WASHINGTON — President Bush on Saturday entered the growing debate about providing healthcare coverage for uninsured Americans, calling for a major change in the tax system to help those whose employers don't offer a plan.

Bush's proposal is a combination of carrots and sticks — and, if enacted, would create new winners and losers in the health insurance arena. It is likely to run into opposition in the Democratic-led Congress but could serve as a key element of a broader package dealing with rising healthcare costs and shrinking coverage.

The carrot in Bush's plan is the creation of a health insurance tax deduction that all taxpayers would receive — $7,500 a year for individuals and $15,000 for families.

But the proposal also comes with a stick: Those with insurance plans with an annual premium more than the deduction would have to pay income taxes on the difference. That would be a big change from current law, under which all employerprovided health insurance is tax-free for workers.

Bush wants to use tax revenue from people with benefit-rich plans — the healthcare haves — to pay for the new health insurance deduction. That would enable many of the estimated 47 million uninsured Americans — the healthcare have-nots — to buy coverage...

Many economists, however, say that Bush's plan deserves serious consideration.

"Given that we agree that we need some combination of individual and social responsibility, this is one key step in a total package that could bring coverage to all Americans," said Len Nichols of the nonpartisan New America Foundation think tank.

But Nichols would use the additional revenue to expand group coverage instead of individually purchased policies...

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