Current Issue Pic Top Harvard Health Policy Review Archives Top
Current Issue Pic Middle About Us Fill Archives Bottom
Contact Us Fall 2000; Volume 1, Number 1
Features: Election 2000

Summary of the Bush Health Care Plan
Summary Compiled by David Sclar

Governor George W. Bush has made proposals aimed at helping low-income families to afford health insurance, small businesses to insure their employees, and the elderly to afford prescription drugs. He also supports increased choice and flexibility in health insurance arrangements through reforming Flexible Savings Accounts (FSAs) and Medical Savings Accounts (MSAs). His health care positions emphasize consumer choice, reducing uninsurance, and lowering health care costs.

Bush's main proposals are as follows:

A refundable health credit for low-income families and individuals
Bush proposes a refundable health credit for every family making less than $30,000, and individuals making less than $15,000. Families receiving this credit would be otherwise ineligible for government programs such as Medicaid, and they would not be covered by their employers. Bush would provide families with a health credit of up to $2,000 ($1,000 for individuals) or up to 90 percent of the cost of health insurance. The size of the credit declines with increases in the income of the recipients, so that those with lower incomes receive the largest credit. The goal is to help more Americans purchase health insurance on their own by lowering its cost.

Help small businesses to provide insurance through associations
Bush supports Association Health Plans (AHPs), such as the Chamber of Commerce, which allow small businesses to join together for the purchasing of health insurance so that they can enjoy the benefits of economies of scale.

Reducing federal regulations on state health programs
Bush would "remove federal regulations that restrict state flexibility in designing and implementing programs for the uninsured." At the community level, Bush also supports Community Health Centers (CHCs) that care for underserved communities.

Making FSA's More Flexible
Flexible Savings Accounts (FSAs) allow employees to save pre-tax wages for unexpected health expenses. However, remaining FSA funds return to the employer at year-end, "creat[ing] a perverse incentive for working families to spend all the funds in the FSA, even if the medical services they purchase are only marginally beneficial." Thus, Bush proposes that up to $500 should "rollover" from one year to the next.

Expanding and Reforming MSAs
Medical Savings Accounts (MSAs) allow individuals to save up tax-favored funds to pay off high deductibles when they need catastrophic coverage. Governor Bush would:

  • make MSAs permanent, as the law authorizing them is set to expire this year
  • eliminate the cap of 750,000 on the number of accounts
  • allow all employers to offer an MSA
  • allow both employer and employee contributions to MSAs
  • allow MSA funds to contribute to a lower minimum deductible as well as to pay the full cost of that deductible
Bush's plan for Prescription Drug Coverage ($158 billion + $40 billion for healthcare providers over ten years)
Bush's plan, called MediCARxES, covers all costs for seniors with incomes at or below 135% of poverty. Seniors with incomes between 135% and 175% of poverty would receive a subsidy to pay for drug coverage - the lower their income, the greater the subsidy. For all other seniors, the government would provide a 25% subsidy towards the cost of premiums and would pay for all costs above a stop-loss of $6,000. Premiums would be determined by private health insurance companies, and seniors would be able to choose which plan to join. Of the $158 billion cost of the plan, $48 billion would provide an "immediate helping hand" to states over the next four years. Bush emphasizes the simplicity of his plan (enrollees pay one premium as opposed to enrolling in multiple parts of the Medicare program), its 2001 start date, and the flexibility given to seniors to choose the health plan that's right for them.

Bush's Record as Governor of Texas
  • Bush funded increased emergency medical services and trauma care.
  • Bush enacted tobacco education programs for children and young adults to teach them about the hazards of tobacco use. Bush also funded enforcement activities to restrict youth access to tobacco.
  • Bush directed $1.8 billion dollars to fund health care initiatives in Texas. These funds were in addition to the $4 billion Texas spent on health care for the uninsured in 1999.
  • Under Governor Bush, Texas enrolled in the Children's Health Insurance Program. He also created an optional program for immigrant children. The two programs have improved access to health insurance for 423,000 children.
  • Under Governor Bush, Texas passed a Patients' Bill of Rights that ensured coverage for women for a minimum of 48 hours in the hospital after giving birth or undergoing a mastectomy. The bill also created an independent review panel for patients to appeal care denied. Patients were given the right to sue their health plan, though without the governor's signature. And employees were given the right to choose doctors outside their health plan, though they need to pay extra for the privilege.

Information on George W. Bush's health care proposals was gathered from

Fall 2000, Volume 1, Number 1
Table of Contents
Editor's Note
Features: Election 2000
Health Highlights
In Focus
Glossary of Health Care Terms

about us | links | contact us | subscribe | epihc