Barack Obama's campaign's promises to guarantee access to affordable health coverage, regardless of illness or condition. Obama is proposing a National Health Insurance Exchange that would be like a government-run shopping mall for health insurance, and would negotiate prices and benefits with private insurers. The coverage guarantee is not a new concept, but it has had a troubled history in several states that tried it for people seeking coverage through the insurance market. Under the guaranteed coverage, for example, monthly premiums generally are much higher for younger, healthier people than in nearby states.