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STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. Good morning. I'm Steve Inskeep.

RENEE MONTAGNE, host:

And I'm Renee Montagne.

Health care reform is back, you might have noticed. For the first time since the early '90s, politicians are talking more about health insurance and making it available to everyone. NPR's Julie Rovner has this first in a weekly series.

JULIE ROVNER: The emergence of health reform as an issue in Washington is as predictable as that of the 17-year cicadas and nearly on the same schedule. These days health care is the buzz in Washington. President Bush is part of the chorus. His plan would change how health insurance premiums are taxed in order to help more Americans afford more health insurance.

President GEORGE W. BUSH: This common sense solution will level the playing field for all Americans, whether you get your health insurance through your job or on your own.

ROVNER: Then, of course, there are the Democratic presidential candidates, led by Senator Hillary Rodham Clinton of New York. She poked a little fun at the president's newfound interest in health in a speech next month.

Senator HILLARY CLINTON (Democrat, New York): I'm going to send him a suit of armor because I know that anybody who puts a foot into the health care debate is going to need that.

ROVNER: But even Clinton's ready for another try.

Sen. CLINTON: I believe we still need to make a commitment to universal health care.

ROVNER: And that phrase universal health care is, well, universal among the Democratic presidential candidates. Here's Illinois Senator Barack Obama.

Senator BARACK OBAMA (Democrat, Illinois): By the end of my first term as president, we will make sure that everybody has universal health care in this country.

ROVNER: Not to be outdone, former North Carolina Senator John Edwards has already laid out a fully detailed plan for universal health coverage. And he said on NPR's TALK OF THE NATION he'd implement it even faster than Clinton and Obama would.

Mr. JOHN EDWARDS (Democratic Presidential Candidate): It would be active before the end of the first term.

ROVNER: All this talk about universal health care may be cyclical but an awful lot of people didn't see this particular cycle coming. Drew Altman, president of the nonpartisan Kaiser Family Foundation, has tracked health reform's ups and downs for decades. He says health care was still a political afterthought as recently as last November when political pollsters didn't even include a question about it in the national exit polls for the midterm congressional elections.

Mr. DREW ALTMAN (President, Kaiser Family Foundation): That's an awful lot of change in just a few months.

ROVNER: Why is health care coming on so fast as a national political issue? Altman says it's not because the public cares about health care more than it did last fall.

Mr. ALTMAN: Their level of concern has been pretty constant, and it's about the same now as it was in the early '90s. What's really changed is that leaders and leadership groups driving the national agenda from the top are back in the game.

ROVNER: And that hasn't been the case since the early 1990s. That was when political unknown Harris Wofford won a surprise election to the Senate from Pennsylvania largely on the strength of the health care issue in general and this ad in particular.

(Soundbite of political advertisement)

Mr. HARRIS WOFFORD (Former Senator, Pennsylvania): If criminals have a right to a lawyer, I think working Americans should have a right to a doctor.

ROVNER: Altman says Wofford's win sent shockwaves through the political world.

Mr. ALTMAN: Because it was the first time that politicians came to see that you could win an election and get votes by talking about health care as an issue.

ROVNER: Bill Clinton was the next politician to do it.

President BILL CLINTON: We must make this our most urgent priority, giving every American health security. Health care that can never be taken away. Health care that is always there.

ROVNER: Except the opposition proved stronger than the president.

Mr. ALTMAN: And the rest is history that everybody knows about.

ROVNER: Key to that opposition was the business community and its friends, Harry and Louise. Remember them? The couple in the insurance industry ads that came to symbolize the opposition to Clinton Care.

(Soundbite of political advertisement)

Unidentified Man: The government may force us to pick from a few health care plans designed by government bureaucrats.

Unidentified Woman: Having choices we don't like is no choice at all.

Unidentified Man: If they choose…

Unidentified Woman: …we lose.

ROVNER: But that was then. Today, business and insurance groups are pushing health care reform on their own and their plans have a major role for the government. Even further along than business or federal officials are the nation's governors. Altman says there's a key reason they've been able to make headway.

Mr. ALTMAN: Because states are practical. They're not as frantically ideological as Washington is.

ROVNER: For example, Illinois is on its way to providing insurance to every child in the state. Massachusetts is implementing a plan to cover virtually all residents. And at least a dozen other states are in various stages of planning overhauls. Californian Governor Arnold Schwarzenegger spoke at the National Press Club last month about his plan which, like several others, includes a so- called individual mandate.

Governor ARNOLD SCHWARZENEGGER (Republican, California): I believe that part of the health care answer is mandatory medical insurance, just like we have mandatory car insurance.

ROVNER: What's really new about these plans, says Altman, has been the willingness of governors to take ideas from both ends of the ideological spectrum.

Mr. ALTMAN: They kind of sent a message to the country and to Washington that the paralysis that has gripped us on health reform is not necessarily an inevitable or insurmountable condition.

ROVNER: But only if reform advocates overcome the biggest sticking point of all: finding the money to provide health insurance for everyone.

Julie Rovner, NPR News, Washington.

MONTAGNE: And you can track America's uninsured state-by-state at npr.org.

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