The side-by-side comparison below focuses on important health care issues not necessarily addressed in the candidates' health care reform proposals. It was prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc. The comparisons are based on information compiled from the candidates' Web sites, speeches and campaign debates.
John McCain
Barack Obama
Medicaid/State Children's Health insurance Program (SCHIP)
General Approach
- Would provide states with flexibility to experiment and find solutions that work and would allow increased private sector insurance options in Medicaid/SCHIP.
- Through comprehensive health reform efforts, would ensure that Medicaid and SCHIP continue to serve their critical safety net function.
Eligibility and Enrollment
- Advocates focusing on currently eligible SCHIP children who are not enrolled and expanding only to low-income uninsured children not eligible for SCHIP under current policy. Opposes expansion of SCHIP to children in higher income families and to adults.
- Supports expanding eligibility for Medicaid and SCHIP.
Benefits
- Advocates allowing states to use Medicaid and SCHIP funds for private insurance.
- Would require coverage of essential clinical preventive services, such as cancer screenings and smoking cessation programs in Medicaid and SCHIP.
Quality and Provider Payment
- Supports reforming the payment systems in Medicaid to compensate providers for diagnosis, prevention and care coordination.
- Believes Medicaid should not pay for preventable medical errors or mismanagement.
- Supports state efforts to constrain Medicaid costs, such as negotiating for low drug prices, and implementing disease management and quality initiatives.
Financing
- Opposes the use of a tobacco tax to fund SCHIP and would instead fund out of general revenues.
- Campaign has not addressed.
State Flexibility
- Believes States should have the flexibility to experiment with alternative forms of access, coordinated payments per episode covered under Medicaid, use of private insurance in Medicaid, alternative insurance policies and different licensing schemes for providers.
- As part of comprehensive reform, would allow states to continue to experiment, provided they meet the minimum standards of the national plan.
Medicaid Fraud
- Advocates a zero tolerance policy towards Medicaid fraud.
- Would empower the HHS Inspector General to fight fraud, implement anti-fraud measures in CMS contracting, expand the scope of Medicare and Medicaid audits, strengthen the federal False Claims Act, encourage states to go after fraud, and increase funding for Justice Department prosecutors and FBI agents to fight fraud.
Medicaid/State Children's Health Insurance Program (SCHIP)
