Scenario 3: Small employer who provides health care

Name: Jody Hall, 41, of Seattle

Occupation: Owner of Cupcake Royale and Vérité Coffee in Ballard, West Seattle and Madrona

Jody Hall's employees are some of the cheapest to insure: healthy people in their 20s.

Yet Hall spends more than $70,000 a year on health insurance for the 23 of her 55 employees who have chosen to use the benefits — almost as much as what she pays in rent for her three cafes combined.

A former marketing executive at Starbucks and at REI, Hall knows too well that health insurers penalize small employers.

"If I work at Starbucks, I get so much better coverage and it costs less," said Hall, who gets the same coverage as her employees. "It's my biggest frustration as a small-business owner."

Obama's "pay or play"

A tenet of Obama's health plan is that it's cheaper in the long run to pay now for coverage, instead of leaving the uninsured to forgo medical care or rely on emergency rooms.

Hall agrees. She considers it a moral, if not a legal, obligation for profitable businesses to provide health benefits for their workers. She pays 75 percent of her workers' premiums.

Obama would make it mandatory for employers to provide "meaningful" coverage, or pay a tax based on payroll.

Small businesses would be exempt. But Obama hasn't defined "small," so it's unclear where Hall and her 55 employees would fall under that plan.

For small businesses that do choose to offer coverage, Obama would refund up to half their premium costs.

Under McCain's plan, it wouldn't matter if Hall is considered a small business or a large one; his plan would not require any employer to offer coverage.

Free-market health plans

McCain would permit health plans to be sold across state lines, which he says would foster competition.

But that arrangement would also force consumers to navigate a patchwork of state regulations to pick a plan.

In Washington, for instance, premiums for a small group like Hall's are based largely on the average claims for all small businesses.

But other states permit insurers to set small-group premiums based on a single company's past medical claims — which could sting a company with a seriously ill employee.

Hall doesn't exactly relish the prospect of having to sort through all that. But she welcomes reforms that would bring true relief to the uninsured.

"We're the wealthiest country in the world," she said.

"Why can't we afford health care?"