Why the medical insurance industry is cheering Obama’s victory.

Barack Obama's campaign was built on shattering conventions on race in American politics, so it's fitting that his presidency may smash another cliché: that when it comes to health care, Republicans are sympathetic to the concerns of insurance companies while Democrats are hostile to the industry. Judging by Obama's health care proposals during the campaign, he may prove the opposite to be true.

During the campaign, John McCain's proposals were the more radical, at least as far as the insurance industry was concerned. McCain promised to decouple health insurance from employment, shifting to a system of individual- and family-based insurance. McCain said that encouraging individuals to shop for their own insurance would make insurance more accessible; health care economists disagreed, saying the proposal was more about embracing free-market principles than covering the uninsured.

The insurance industry, too, disagreed with McCain's approach. "Employer-based health care coverage is a valuable source of coverage for something like 200 million Americans," Robert Zirkelbach, spokesman for America's Health Insurance Plans, the industry's main umbrella group, told me during the summer. "We do not support abandoning the employer-sponsored system."

Instead, AHIP calls for expanding federal programs like Medicaid and the State Children's Health Insurance Program and providing subsidies to help families afford health insurance-proposals that form the core of Obama's health care plan. AHIP didn't endorse either candidate, but its proposals for expanding health insurance are so close to Obama's plan that it didn't need to.

How do health insurance companies stand to gain under Obama's plan? The industry would see the size of its market increase as more Americans either buy private health insurance with the help of subsidies or enroll in expanded government-funded insurance plans. Programs like Medicaid and Medicare may be paid for by the government, but they are increasingly run by private insurers, according to Jack Rowe, the former CEO of Aetna, one of the country's largest health-insurance providers.

Rowe uses the example of the Federal Employee Health Benefits Program, which covers 8.5 million people. The FEHBP, which covers the president and members of Congress, has become political shorthand for the level of care that ordinary Americans ought to be able to attain. Obama's plan calls for something similar to the FEHBP that would be available to every American.