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Journal Issue: Children and Divorce Volume 4 Number 1 Spring/Summer 1994

REVISITING THE ISSUES: Children and National Health Care Reform
Sara Rosenbaum

State Administration and Cost Controls

All of the measures depend heavily on state administration. Only in the President's bill and the McDermott/Wellstone bill does the cost control system not differentiate between children whose coverage is publicly subsidized and children whose coverage is not. The McDermott/Wellstone bill achieves this goal by covering all children with government insurance. The President's bill achieves this goal by paying identical health plan enrollment rates for children regardless of family income. Funds from employers, individuals, and the state and federal governments are commingled in a common pool and are subject to uniform premium controls.

The other measures contain direct cost controls only for persons whose insurance is publicly subsidized. While the Cooper/Breaux, Thomas/Chafee, Michel/Lott, and Stearns/Nickles bills limit tax deductibility, plans can raise premiums above this level for privately insured persons. Because public subsidies are limited, as a practical matter children in lower-income families face more stringent health care budget limitations.