Dr. Maura Shea examines patient Michelo Cineas at the Codman Square Health Center in Dorchester, Mass.
Dr. Maura Shea examines patient Michelo Cineas at the Codman Square Health Center in Dorchester, Mass. - 
Listen To The Story


Kai Ryssdal: Two prominent states experimenting with universal health care have run into roadblocks.

Yesterday, the California Senate rejected Governor Arnold Schwarzenegger's plan to insure nearly all Californians. Massachusetts mandates insurance; It's now facing 400 million dollars in cost overruns.

So, if the states are having problems, why are some presidential candidates still backing universal health care plans? Marketplace's Nancy Marshall Genzer takes a look.

Hillary Clinton: I want to get to universal health care for every single American.

Nancy Marshall Genzer: Mandatory health insurance is a central part of Hillary Clinton's message. Her proposal is similar to the Massachusetts plan now spattered with red ink. Barak Obama would only mandate insurance for children.

John Edwards backs mandates. His healthcare advisor Peter Harbage says the Massachusetts plan is just having growing pains:

Peter Harbage: There's no such thing as universal, voluntary anything.

Harbage says Massachusetts and California are having problems with universal coverage because they have to guess how much healthcare money the feds will give them. UCLA School of Public Health Professor Richard Brown says the federal government doesn't have to guess:

Richard Brown: But clearly the federal government has more resources -- dollars that can be put into direct subsidies for health insurance expansion and also tax credits.

Republican candidates support tax credits for health insurance. Mitt Romney has backed away from mandates he embraced as Massachusetts governor. Democrats who favor them still have to explain where the money will come from. Duke University health policy analyst Chris Conover:

Chris Conover: The typical response is "Oh well, we can pay for it by repealing the Bush tax cut." So I think the average American thinks "Oh cool! Those rich folks are going to pay for it."

Conover says that's not realistic. Either way, it's a a top issue for voters and the candidates.

In Washington, I'm Nancy Marshall Genzer for Marketplace.