Obama's Plan Wins at Covering the Uninsured

Slightly fewer people are going without health insurance, but the tide hasn't turned.

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Nobody's celebrating over the new Census Bureau figures showing that the number of people without health insurance dipped slightly last year, to 45.7 million, from 47 million in 2006. It doesn't indicate a trend, say experts.

Things seemed different when 2007 began. Back then, many experts were cautiously optimistic that other states might follow Massachusetts's lead and aim for universal healthcare or at least expand coverage significantly for more children and uninsured adults.

In fact, children were almost entirely responsible for the gains in the number of insured, thanks to government programs like Medicaid and the State Children's Health Insurance Program. But SCHIP's future is unclear: Last year, Congress twice passed and Bush twice vetoed expanded funding for the program; it was extended until next spring without additional funding.

Now, voters are looking to the upcoming presidential election for healthcare reform, and John McCain and Barack Obama have laid out very different plans for how they'd fix the system. How would each alter the number of uninsured? The Urban Institute and the Brookings Institution have come up with an estimate. The numbers are "very, very, very preliminary," cautions Roberton Williams, a principal research associate at the Urban Institute who is one of the study's authors. Researchers will come up with a more complete analysis next month.

Based on their preliminary analysis, Democratic candidate Obama's healthcare reform proposal—which would require children to have healthcare coverage and provide subsidies to make insurance affordable, among other things—would reduce the number of uninsured by 18 million in 2009 and 34 million by 2018. McCain's plan—which would eliminate the tax break employees get for employer-sponsored coverage and replace it with tax credits for people to buy their own coverage—would trim the number of uninsured by a much more modest 1 million in 2009, rising to a maximum of 5 million in 2013.

Of course, these numbers rely in part on assumptions that the researchers made about the candidates' proposals, filling in details where none have yet been supplied. In addition, as the report notes, "changes in plan design could significantly affect coverage." So don't take those figures as gospel. It's one more piece of information to consider as you prepare to head to the polls this fall.