More of the people I interviewed would benefit more from Obama’s proposals than those of John McCain. They are older, sicker, with lower incomes—the very people who will have trouble getting coverage under a McCain plan, according to a Lewin Group study released last week. Some people with the lowest incomes, like James Bell IV and Michelle Hernandez, might get coverage from an Obama public insurance option if government helped pay for the coverage and if the government provided the benefits. But if an Obama public program option calls on commercial insurers to provide the benefits, and if they are not forced to take people with diabetes, then people like Bell and Hernandez will remain uninsured.
Obama’s plan would expand current public health programs. But if the government has no money to improve coverage under Medicaid—which might allow Hernandez’s daughter, Jasmine, to continue her insurance when she turns eighteen in a few months—or if it can’t afford to let the disabled Annette Murph get on Medicare without waiting two years for the opportunity, then these people, too, would continue to be uninsured. James Bell III and Kevin Smith have employer coverage, which means they will have to come up with extra money to pay income taxes on those benefits, as McCain has proposed. Neither would benefit from his tax credit, because they have preexisting health conditions that disqualify them from coverage and couldn’t buy insurance on their own. Smith, Pam Culp, and Glenn Hall would continue to be underinsured under either plan. Their incomes are high, and they wouldn’t qualify for any subsidies to help them buy insurance. Most likely they would keep what they have—insurance with high copayments, high deductibles, and, in Hall’s case, an exclusion from coverage of his existing health conditions. (Under Obama, insurance companies might be prohibited from adding such exclusions.) And they’d pay a pretty penny for the coverage they do get.
We have repeatedly urged the media to find people in their communities and tell their stories through the lens of the candidates’ proposals. News outlets that have done that are few and far between, which may be one reason why a recent poll by the Harvard School of Public Health and Harris Interactive found that average people don’t see much difference between the two plans, and don’t know how the plans would affect them personally. As we move toward a new administration with health care maybe somewhere on the agenda, it’s not too late for the media to put the new president’s health proposals to the test.