"Under the McCain plan, at least 20 million Americans will lose the insurance they rely on from their workplace," he said, citing a recent analysis of McCain’s plan in the journal Health Affairs. But the Illinois senator did not mention that the same analysis found that 21 million Americans could gain coverage under the Republican nominee's plan.
Holtz-Eakin disputed Obama's 20-million figure and called the Democratic nominee's assertion that employers would stop providing insurance "patently false." Employers would still be able to deduct health insurance costs, and they would still be competing to attract quality employees, he said. "Their incentive will be unchanged."
John Holahan, director of the nonpartisan Health Policy Research Center at the Urban Institute, said that though Obama's wording about the 20 million workers was technically correct, analyses of McCain's plan have shown "the net effect is more or less a wash, or a small gain."
Obama's charge that taxes may go up under McCain's plan is true in some cases, Holahan said, because McCain's tax credit would not keep up with healthcare inflation.
"After five to 10 years, the current tax deduction is going to be worth more than the current value of the credit," Holahan said. "Depending on your income -- you could be worse or better off."
The McCain campaign estimates, however, that less than 5% of Americans would see their taxes rise.
"It is the case there may be some people at the very top who have a liability greater than their health tax credit," Holtz-Eakin said. But "under the current system . . . we are having the middle class pay taxes and subsidize the gold-plated coverage of the most affluent in America."
Before leaving Newport News for Asheville, N.C., where he is preparing for the debate, Obama also criticized a controversial provision of the McCain plan that would allow employers to sell insurance across state lines, which he called "a starting gun for a race to the bottom."
"Insurance companies will rush to set up shop in states with the fewest protections for patients," he said.
Holtz-Eakin called Obama's remarks "cynical" and "deceitful," and emphasized that McCain's plan would set up a program guaranteeing coverage for high-risk patients and a mechanism allowing patients to appeal insurance company denials.
For months, McCain has sharply criticized Obama's healthcare approach as an expensive, intrusive expansion of government.
The Obama healthcare plan would help the uninsured get coverage through a new National Health Insurance Exchange and would provide subsidies for low-income Americans to help them purchase insurance. The plan would also boost the number of workers who are insured by requiring employers to automatically enroll their workers in employer-sponsored health plans, but would permit employees to opt out.
--
maeve.reston@latimes.com
seema.mehta@latimes.com
Reston reported from Virginia and North Carolina and Mehta from Arizona.
