Healthcare is returning as a campaign issue, with special interest and advocacy groups preparing in Hawai'i and on the Mainland preparing to push politicians to provide better access to affordable healthcare.

The efforts, one by a coalition of labor and liberal groups and another by AARP, also include direct appeals to the presidential contenders and congressional candidates to change a system in which millions of people are without coverage.

In Hawai'i, a group that includes Faith Action for Community Equity and local unions, said it expects to receive $40,000 to push for affordable healthcare.

FACE is part of a broader coalition of labor unions and Democratic-leaning organizations called Health Care for America Now which yesterday announced a $40 million campaign to promote affordable healthcare coverage for all. The group is spending $1.5 million on a national cable ad, and print and Web advertising. It also plans to spend $25 million on advertising through the end of the year. The effort will concentrate on key congressional districts in 45 states, where the coalition also plans to deploy 100 organizers.

A top goal is to encourage lawmakers to devise a plan that would offer consumers the choice of retaining their current private coverage, choosing a new insurance plan or joining a government-run plan. The options are designed to address one of the insurance industry's central criticisms of President Clinton's failed plan.

"We've got to make the plan that we put forward reasonable to people who don't have health insurance and desperately need it, but also not threatening to people who do have fairly decent healthcare and would gladly support healthcare change as long as it doesn't undermine what they've got," said Roger Hickey, co-director of the liberal Campaign for America's Future, part of the Health Care for America Now coalition.

Still, disagreements are certain to surface. The insurance industry's proposal for expanded health care puts more emphasis on private plans than on public ones. And the coalition's ad makes clear that the old battle lines remain. "We can't trust insurance companies to fix the health care mess," the ad states.

The AARP-led group is airing an ad on national cable and in markets in key states calling on the presidential candidates — Democrat Barack Obama and Republican John McCain — to keep discussing health care and financial security.

The seniors' advocacy group, acting on behalf of a coalition called Divided We Fail, plans to spend more than $20 million through Labor Day to push for bipartisan solutions to healthcare and Social Security.

McCain would provide refundable tax credits of $2,500 for individuals and $5,000 for families that buy health insurance, but would not require universal coverage.

Obama would require coverage for children, not adults, and would aim for universal coverage by requiring employers to share the cost of insuring their employees.

"We felt we needed more than policy ideas, but the political will to actually get something done," said Nancy LeaMond, an AARP executive vice president.