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How rich healthcare mandates could bust the budget

Fortune, May 5, 2011

The Patient Protection and Affordable Care Act aims for a delicate balance that even its champions acknowledge as highly challenging: Making medical services affordable for tens of millions of uninsured Americans, and yet restraining the expenditures needed to vastly expand coverage so that it shrinks, rather than swells, the looming deficits. To grasp why the reform bill risks missing both goals -- and why the measure's margin for error is so perilously narrow ? it's crucial to follow the debate over its central provision, what it calls the "Essential Health Benefits" package. That debate is now playing out in a series of wonkish conferences sponsored by the Department of Health and Human Services that the press, pundits and even politicians are mainly overlooking.