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Under attack at a recent debate from rival Hillary Clinton on health care, Barack Obama shot back:
"Well, let's talk about health care right now because the fact of the matter is that I do provide universal health care. The only difference between Sen. Clinton's health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated — forced — them to get health care."
Before jumping into this fray, it's important to note that when it comes to health care, the two Democratic presidential candidates have a lot in common.
One of the few differences is that Clinton includes a universal mandate. That means that after everything else goes according to plan, individuals will be required by law to purchase insurance. Think of how people are required to buy auto insurance and you get an idea of what that might look like.
Obama's plan includes a mandate to insure children, but it does not include a mandate for adults, as the Clinton and Edwards plans do. That likely means not as many people will be insured, said Kenneth Thorpe, professor of health policy and management at Emory University.
Obama's decision not to include a mandate is a more cautious approach, one Obama says is designed not to penalize people with modest incomes. If premiums don't drop enough after all the reforms are implemented, people will still be unable to afford insurance. If a law mandates they buy it anyway, they probably won't. Obama's argument is that if you then fine them, you're essentially punishing the poor — and they will still be uninsured. Obama is betting that his plan will get costs low enough that many of the estimated 47-million uninsured will sign up without a mandate, and a mandate will come later.
So is it fair for Obama to call his plan "universal"? Well, not really. Even if you buy his argument that his plan will create the market conditions to make health care universally available, nothing in his plan guarantees it. We rate his claim Barely True.
Editor's note: This statement was rated Barely True when it was published. On July 27, 2011, we changed the name for the rating to Mostly False.
CNN via New York Times, Democratic debate transcript, Nov. 15, 2007
New Republic via CBS News, Cautious Candidate, Cautious Plan, June 3, 2007
Hillary Clinton campaign, Health Care Plan
Barack Obama campaign, Health Care Plan
Interview with Sara Collins, assistant vice president of the Commonwealth Fund
Factcheck.org, Clinton vs. Obama, Nov. 16, 2007
New Hampshire Public Radio, Interview with Barack Obama, Nov. 21 2007.
Lowell (Massachusetts) Sun, "For some, health insurance reform not so affordable," Aug. 26, 2007
Boston Business Journal, "Thousands balk at health law sign-up mandate," Nov. 12, 2007
Interview with Kenneth Thorpe, professor of health policy and management at Emory University
Interview with Robert Blethen, professor of health policy and politics at Harvard School of Public Health
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