Health care ideas divide Democrats

Sunday, August 1, 2004 | 12:00 a.m. CDT; updated 4:48 p.m. CDT, Monday, July 21, 2008

Health care is a hot topic for both 19th District state Senate Democratic candidates, Tim Harlan and Chuck Graham. It has been the source of conversation at forums, in radio and television ads and at stump speeches.

Although the two candidates set to face off in Tuesday’s primary share similar views on many aspects of health care, they are split over what issues warrant the most concern. While Graham has campaigned on expanding his personal-care assistance program, Harlan’s focus has been on providing health care to small-business employees and farmers.

Harlan stresses Missourians’ need for health insurance, citing a study conducted by Families USA, which found that 27 percent of Missourians younger than 65 went without health insurance in 2002 and 2003.

“If you don’t work for big business or the government, and if you are able to purchase health insurance, it is at risk. Everyone agrees that small business is the growth engine of the economy, but at the same time we’ve created a situation that very much limits people going into small business,” Harlan said Thursday in a news conference.

Graham, who supports Harlan’s proposal, said he worries whether Harlan’s plan will gain traction in the Senate. The Republican majority won’t permit the proposal and will be “dead on arrival,” Graham said.

“It is the same plan he (Harlan) wasn’t able to pass during his eight years in the House, which was a much more favorable environment with Democrats controlling the Senate and House,” Graham said.

The Missouri Health Insurance Pool, offered by the state and administered privately, provides coverage for people unable to obtain health insurance because of their high-risk status or people who are being charged more than 300 percent of standard premiums. But because of high costs, the so-called “high-risk pool” has been limited to only about 1,000 people.

Harlan’s plan would allow entry into the pool if someone were turned down or only offered coverage that is at least 135 percent over the standard rate. He hopes people could use the pool to become insured and then transfer a year later to a private policy.

Insurance companies are much more likely to offer insurance to someone who has had previous coverage, Harlan said.

The proposal would also prohibit the purchase of life insurance with health insurance, prohibit carriers from substantially raising prices once an individual becomes ill, and create a health insurance pool so that companies could share any additional costs that might arise.

In addition, Harlan’s plan would establish a $400,000 fund to administer grants that would help farmers and businesses band together to buy insurance.

Harlan’s proposal would be financed by the state’s general revenue fund. “I don’t know that I have a figure,” Harlan conceded, but he added that insurance needs to be a bigger priority than it has been in the past.

As the 23rd District state representative, Harlan tried passing similar bills that were approved unanimously in the House but not approved by the Senate. Harlan said big businesses oppose the plan based on the concern that any amount of subsidy is inappropriate because their employees don’t use the high-risk fund.

“But I think at some point we have to agree that if we’re going to grow small business, we have to provide health insurance,” he said.

Graham said he would also like to help people in small businesses afford health insurance. “As someone with a pre-existing condition, I know the fear of not having insurance,” he said.

Like Harlan, Graham proposes allowing businesses and farmers to band together to buy insurance, a practice that is now prohibited.

Graham wants to see a federal, single-payer health-care plan developed, in which the government would collect and pay health-care providers.

“I think it would be more cost-efficient, and we would be able to provide better health care.

“You could move in and out of the labor force without risking losing health care or losing coverage because of pre-existing conditions,” he said.

Graham concedes a single-payer system would have to be established on a national level, but said he has other plans for work that can be done on a state level.

In his first term as the 24th District state representative, Graham persuaded then-Gov. Mel Carnahan to apply for a Medicaid waiver that would allow people with severe disabilities to live in their own homes instead of nursing homes.

“It gives them more opportunity, more dignity, more independence, and it saves the state money. It’s a lot less expensive to have them in their own home than in a nursing home,” Graham said.

The program now serves 5,000 people, but Graham would like to see it expanded.

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