OVERALL APPROACH

Clinton: Clinton's approach would require every individual to have healthcare coverage, with income-related tax subsidies available to make coverage affordable. Private and public health-plan options would be accessible through a new "Health Choices Menu" operated through the Federal Employee Health Benefits Program (FEHBP). Coverage provided by employers and public programs (e.g., Medicare) would continue as is.

Edwards: Edwards's program would mandate that individuals obtain health insurance coverage and that employers must provide insurance or help finance insurance for employees to achieve universal coverage by 2012. Edwards also suggests the creation of "Health Markets," which are nonprofit purchasing pools that offer competing public and private health plans. The former North Carolina senator recommends the establishment of tax credits to help subsidize the cost of insurance purchased through Health Markets. He also calls for expanded public insurance to serve more low-income adults and children.

Obama: Obama would start with children, requiring all children to have health insurance coverage of some kind. He also wants employers to offer employee health benefits or contribute to the cost of the new public program. Obama's program calls for the creation of a new public plan, and expansion of Medicaid and the State Children's Health Insurance Program (SCHIP). He also recommends a National Health Insurance Exchange through which small businesses and individuals without access to employer-based coverage or other public programs could enroll in the new public plan or in an approved private plan.

EXPANSION OF PUBLIC PROGRAMS

Clinton: Clinton recommends a strengthening of Medicaid and the SCHIP safety net for the most vulnerable populations. Her goal would be to "plug gaps," such as lack of coverage for poor, childless adults.

Edwards: Edwards would expand Medicaid and SCHIP to serve all adults under 100% of the federal poverty level (FPL) and all children and parents under 250% FPL. Under his Health Markets proposal (see above), at least one public insurance plan (similar to Medicare) would be offered to uninsured individuals and families and to those who do not have access to comparable employer-based coverage.

Obama: Like Clinton and Edwards, Obama would also expand Medicaid and SCHIP. He also wants to create a new public plan that allows small businesses and individuals without access to public programs or employer-based coverage to purchase insurance. Coverage would offer comprehensive benefits similar to those available under FEHBP.

COST CONTAINMENT

Clinton: Clinton proposes a "7-Step Strategy to Reduce Health Costs." The seven steps include a national prevention initiative; a "paperless" health information technology system; chronic care coordination to improve outcomes; elimination of insurance discrimination to help reduce administrative costs; an independent "Best Practices Institute" to help consumers and payers make appropriate care choices; "smart purchasing" initiatives that constrain certain healthcare costs; and linking medical error disclosure with physician liability protection.

Edwards: Edwards would try to contain costs by increasing the use of health information technology and other technologies to reduce administrative costs. His program also would provide consumers with information to allow comparisons of doctors and hospitals on price and performance. His malpractice-reform measures would attempt to reduce "frivolous lawsuits," create competition among insurers and encourage voluntary reporting of medical errors. He also would seek to end Medicare Advantage overpayments.

Obama: Among several cost-control measures, the Illinois senator proposes investing $50 billion toward adoption of electronic medical records and other health information technologies; and promoting insurer competition through the national Health Insurance Exchange (which would require regulating the percentages of health plan premiums that must be paid out in benefits). Obama would also seek to improve the prevention and management of chronic conditions; pay Medicare Advantage plans using the same schedules as regular Medicare; and preserve patient rights by strengthening antitrust laws and promoting new models for addressing physician errors.