They've Got You Covered?

In recent ads and appearances, Clinton has said that her plan would provide "universal" health care coverage and Obama's would not. Obama has countered that his plan is "universal" too. The disagreement has played out in dueling television ads. A Clinton ad airing in Wisconsin and Texas says, "She's the only candidate for president with a plan to provide health care for every American." An Obama ad that has run in those same states, as well as in Ohio, features the candidate saying he has a plan to "cover everyone," with the words "universal coverage for all Americans" in a full-screen graphic.

The debate between the candidates hinges on the major difference in their proposals: Clinton's includes an individual mandate that would require everyone to obtain health insurance; Obama's plan only mandates that children have it.

Which one would cover everyone? Studies and experts say an individual mandate would lead to universal or near universal coverage and a plan without such a mandate would cover substantially less of the currently uninsured.

"I hear Obama saying he's got universal coverage, he's just wrong," says John Sheils, senior vice president of The Lewin Group, a politically neutral health care research organization. "I don't know of anyone who studies this issue that would consider his plan to be universal coverage. You might call it universal access to coverage ... but the distinction Clinton is drawing here is correct."

Not even Clinton's mandate is certain to lead to 100 percent coverage, however. Estimates say a mandate would lead to coverage for more than 90 percent of the now-uninsured, or even close to 100 percent. But experts say some inevitably would be missed, or even evade the mandate. The most recent report on this issue, by Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology, says a plan with an individual mandate would cover 97 percent of the uninsured; a plan without one would cover 49 percent. But Gruber, who talked to the campaigns of Clinton, Obama and John Edwards about health care, stresses that the precise numbers are difficult to know for certain. "There is a legitimate debate about whether a plan with a mandate will get you to universal coverage," he says. "But what is beyond dispute is that a plan without a mandate will not get you universal coverage."

Who's Left Out?
Obama Ad: "Mother"

Obama: My mother died of cancer at 53 and those last painful months, she was more worried about paying her medical bills than getting well. I hear stories like hers every day. For 20 years, Washington's talked about health care reform and reformed nothing. I've got a plan to cut costs and cover everyone.

Graphic: The Obama Plan
–Universal coverage for all Americans
–Saves typical family $2,500
For more details:
BarackObama.com/Healthcare

Obama: But unless we stop the bickering and the lobbyists, we'll be in the same place 20 years from now. I'm Barack Obama and I approve this message because to fix health care, we have to fix Washington.