Health care was a larger focus of the president's 2006 speech than in past years -- but many of the proposals were those he has unsuccessfully offered before. Bills to ban human cloning, to create "Association Health Plans" to help small businesses pool their buying power, and to limit medical malpractice damage awards have each passed the Republican-dominated House multiple times, but failed in the more closely divided Senate.
Background materials provided by the White House suggest that the administration will make a major push to expand the use of "Health Savings Accounts" (HSAs), originally authorized by the 2003 Medicare law. The number of people covered by HSA-eligible insurance polices has grown rapidly -- to more than 3 million, tripling in just the past 10 months, according to the trade group America's Health Insurance Plans. But that remains a tiny fraction of a health system that covers more than 160 million Americans through their jobs.
HSAs combine with high-deductible health insurance plans to give consumers more control -- and more responsiblity -- over their health spending. Patients use the money in their HSA to pay for routine care, and can keep whatever they don't spend, giving them an incentive to seek out higher quality, less expensive services.
The president's proposals would give HSAs -- already tax free -- even more tax advantages. It would allow individuals who buy their own insurance the ability to deduct premiums for the high deductible insurance that accompanies an HSA. Currently only businesses and those who are self-employed can deduct premium costs. The President will also propose tax credits for low-income Americans to buy insurance -- again, only insurance that goes with an HSA.
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