Health Care Spin

Summary
McCain and Obama have sharply different health care plans, and each has made sharply worded attacks that are either false or misleading. McCain proposes a market-based system that relies on tax incentives, which one Obama ad falsely characterizes as the "largest middle-class tax increase in history." Obama proposes new subsidies to expand private insurance coverage and some expansion of government insurance, which McCain falsely claims "will rob 50 million employees of their health coverage."

Neither candidate has offered enough specifics about his plan to allow experts to assess the cost or impact without making various assumptions. Studies agree generally, however, that Obama's plan would cover more of the uninsured than McCain's would.

Here we lay out a brief explanation of both plans, what the experts are saying about them, and some of the ways each campaign is trying to fool the voters about the other.

Analysis
The Obama-Biden campaign is running half a dozen TV ads attacking Sen. John McCain's health care plan, while the McCain-Palin campaign is countering with a radio ad of its own. Together they give a distorted and confusing picture of what each man proposes, how it would affect workers and families, and how much it would cost.

This is our attempt to lay out clearly what each candidate actually proposes, what the experts say the plans might accomplish, and how each candidate tries to confuse voters about this issue.

The Details
Sens. Barack Obama and John McCain have sharply different plans. Obama focuses on requiring health insurance plans to meet certain standards and expanding government offerings and subsidies. McCain favors a market-based approach that aims to move more individuals into the private insurance market and foster competition.

McCain's plan would:

• Give a health insurance tax credit of up to $5,000 for couples and families and $2,500 for individuals. Those who choose to buy insurance on their own would be able to use the credit to pay for their health coverage, with payment going directly from the government to the insurance company. Nobody would be required to buy insurance for themselves or their children, and employers large or small would not be required to offer health insurance as a benefit.
• Tax the value of employer-provided health benefits. Employees would pay federal income taxes (but not Social Security or Medicare payroll taxes) on the value of those benefits. The tax credit would offset those taxes. Companies would not be taxed.
• Expand health savings accounts so that any money left over from the tax credit could be put into such an account, where it could be used for approved medical expenses.
• Allow the sale and purchase of insurance across state lines. No federal standards would be imposed, and insurance companies would not be required to cover preexisting conditions.
• Expand high-risk pools that exist in many states to cover those who have been denied coverage or have high-cost health issues. Some financial assistance would be given to low-income people in such pools.

Obama's plan would: