Our guest blogger is James Kvaal, Domestic Policy Adviser at the Center for American Progress Action Fund.

We’re halfway through health care week for the McCain campaign, with speeches in five states. But one critical question remains unanswered: how does the value of the credit change over time? If it grows slower than health care costs – as does the Bush plan it was modeled on – it would be a huge tax increase over time.

Sen. McCain has proposed a massive tax shift. He would end the tax break for health benefits that workers get from their jobs – a $3.6 trillion tax increase over the next decade. Then he’d redirect those resources into new tax credits worth $5,000 per family in the first year. The change would be a tax cut for some families and a tax increase for others.

The McCain campaign has not released a lot of details, particularly for such an important proposal. But we know more about the model for the McCain plan, a very similar Bush Administration proposal. (Bush’s proposal created tax deductions, but his aides said it was equivalent to a $4,500 credit for families. Adjust for rising health costs and you basically have McCain’s plan.)

The Bush plan capped the growth of credits at the rate of inflation (expected to be about 2 percent a year). That is much slower than current tax benefits, which grow with premiums (about 6 percent a year).

For Bush, capping the growth of tax benefits has two advantages. It makes the numbers work: the plan has a large initial cost that is slowly recouped over time as the tax cut turns into a tax increase. Second, as Ezra Klein notes, it drives families into cheaper coverage that will make them pay more for health care and therefore use less of it.

But this isn’t such a good deal for families. It’s more like a Trojan Horse: a tax increase disguised as an initial tax cut. The slower growth adds up to a 30 percent cut after 10 years and a 50 percent cut after 20 years.

So here’s my question: does the McCain proposal also limit health care cost growth? If so, it will soon become a massive cut in support for families’ health coverage costs.

UPDATE: In today’s New York Times, Kevin Sack and Michael Cooper observe that McCain’s plan “would have the effect of increasing tax payments for some workers.” Sack and Cooper note that even middle-income workers with conventional coverage could pay more over time, depending on how the tax credits are adjusted for inflation.

UPDATE II: Over at Swampland, Karen Tumulty confirms with Douglas Holtz-Eakin that the tax credit’s growth is limited to the inflation rate.

Sen. John McCain (R-AZ) released additional details of his health care plan today. In terms of key principles, there was nothing new. Sen. McCain is still not concerned about achieving universal coverage, and he continues to want to put a greater burden on individuals to take on health insurance companies by themselves and hope that they can get needed care.

Today, the Center for American Progress Action Fund released two new analyses of the McCain plan (you can read the whole reports here and here). The only two key things you need to know are the numbers 158 million and 56 million:

• 158 million is the number of people who could lose their existing health care coverage under the McCain plan. McCain believes that individuals should find health insurance by themselves, and he will give them a small tax credit to help cover the cost. To pay for this, McCain ends the tax break given to those who purchase insurance from their employer today. This means that all 158 million people with employer-sponsored coverage today could eventually be forced to find a new health plan.

• 56 million is the number of people who are at risk of not getting health insurance at all under the McCain plan because of their chronic condition. The individual market is notorious for denying coverage to those with preexisting conditions. By creating a system that tries to push people towards individual coverage, McCain’s plan could leave out in the cold the 56 million Americans with employer insurance who have one or more chronic diseases like hypertension, arthritis, and asthma.

Overall, the McCain plan today was just more of the same old conservative rhetoric. His promises to help cover those with pre-existing conditions have turned out to be empty. The McCain plan still doesn’t help cancer patients like Elizabeth Edwards. Far from improving health care, John McCain will only make it much worse.

Our guest blogger is Adam Jentleson, the Communications and Outreach Director for the Hyde Park Project at the Center for American Progress Action Fund.

Today at a campaign event, Sen. John McCain (R-AZ) toured Miami Children’s Hospital and met with some of the facility’s young patients. As The New York Times reported, McCain heard the story of Jake, a 9 year-old child with a cleft palate. Cleft palates can be fixed with a simple operation, but as Jake’s father told McCain today, his family has been struggling to get their insurance company to cover the post-operation therapy Jake needs.

While Jake’s father related his story, McCain “nodded intently” –- but failed to tell him that Jake would not get coverage under his health care plan.

As we have documented on this blog, John McCain’s plan would not guarantee coverage to people with pre-existing conditions – a category that includes Jake, as well as anyone with cancer, diabetes, or even hay fever.

In fact, under McCain’s plan, insurance companies would get much broader latitude than they currently have to decide who to cover and who not to cover. Since people with pre-existing conditions are expensive for companies to cover, they’d get left out in the cold.

They wouldn’t be the only ones. McCain’s plan is a radical assault on the employer-based system of health care, and would leave many of the 158 million Americans who get health care through their jobs at risk of losing coverage. But people with pre-existing conditions – people like Jake – would be worse off than most.

In the Times article, McCain advisor Douglas Holtz-Eakin ducks the simple question of whether McCain’s plan would guarantee coverage for Jake, saying only that McCain would address the issue in his speech tomorrow.

We will be watching closely for some “straight talk” on this issue, because so far, it’s been way too serpentine.

UPDATE: Covering the same exchange, the Wall Street Journal also pointed out that “left unsaid was that McCain’’s health plan is designed to weaken state regulations like the one in Florida that, like 14 other states, mandates that insurance companies cover treatment for cleft palates.”

Much has been said lately by Elizabeth Edwards and others about individuals who would be in trouble under the McCain health care plan. But they aren’t the only ones. McCain’s plan could very well leave the engine of America’s economy out in the cold as well — small businesses.

Small businesses face significant barriers in getting and keeping health insurance. Recent survey data from the National Federal of Independent Business bear this out, with 81 percent of small business owners indicating that “finding affordable healthcare” is a challenge, with 16 percent calling it was their biggest challenge.

The reason is that small businesses do not have enough people to create a “stable risk pool.” That’s insurance gibberish for simply saying that, if just one employee develops a catastrophic disease or has a major accident, then the insurance company loses money on that small business. In the insurance marketplace, small businesses don’t have it much easier than individuals.

To help small businesses, the majority of states take steps to cap premium rates within a certain range (technically called a “rate band”), and many states will also cap the annual increase in premiums. As research from Georgetown University shows, some states have strong protections, like California. Other states do not, like Kentucky and Louisiana where insurers are allowed to increase rates by more than 20% in a single year for a small business (most states only permit increases smaller than that). Very few states offer no rate protections: District of Columbia, Hawaii, Pennsylvania, and Virginia. Read more

Our guest blogger is Adam Jentleson, the Communications and Outreach Director for the Hyde Park Project at the Center for American Progress Action Fund.

The Hill had an article today in which Sens. Jay Rockefeller (D-WV) and Chuck Schumer (D-NY) appear to go soft on universal health care. Rockefeller said, “We all know there is not enough money to do all this stuff,” while Schumer seconded: “Healthcare I feel strongly about, but I am not sure that we’re ready for a major national healthcare plan.”

Come on guys – let’s not give up so easily! The arguments are wrong on both facts and principle.

First of all, on cost: what we can’t afford is the health care system we have now. Universal health care is a necessary step for bringing skyrocketing costs under control. As Robert Rubin and Jason Furman write, “It is impossible to address fully the problems of affordability and effectiveness without covering everyone.”

Second, when it comes to costs, the elephant in the room is the Iraq war. The entire cost of enacting universal care – that is, of extending coverage to the 47 million Americans who don’t have it and lowering costs for everyone – amounts to one half of the cost of a single year of the Iraq war. We have the money – the question is, how do we choose to spend it?

Finally, to wax philosophical for a moment, it’s disheartening to see our leaders responding to a big challenge like achieving universal health care by lowering the bar well before the national conversation has started in earnest. No one doubts that enacting universal care will be a big challenge. But in the face of big challenges, we should expect bold leadership from our elected leaders – not hedging.

UPDATE: Ezra Klein reports that Rockefeller is actually saying the opposite of what was presented in The Hill. According to a Rockefeller spokesperson, the Senator believes that universal health care is so important that it must be taken “off budget” so we aren’t “tying our hands with budget rules.” Ezra explains, “Rockefeller isn’t saying we can’t pay, so we shouldn’t try. He’s saying, essentially, money shouldn’t be the object here.”

UPDATE II: A spokesman for Senate Finance Chairman Max Baucus (D-MT) issued this statement:

Baucus’s perspective is that this year in Congress, though you can’t get much done legislatively, you can lay the groundwork to start a major discussion on reform in 2009. He’ll hold hearings, have a major summit [on comprehensive reform] in June, and host a great deal of discussion so members of Finance and Congress more generally can dig into both the problems and the possible solutions, leaving Finance ready to fully partner with any president. He wants Finance ready to fully engage on this.

UPDATE III: Sen. Chuck Schumer’s office has responded to our post:

Senator Schumer is highly supportive of providing health care coverage for as many of America’s 46 million uninsured as possible.

He has a long history of fighting for high-quality, affordable health care, particularly for affordable prescription drugs. Senator Schumer believes this is a top priority for the new administration, but understands the political challenges caused by Republican obstructionism in today’s Congress.

Elizabeth Edwards has gotten a lot of attention lately for her statement that neither she nor Sen. John McCain would be able to get coverage under McCain’s health plan because they have both had cancer. Recently, a conservative blogger tried to counter Edwards, but he just misses the point. The comments of John Goodman, President of the National Center for Policy Analysis, are either uninformed or just intentionally misleading:

GOODMAN: “Elizabeth Edwards apparently thinks insurance companies should have to insure cancer victims even if they were willfully uninsured and paid no premiums during all the years when they were healthy.”

Wrong. Edwards has said time and again that everyone should be expected to take responsibility for themselves and enroll in affordable health insurance. Goodman wants to ask Edwards a series of questions about the kind of health system she wants, but it’s easy. It’s called universal coverage.

GOODMAN: “In the Elizabeth Edwards’ world, by contrast, health plans would try to avoid the sick and if they failed at that, their incentives would be to under provide care.”

Wrong. That’s the world we live in today; the world that Edwards wants to change. The reality is that pre-existing conditions make it hard, if not impossible, for people to get health insurance in the individual market that McCain is promoting. The Democratic reform proposals call for guaranteed issue, so everyone can get insurance, regardless of their health status. And even though McCain has turned his back on patients by supporting a marketplace free of insurance company oversight, Democrats still support a Patient’s Bill of Rights to make sure managed care plans put people before profits.

GOODMAN: “Any Senator or Senator’s spouse who has been participating in the federal employee’s health program cannot be denied coverage by any subsequent employer plan or in the individual market. This guarantee also applies to every other American who is currently in an employer plan under federal law.”

That’s overstated. The Federal government has a 52-page guide explaining insurance coverage protections, and it is clear how individuals’ legal protections are limited. For many Americans, their ability to retain coverage as they change jobs or move from group to individual coverage are determined by the type of coverage they have and the benefits it covers. And for those who can’t afford coverage as they leave a qualified employer plan, those protections disappear completely after 63 days.

Edwards makes an excellent point. John McCain is promoting an individual market with few protections. By pushing more people into that market, McCain puts everyone at risk. Sure, US Senators and their spouses, as Goodman points out, have strong protection. But we need a system that works for everyone.

Our guest blogger is Elizabeth Edwards, a Senior Fellow at the Center for American Progress Action Fund and wife of former Presidential candidate John Edwards.

John McCain accused me of taking a “cheap shot” on “This Week with George Stephanopoulos” yesterday for noting that people with preexisting conditions, such as he and I have, would not be able to get health care under his plan –- and that he perhaps was not as sensitive to this problem as he should be since he has been in government health care his whole life.

Sen. McCain noted that he was not receiving government health care for the six years he was in captivity. That is true. But it has nothing to do with my point — which is that the problem with Sen. McCain’s health care plan is not how it affects us –- but how it affects the tens of millions of Americans with preexisting conditions who, unlike Sen. McCain and myself, do not have the resources to pay for quality health care.

That is not a cheap shot, it is a potentially life and death question for tens of million of Americans. And it is a question Sen. McCain must address.

McCain’s health care plan is centered around the idea that we’d be better off if more Americans bought health coverage on their own, rather than receiving it through a job or government program. But maybe since he has never purchased insurance in the individual market, he does not know the challenge it presents for Americans with preexisting conditions.

A recent study showed that nearly nine out of every ten people seeking individual coverage on the private insurance market never got it. Insurers will disqualify you for just taking certain medicines because of the possibility of future costs, including common drugs as Lipitor, Zocor, Nexium, and Advair. People who have had cancer are denied coverage and those who get cancer run the risk of simply being dropped by their insurer for any excuse that can be found. And insurers make it a practice to deny coverage to individuals in high risk occupations, such as firefighting, lumber work, telecom installation, and pretty much anything more risky than working in an office.

McCain opposes universal health care because he claims it represents a “big government takeover and mandates.” But yesterday, he said he would help cover people with preexisting conditions by creating a “special Medicaid trust fund.”

A “special Medicaid trust fund”? Talk about a big government takeover. Tens of millions of Americans have preexisting conditions. If he is going to expand Medicaid to cover Americans with preexisting conditions, he is talking about a massive, massive increase in the Medicaid program. He says he opposes more government involvement in health care, but his idea really would be government-run health care.

My questions is: why is he doing this? If he is so concerned about expanding government’s role in health care, why doesn’t he just tell the insurance industry that they have to cover people with preexisting conditions? Why is he more concerned about protecting the insurance industry –- an industry which, by the way, his corporate tax cut plan gives a $1.9 billion tax cut to –- than the tens of millions Americans with preexisting conditions?

McCain’s advisors still can’t say how this special Medicare trust fund will work. I gather we will find that out when Senator McCain gives a speech on health care later this month. Rest assured, I will be paying attention.

UPDATE: Watch the video here.

Once a strong supporter of patients’ rights, Sen. John McCain (R-AZ) today is more worried about insurance companies than patients.

In 2001, McCain was in the middle of Washington’s biggest health debate in years. In drafting the Patients’ Bill of Rights (S. 1052), McCain’s fight though was with Republicans, not Democrats. The goal was to find ways to keep insurers under control and to stop some of the worse abuses of managed care.

McCain’s co-sponsors were none other than Sen. Edward Kennedy (D-MA) and John Edwards (D-NC). McCain even co-authored a Washington Post opinion piece with Edwards. Titled “Let’s See Some Bi-Partisanship,” the piece read in part:

For too long, some of us in Congress have struggled to come up with a way to create rights for patients who have disputes with health maintenance organizations…We all agree that patients deserve basic rights.

McCain was bucking his party. President Bush verbally threatened a veto early in 2001 and then issued a written veto during the summer. Senator Don Nickles of Oklahoma, then part of the Senate Republican leadership, once warned, “Employers beware. There is language in this bill that can bankrupt you.” Patients’ rights became so difficult for Bush that the newly elected president quipped, “A dictatorship would be a heck of a lot easier, there’s no question about it.”

That was then. Today, McCain has learned to get along with his party and insurers. When asked recently plans that offer coverage guarantees at reasonable prices and consumer protections for individuals with preexisting conditions, McCain said, “That would be mandating what the free enterprise system does.”

Instead of regulating the insurers, McCain now wants to deregulate them. For example, his plan to allow insurance companies to sell products across state lines would weaken consumer protections. And while John Edwards called for a new and even stronger patients’ rights during his 2007 run for president, McCain’s position actually weakens patient protections. McCain’s plan to enroll everyone in high deductible health plans will create barriers to access for low-income persons.

In 2001, much was made of how Bush was trying to cut his former presidential rival out of the patients’ rights negotiation. Maybe McCain found solace for his 2000 presidential loss in knowing that patients’ rights debate was an embarrassment to his former rival? Whatever his motivation in the past, McCain has now embraced conservative orthodoxy.

On Tuesday, the Center for American Progress and the Center for American Progress Action Fundannounced that Elizabeth Edwards would join the both organizations as a Senior Fellow, and that she will also be contributing regular posts on health care policy to CAPAF’s Wonk Room. In an interview with the New York Times, Edwards cited the importance of the fight for health care reform, saying “I don’t want to put down the sword until we get the job done.”

Last week, Edwards wrote here that Sen. John McCain’s (R-AZ) health care plan would leave both the him and Edwards herself “outside the clinic doors” because of their preexisting condition — cancer. “Doesn’t your plan really encourage insurers’ plans to compete to avoid people with cancer or other high-cost diseases?” she asked McCain.

Last night on Countdown with Keith Olbermann, Edwards described what she called “a gulf…a solar system of difference” between Sen. John McCain’s (R-AZ) health care plan and progressive proposals. She also discussed McCain’s enormously regressive corporate tax policies, which dole out nearly $2 billion to the biggest health insurance companies and $3.8 billion to oil companies.

Watch it:

[flv http://video.thinkprogress.org/2008/04/lizee.320.240.flv]

Despite her concerns about the “pressure” of contributing to a hard-hitting news blog, the Wonk Room is thrilled to welcome Elizabeth Edwards, and we look forward to the insight and clarity she will offer on this integral issue.

Our guest blogger is James Kvaal, Domestic Policy Advisor at the Center for American Progress Action Fund.

More bad news for regular families today: the median family income is down and income inequality is up. But although John McCain’s tax plan costs $2 trillion, it gives little or nothing to most families.

Instead, McCain chose to earmark 80 percent of his tax relief proposals for corporations. He would cut the top tax rate from 35 percent to 25 percent and allow corporations to immediately write off many investments.

For the ten largest American health insurance companies, the McCain plan is worth nearly $2 billion a year, according to a new analysis released today by the Center for American Progress Action Fund. UnitedHealth Group alone would receive a $700 million tax cut. The tax breaks come in addition to the benefits of McCain’s health care plan for insurance companies.

Read the whole analysis here (pdf).

Our guest blogger is Robert Gordon, a Senior Fellow at the Center for American Progress Action Fund.

Ezra Klein captures some of the magic of Douglas Holtz-Eakin’s presentation today. One more funny number: Holtz-Eakin said that earmarks, or spending connected with earmarks, cost $60 billion per year. That’s more than three times the figure for earmarks cited by the Wall Street Journal and the anti-earmarkers at Taxpayers for Common Sense.

Holtz-Eakin also showed little patience with an Americans for Tax Reform (Norquist’s outfit) staffer who complained that replacing a tax break with a refundable tax credit by definition amounts to a tax increase. On this narrow point, Holtz-Eakin has it right. This is the kind of accounting game that conservatives have long used to derail rational budget proposals. What matters is how McCain’s health plan changes people’s lives. And without resorting to accounting games, it has problems enough.

Our guest blogger is James Kvaal, Domestic Policy Advisor at the Center for American Progress Action Fund.

The debate continues: Joseph Rago of the Wall Street Journal argues that Sen. McCain “ought to welcome” Elizabeth Edwards’ criticisms of his health care plan. As Edwards says, McCain lets insurers discriminate against people with costly diseases – ironically including McCain himself.

But Rago says that’s okay for three reasons. First, Sen. McCain would create a government backstop for expensive cases. Sounds good, but the devil is in the details – and McCain aides are still “scrambling to come up with ways to satisfy those who want more coverage without violating what they call McCain’s conservative principles.” I’m sure it’s hard to create a new government backstop for millions while also “shrinking government’s role in health care.”

Second, Rago says the McCain plan lets people carry their coverage from job to job. But you can’t keep coverage you never get, and the individual market is fundamentally broken for millions of people.

Finally, Rago says the McCain plan would lower costs. But by leaving millions uninsured, the McCain plan drives up costs by raising administrative costs and undermining preventive care and other efforts to keep costs down.

McCain wants more people to buy health coverage on their own, and his plan might work for families who are healthy and upper-income. But shouldn’t health reform start with people who need help most?

In recent days, Elizabeth Edwards has argued that John McCain’s health care plan would make it impossible for many Americans to get health insurance because of their preexisting illnesses – illnesses like the ones that Edwards and McCain suffer from themselves. She’s right.

Paul Krugman today called McCain’s approach “voodoo health economics.” McCain asserts that the insurance industry, once free of regulation, will provide sufficient “supply” of insurance to cover everyone. That’s wrong. The reality is that McCain himself – if he did not have access to government health insurance – would struggle to find health care under his own plan.

McCain – driven by his extreme free-market ideology – has written a health care plan that leaves individuals at the mercy of insurance companies’ profit motive. Insurance companies have strong incentives to avoid covering people who need health insurance the most – sick people. And McCain has been unwilling to build in consumer protections, saying “That would be mandating what the free enterprise system does.”

Like many conservatives, McCain believes in leaving people on their own to figure out the health insurance market. Instead of supporting group health insurance (i.e., employer and public coverage), he believes in tax credits that could be used in the individual market. In fact, the whole goal of his free market approach seems to be to grow the individual market.

Yet, the individual market is the Wild West for consumers with relatively few protections, as Georgetown research highlights. The individual market is so dysfunctional that 89 percent of those that tried to get individual coverage ultimately never bought a plan, according to a 2005 Commonwealth Fund study.

The reason is that insurance companies do everything possible to eliminate their financial risk. Although McCain has yet to release his health records, he has made public his fight with skin cancer. Ordinary people with cancer, let alone those in their 60s when McCain was treated, are considered “bad risks” and can in most states be denied or charged more for coverage in the individual market, which McCain says is a key part of his reform plan.

In fact, insurers will disqualify you from coverage even for just taking certain medicines because of the possibility of future costs, including the most common drugs as Lipitor, Zocor, Nexium, and Advair. People who have had cancer are denied coverage and those who get cancer run the risk of simply being dropped by their insurer for any excuse that can be found. And insurers make it practice to deny coverage to individuals in high risk occupations, such as firefighting, lumber work, telecom installation, and pretty much anything more risky than working in an office.

For taking on even minimal risk in the individual market, insurers charge a high premium. Of those in the Commonwealth Fund study, 71 percent of those with health problems found it difficult or impossible to find affordable coverage, as compared to about half of those with no health problems. Even the healthy only have a 50/50 chance of finding affordable individual coverage. As Nancy Metcalf of Consumers Union recently said, the two solutions to the individual market are to “be healthy or be rich.”

Individual Market Coverage: Barriers Abound
Adapted From Commonwealth Fund study, 2005

Adults 19 to 64 who bought or tried to buy individual coverage:	Total	Health Problem	No Health Problem	Less Than 200% Federal Poverty Level	Great Than 200% Federal Poverty Level
Found it “very difficult to impossible” to obtain  needed coverage	34%	48%	24%	43%	29%
Found it “very difficult to impossible” to obtain  affordable coverage	58	71	48	72	50
Never Purchased a Plan	89	92	86	93	86

If McCain was even offered insurance in the individual market, it would likely come with an exclusion for preexisting conditions. McCain’s plan calls for health insurance plans sold in one to be able to be sold in all states. Link back to freedom for insurers blog piece Just as companies go to the Cayman Islands to get around tax rules, Arizona would become the “Cayman Islands” of the health insurance world since that state is one of only four states that grants free reign to insurance companies on preexisting conditions issues. Under their rules, if McCain makes a claim for any service for as long as he has the policy, the insurance company could choose to go back and review his life-time medical history to see if the condition existed previously. Worse yet, Arizona lacks a set legal definition of preexisting condition, giving insurers even more power.

In an understated warning, an official state of Arizona publication offers that, “Many claims are denied because of these [preexisting condition] provisions” and explains that a condition can be preexisting even if it was unknown when coverage is purchased.

What would McCain do under his health plan? Without a government promise of coverage, he’d be out of luck. The fact is, Senator McCain’s plan doesn’t work for the average guy—not even himself.

Our guest blogger is James Kvaal, Domestic Policy Advisor at the Center for American Progress Action Fund.

Earlier this week, Elizabeth Edwards wondered whether John McCain’s health care plan would cover people with costly diseases – like Edwards and McCain themselves.

According to the McCain campaign, Edwards did not understand “the comprehensive nature” of McCain’s plan. But it turns out that McCain advisors themselves are struggling to figure it out, according to today’s Boston Globe:

Lately, some of McCain’s aides have said he might try to divert some Medicaid funds into a program that would help people with preexisting conditions, but his advisers can’t yet say how such a program would work or how many people would be covered.

“These are real questions, and I think there will be answers, and there better be, but they are not there yet,” said McCain adviser Thomas P. Miller, a resident fellow at the American Enterprise Institute. “A lot more remains to be hammered out.”

Indeed, while McCain talks about having a comprehensive healthcare plan, many of the details are being debated within the campaign as aides try to determine how to pay for McCain’s promises.

The problem is simple: insurance companies profit from covering healthy people but not sick ones. Sick people can get coverage as a part of a group, such as a job or through a government program, but often struggle if left on their own. The McCain plan will make the problem worse by raising taxes on employer-provided health care, reducing the number of people covered through their jobs, and by deregulating the insurance market, undercutting even the inadequate consumer protections that exist now.

It’s no wonder McCain aides are having troubling squaring that circle.

You know it’s bad when arch-conservative Bill Bennett won’t even endorse the Republican presidential candidate’s health care plan.

It’s just the latest chapter in Elizabeth Edwards’ effort to explain the facts on the McCain health plan, which started Saturday at her speech to the Association of Health Care Journalists. While there, Elizabeth Edwards pointed out that she and John McCain had something in common, that neither of them would get coverage under his health plan.

This lead to the McCain campaign calling her “confused” in a piece published by the Los Angeles Times, something Edwards responded to on this blog and then this morning on the Today Show.

When Bill Bennett followed Edwards this morning, the best response he could muster was a generic assertion that the free market could cure the country’s health care crisis, saying, “I think a market approach is going to be the better approach.”

He added that what McCain is trying to do is, “unprecedented,” and because of that, “ We don’t know what the market will provide.” Commenting on whether all persons would be covered under the McCain plan, the best Bennett could do is to say, “It is John McCain’s position, and Dr. Coburn’s position [Republican Senator from Oklahoma, whose health idea McCain's follows], that an influx of that amount of supply [under their plan], if you will, will create possibilities for people that haven’t existed before. So, I don’t think you can rule this out categorically.” Watch it:

[flv http://video.thinkprogress.org/2008/04/bennetthc.320.240.flv]

We can’t rule out that the McCain plan will help people get coverage? We don’t know what the McCain plan will mean? Wow Bill, there is a ringing endorsement. It was a simple enough question, and Bennett couldn’t give a straight forward answer supporting McCain. Bennett got one thing right though, McCain’s idea of trying to move everyone into the individual market is “unprecedented,” mostly because the individual market is broken and conservative ideas to markets like McCain’s would further weaken individual market protections.

I’ll be waiting for the McCain campaign statement that Bennett must be just as “confused” as Edwards on the merits of the McCain plan.

Our guest blogger is Elizabeth Edwards, wife of former Presidential candidate John Edwards.

I freely admit that I am confused about the role of overnight funding in repurchase markets in the collapse of Bear Stearns. What I am not confused about is John McCain’s health care proposal. Apparently Douglas Holtz-Eakin, a senior policy advisor to McCain, thinks I do “not understand the comprehensive nature of the senator’s proposal.” The problem, Douglas, is that, despite fuzzy language and feel-good lines in the Senator’s proposal, I do understand exactly how devastating it will be to people who have the health conditions with which the Senator and I are confronted (melanoma for him, breast cancer for me) but do not have the financial resources we have. In very unconfusing language: they are left outside the clinic doors.

Senator McCain likes to start speeches with a litany of questions that, presumedly, less plain-spoken politicians would refuse to answer. Well, here are some questions he does not ask but, as that plain-spoken politician, he might want to answer:

1. Under your plan, Senator McCain, would any health insurer be required to sell you or me (or those like us with pre-existing conditions) a health insurance policy?

2. You say your plan is going to increase competition to the point that it actually lowers costs. Isn’t there competition today among insurance companies? Haven’t costs continued to go up despite that competition?

3. You say that under your plan everyone is going to pay less for health insurance. Nice words, I admit, but they are words we have heard before. You must know when American families calculate the actual cost of health care, they have to include those deductibles and co-pays and not just the cost of the insurance. Are you talking about cheaper overall or just a cheap policy that doesn’t kick in until after thousands of dollars of deductibles have been paid?

4. Isn’t the type of competition you are talking about really a rush to the bottom? As long as you allow insurers to underwrite and deny access, you encourage insurers to offer plans that may be cheap, but that get that way by avoiding people with cancer or other high-cost diseases or by limiting benefits and treatments, particularly if the treatment is expensive or might be needed for a long time. We all live in the real world; those of us lucky enough to have health insurance have seen how insurers cut coverage and up co-pays or deny particular treatments. The insurance company makes money when it doesn’t have to pay for our health care. (I suspect that if they could, they would write obstetrical-only policies for nuns.) Doesn’t your plan really encourage insurers plans to compete to avoid people with cancer or other high-cost diseases? Don’t you think that the kind of competition that starts with a decent level of required coverage, that doesn’t exclude the care we actually need, would be better?

I am not confused about your reputation: you are the straight-talker, you like to say. This is about health care, Senator McCain. Doesn’t the American voter deserve some straight answers to these questions? As one of those with a pre-existing condition, I sure would like some straight talk.

– Elizabeth Edwards