Scenario 1: Working couple with generous health coverage

Name: Lupe White, 45, of Renton

Occupation: Medical assistant at Swedish Medical Center

Lupe White has the kind of gold-plated health coverage that's becoming less common in the American workplace: a plan with low deductibles and low co-pays that's paid almost wholly by her employer.

And White and her husband have needed it. The younger of their two daughters, 11-year-old Mariah, was born with multiple heart defects and has undergone three surgeries, including one that cost $90,000. Insurance paid for much of it.

White worries that Mariah's heart problems will make her uninsurable as an adult.

As union workers, White and her husband, a food-services worker at Swedish, pay no premiums on coverage for themselves and just 5 percent of the standard premiums for their daughters. Swedish picks up the rest — to the tune of nearly $20,000 a year for the family.

Nationally, employers now spend an average of $9,325 a year for family coverage, with workers chipping in another $3,354.

A concern: more taxes

Under McCain's plan, those benefits for the first time would be subject to income taxes, likely raising the Whites' taxes by thousands of dollars a year.

Under McCain's proposal, workers would get refundable tax credits — $5,000 for families and $2,500 for individuals — to offset the higher taxes. For some, the money from the government would exceed the extra taxes, and in some cases could be set aside for future health expenses.

Those without insurance could use the tax credit to buy their own insurance.

But for families without insurance, the $5,000 is barely enough to buy a no-frills, catastrophic policy that does not cover prescription drugs or preventive care and typically leaves them responsible for the first several thousand dollars in medical bills.

What about job loss?

White also worries that, if she were to lose her job, she might not be able to get any insurance at all.

In most parts of the county, Mariah's heart problem would prevent the Whites from getting new coverage on their own. Only a handful of states require insurers to sell coverage to anyone with a pre-existing condition, such as a pregnancy or cancer.

Washington doesn't go that far, but it operates a state health pool that accepts the sickest 8 percent of individuals who have been turned down by commercial health plans.

Obama would outlaw cherry-picking by insurers, requiring them to insure anybody, regardless of pre-existing conditions.

Obama has not said whether he also would eliminate a waiting period for coverage on any pre-existing condition. In Washington, the wait can be up to nine months.

McCain would separate people who've been turned down for coverage on medical grounds into a federal insurance pool, with some limits on premiums and with financial help for people with low incomes.