped set the stage for each candidate to tout his approach to helping cover the uninsured.
President Bush called Kerry’s plan "government-run" health care on a grand scale that will cost Americans more than a trillion dollars over a decade. A better plan, he said, is to empower people to purchase their own insurance using refundable tax credits.
Advocates for the uninsured said the debate showed how much Arizona, which often ranks low in health care surveys, stands to gain or lose based on which health care proposal is implemented.
"We are a perfect example of a state where people work hard and who are either uninsured or underinsured," said Carol Kamin, president and chief executive officer of the Children’s Action Alliance. "We are the poster child state for a plan that would in fact help families and kids have health insurance."
Kamin and others said Kerry’s plan would be better for Arizona because it would cover more people. Kerry estimates his plan would cover about 27 million more people and cost $650 billion over 10 years. Bush estimates his plan would cover about 7 million more people and cost $128 billion over 10 years.
Critics, however, questioned whether the number of uninsured people in Arizona is really nearly 1 million. Such estimates may include undocumented residents, people who switched jobs and are uninsured for a short period, those who are eligible for state Medicaid programs but have not enrolled, or those who choose not to be covered.
"All those people (in Kerry’s uninsured estimate) are not people who don’t have access to coverage," said Jeff Gennaro, legislative chairman of the Arizona Association of Health Underwriters. "It’s not as big a problem as they want you to believe it is."
But at organizations that reach out to those who are poor, abused or homeless, leaders said there is no question that the uninsured is a large and growing group.
At Child Crisis Center — East Valley, families seeking help are often earning low wages and struggling just to put food on the table, said Chris Scarpati, the center’s executive director.
"When they’re one paycheck away from being evicted or their jobs don’t offer (health insurance) . . . they just have to hope they’re kids stay healthy and they stay healthy so they don’t miss a day of work," said Scarpati.
What’s needed is a plan that both covers more uninsured people and relieves the increasing financial burden on the Arizona Health Care Cost Containment System, the state’s Medicaid program, said its director, Tony Rodgers. From July to October, enrollment in the program jumped from 954,626 to more than 1 million. If growth continues, the program may need an additional $30 million from the state, he said.
Kerry’s plan would allow people to buy into the federal government’s health care program. It is not nationalized health care, he said, because people would have the choice to join and choose from many health plans. His plan includes tax incentives and help in paying for catastrophic medical bills for small businesses that agree to cover all employees, provide disease management programs and pass along savings by lowering employees’ premiums. Also, Medicaid eligibility would be expanded, including full coverage for 20 million children.
Bush’s plan would provide refundable tax credits of $1,000 per individual and $3,000 per family so people could set up health savings accounts and purchase lowpremium, high-deductible insurance. Tax deductions would be available for contributions to health savings accounts by individuals and employers. The plan encourages organizations to band together to negotiate better rates.
"It will be interesting to see whoever wins and whatever (health care) plan is in place, and how quickly it affects families that are struggling to survive," Scarpati said.