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To achieve universal coverage, both Mrs. Clinton and Mr. Edwards would borrow from the Massachusetts model by making it mandatory for each person to have health insurance and then providing government subsidies to ensure that everyone can afford it. Affordability is already a challenge for some federal employees, who pay about a quarter of the cost of their coverage and sometimes much more. And in at least one case, for a Vermont plan offered by MVP Health Care, a regional insurer in Schenectady, N.Y., the employee premium is $12,400 a year for family coverage.
Timothy Byrnes, a union local president with the Army Corps of Engineers in Buffalo, says the premium deducted from his paycheck in 2008 will nearly double from two years ago. He will now pay about $360 a month — more than $4,200 a year — for family coverage from Univera Healthcare, an insurer in Buffalo.
Not all his union local’s members can afford coverage, Mr. Byrnes said, recalling that one member told him, “ ‘I’m making choices between medicine and gas.’ ”
In order to make insurance affordable to a greater number of the 47 million who currently have none, experts say, the coverage might have to be much more limited than even the most basic federal employees option, and be designed to protect mainly against catastrophically high doctor or hospital bills.
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