Clinton unveils details of her health care plan

— -- Determined to avoid the fatal flaws of her 1993 plan, Hillary Rodham Clinton proposed an overhaul of the nation's health care system Monday that would require Americans to buy insurance but allow them to keep what they have.

The front-runner in the race for the Democratic presidential nomination said that under her new plan, the federal government would spend $110 billion a year to help employers and individuals pay for insurance. About half of the money would come from repealing tax cuts and tax breaks for people with incomes above $250,000; the rest would be saved through efficiencies in the system, such as chronic disease management.

"This is not government-run. There will be no new bureaucracy," Clinton said at a medical center in Iowa, scene of the race's first caucuses. "You can keep the doctors you know and trust. You can keep your insurance plan if you like it."

That was an effort to differentiate the proposal from the plan she devised as first lady in 1993. That plan, which called for a new federal bureaucracy to oversee and regulate insurance markets, was killed in Congress the following year.

Clinton unveiled her plan as Health and Human Services Secretary Mike Leavitt said President Bush wants to achieve universal health care before he leaves office.

Leavitt told the USA TODAY editorial board that Bush will veto a Democratic plan emerging from Congress that would add $35 billion in taxpayer subsidies to the Children's Health Insurance Program over five years. In doing so, Leavitt said, Bush will urge Congress to join him in seeking coverage for all Americans.

"He'd like to see the larger debate begin," Leavitt said. "The very best opportunity we have may well be in the next 15 months."

Clinton was among the last of eight Democratic presidential candidates to lay out her health care plan. The two other leading candidates, Sen. Barack Obama of Illinois and former North Carolina senator John Edwards, have proposed similar plans, although Obama does not call for a requirement that individuals buy insurance. Edwards has said his plan would cost between $90 billion and $120 billion a year. Obama's plan would cost $50 billion to $65 billion a year.

Clinton's plan would mandate that large employers offer health insurance or contribute to a government-run insurance pool. Small businesses would receive tax credits to help them cover employees.

Lower-income individuals would be eligible for tax credits to prevent them from paying more than a set percentage of their income on health insurance. They could keep their policies, choose from an array of private plans similar to what federal employees are offered or enroll in a new government-run plan similar to Medicare.

Insurers, who helped defeat the Clinton plan in 1994, would not be allowed to discriminate against or overcharge people with expensive medical conditions or risk factors. Karen Ignagni, president of America's Health Insurance Plans, said Clinton's plan includes "important ideas" but also "some of the divisive rhetoric reminiscent of 1993."

The plan, like others, is short on details that would be worked out in Congress. For instance, Clinton does not say how she would enforce the mandate that individuals buy insurance.

Health policy experts said Clinton's plan is more centrist than the one 14 years ago because it builds on the current employer-based system. "This is designed to be less threatening to insurers," said Paul Ginsburg of the Center for Studying Health System Change.

Republicans criticized Clinton's plan as heavy-handed. Rudy Giuliani's campaign called it the "Clinton-Moore plan" after filmmaker Michael Moore, whose film Sicko lambastes the U.S. health care system and lauds government-run programs in other countries. Mitt Romney called it "a European-style socialized medicine plan."