2004 Congress may aim spotlight at uninsured: tax credits to be prominently featured.(Practice Trends)

WASHINGTON -- What will Congress' health policy priority be in 2004? Two words: the uninsured.

"The increasing number of people without health coverage truly represents one of the most daunting policy challenges facing our nation," Senate Majority Leader Bill Frist (R-Tenn.) said in a floor statement in December 2003.

"As a physician, I know that the lack of health coverage imposes significant barriers to quality health care, including preventive services. The lack of affordable health coverage is also one of the key factors accounting for health care disparities among minorities and other medically under-served populations," he said.

Dr. Frist has asked Sen. Judd Gregg (R-N.H.) to lead a Senate Republican task force on the uninsured issue; a report is expected soon.

Health policy experts predict that several forms of help for the uninsured will be discussed, with tax credits to buy health insurance appearing to be the most popular. Some form of special

tax treatment for health insurance is in the health care reform proposals of most of the Democratic presidential candidates, said Robert Helms, Ph.D., resident scholar in health policy studies at the American Enterprise Institute, a conservative think tank. "[President] Bush has had a tax credit proposal for the last 2 years, and he is expected to have a new proposal in February," he said.

Tax credits that help uninsured people buy private health insurance policies have several advantages, Dr. Helms noted: They are refundable--that is, people will still get money even if they are too poor to pay taxes--and they are advanceable, so that people can have access to the tax credit's purchasing power before they actually pay their taxes.