Kerry proposes health coverage for all children

WASHINGTON -- Vowing to use his new ''national voice" in the wake of his presidential campaign, Senator John F. Kerry yesterday unveiled a sweeping plan to bring health coverage to all children, paid for by repealing recent tax cuts for the highest-income Americans.

Kerry's bill would make healthcare for children universal by encouraging states to expand coverage under Medicaid and its companion state-federal program, the State Children's Health Insurance Program. He would also give higher-income parents tax incentives to insure their own children.

''It's just unacceptable in our country that we have so many children -- millions of kids -- who are uninsured, they get no healthcare, some of them get learning disabilities for the lack of diagnosis of something as simple as an earache," Kerry said in an interview with the Globe. ''This has to be priority number one. It's a place to start."

Kerry said the bill fulfills a pledge he made on the campaign trail, where he vowed to make such legislation the first bill he'd file as president. He has signed up 300,000 ''citizen cosponsors," recruited via his campaign e-mail list. Kerry said he is planning to ''gin up energy" for his bill through speeches around the country.

He will have his work cut out for him: The bill is not expected to get a warm reception in the Republican-led Senate, although Kerry promised to reach across the aisle to Republicans members who favor expanded healthcare.

Offering a glimpse at how he plans to conduct himself in his return to the Senate, Kerry said in the interview that he will use his perch on the Senate's Finance Committee -- as well as the network of supporters from his presidential run -- to garner support for his priorities.

The Massachusetts Democrat said his experiences on the campaign trail reinforced many fundamental beliefs and left him ''energized" about the possibilities to effect change through Congress. He said he believes that despite his loss, a large majority of Americans agree that health coverage should be provided to all, and he feels he is well-positioned to push for it.

''I haven't had a place to work directly as I can now [through the Finance Committee], nor have I had sort of a national voice to be able to apply to it," Kerry said. ''I'm reinforced in what I felt beforehand, but it's much more passionate and real to me in the sense that you can't help but go out there and be touched by people's lives.

''You can't go out there for two years and be in people's living rooms -- and their restaurants and their barns and their VFW halls -- and have the kind of interaction that I've been privileged to have, and not come back energized and reinforced in what this is all about," he added. ''This is not politics. . . . A lot of people in this country are hurting."

Republicans are already expressing concerns about the bill, particularly given the current record budget deficit. The Bush administration is seeking ways to scale back Medicaid coverage to save money, and many states have slashed health-care programs to cope with their own budget crunches.

Senator John McCain, Republican of Arizona, said that while covering more children is popular in the Senate, budget pressures may make it difficult. But he said Kerry's higher profile following the presidential campaign is likely to help his cause.

''He obviously has an elevated reputation, and that matters around here," said McCain, who returned to the Senate after his own failed presidential run in 2000. ''It's going to increase his influence in the Senate."

Senator Edward M. Kennedy, Kerry's Massachusetts colleague and a cosponsor on the health-care bill, said Kerry is poised to play a leadership role not just in foreign affairs but on major issues like Social Security, tax reform, and the budget deficit.

''He came back to the Senate ready to fight, and he's already leading on key issues," Kennedy said. ''I don't know anyone who's better situated to be a major figure in the Senate agenda."

Kerry's health-care plans drew derision from Bush and other Republicans on the campaign trail. The president mocked Kerry's calls for universal coverage as ''creeping toward Hillary-care," and warned that it would lead to rationing of health services and a lack of choice among doctors.

Kerry and his campaign dismissed such criticisms, noting that his plan for universal coverage relied on employer incentives and tax credits as well as an option to buy into the health program available to federal employees, and that it was not government-run healthcare.

Although Kerry said he plans to introduce a version of his broader plan later in the Senate term, he is initially seeking only to guarantee coverage for children.

''We've got to find a starting place to find a common ground," Kerry said.

Under current law, states are required to provide health insurance through Medicaid to children up to age 18 whose family incomes put them at or below the federal poverty line -- now, earning $15,670 annually for a family of three. The federal government picks up about 57 percent of the cost on average. (For children up to age 6, the family income limit is higher. And many states, including Massachusetts, also choose to insure older children who are above the poverty line.)

Kerry's plan would encourage states to cover children up to age 21 whose family incomes are too high for them to be currently eligible. The federal government would pay two-thirds of the costs of covering children in families with incomes of up to three times the poverty line.

As an additional incentive, those states also would receive full federal funding for Medicaid coverage for children in the state who are at or below the poverty line. For children from families at up to three times the poverty level, the states would have roughly two-thirds of their costs matched by the federal government.

Kerry said the increased federal aid would save states $10 billion annually, and predicted that all state governments would jump on board for the savings, providing coverage to 11 million children who are now uninsured. The expanded coverage would be paid for by rolling back the recent income tax cuts for those who make more than $350,000 a year, to pay for the bill's estimated cost of $22 billion per year.

The senator said he would reach out to his Republican colleagues. But if his bill is stalled by GOP leadership, he is promising to offer it as an amendment to other bills, to force his colleagues to vote on whether all children should get healthcare or the wealthiest taxpayers should keep recent tax cuts.

''I intend to really try to create a grass-roots effort, to help us push people here in the Senate and elsewhere," Kerry said.

Rick Klein can be reached at rklein@globe.com.