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Health Insurance Truth or Dare


McCain’s plan won’t really insure the uninsured; Obama’s will cost more than he says. Find out what’s really going to happen to your health costs in 2009.

By: Charles Noe

Reviewed By: David Slotnick, M.D.

The presidential nominees' healthcare plans will affect every American. Experts foresee a shakeup that expands insurance coverage but costs at least $1.3 trillion over the next decade.

Republican Sen. John McCain would shift more responsibility from businesses to employees by taxing health benefits and instead giving tax credits to individuals who find coverage. The Tax Policy Institute expects that 20 million people would leave employer health plans and 21 million people would find other coverage in 2009, a net gain of 1 million insured. It sees the number of uninsured declining by nearly 5 million by 2013 but then increasing as insurance costs outpace the tax credit.

In contrast, Sen. Barack Obama's $1.6 trillion plan could cost about 19 percent more than McCain's 10-year price tag but cover far more uninsured Americans, about 34 million within a decade. He'd do this by creating a federally run health insurance program that would compete with private companies. Parents would have to insure their children, and large businesses that don't offer coverage would be penalized, but the proposal falls short of Democrats' longtime goal of universal health care.

How the candidates' healthcare proposals may affect you, based largely on recent reports from the Tax Policy Center and the journal Health Affairs:

Major initiatives
McCain's plan Obama's plan
  • Tax workers on the value of their employer-provided health benefits
  • Offset that with refundable tax credit of $2,500 a person or $5,000 a family to buy insurance; any excess goes into health savings account
  • Let people buy health insurance across state lines, increasing choice but undercutting state-mandated benefits
  • Help states cover high-risk individuals
  • Let workers take health plans from job to job
  • Reimport drugs and speed up approval of generics
  • Add a federal health insurance program and let private insurers compete with it
  • Require parents to insure children
  • Subsidize low-income people
  • Reimburse employers for catastrophic healthcare costs
  • Set minimum standards for coverage
  • Make insurers cover people with pre-existing conditions at no greater cost
  • Let workers take health plans from job to job
  • Let government negotiate with drug companies; improve access to generics and overseas drugs
If you already have health insurance
McCain's plan Obama's plan
  • Employers likely to cut benefits
  • Healthy young workers may find cheaper deal than employer's plan, but sick and elderly may have trouble staying covered
  • Regulations and subsidies will raise cost of insurance
  • Some workers face pay cut or job loss
If you don't now have insurance
McCain's plan Obama's plan
  • May cover 1 million more people in 2009, nearly 5 million temporarily by 2013
  • Employers not required to offer insurance
  • May cover 18 million more people in 2009, 34 million by 2018
  • Large employers must offer insurance or pay into fund
Projected cost and how to pay it
McCain's plan Obama's plan
  • $1.3 trillion over 10 years
  • Says he won't raise taxes, so budget deficit may rise
  • $1.6 trillion over 10 years
  • Let Bush tax cuts expire; add 4 percent payroll tax on large employers that don't offer insurance

 

McCain's move toward "a relatively unregulated nongroup market will tend to raise costs, reduce the generosity of benefits, and leave people with fewer consumer protections," the September/October issue of Health Affairs cautions, and Obama's plan "greatly increases the federal regulation of private insurance but does not address the core economic incentives that drive health care spending," raising "serious questions about its fiscal sustainability."

In other words, this election won't cure America's healthcare crisis, and the winner will likely find that his prescription eases some symptoms but also has side effects.

More: Another look at how the nominees would change your health care.

Plus: What do you think of the candidates and their proposals? How are you coping with the high cost of health care? Sound off on the Hot Topics in Health message board.

 

 

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Copyright (c) 2000-2009 iVillage Inc. All rights reserved. The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.