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Three Health Reform Ideas That Will Stay, Three That Will Go

Les Masterson, for HealthLeaders Media, November 11, 2009

Three that will go

  • A public plan.

For the past few months, I have predicted that a public plan will not be part of the final health reform package and I have not been convinced otherwise.

In the final analysis, I don't think the federal government wants to create another program that could cost more than expected. The Senate will likely discuss a compromise public option, such as Sen. Olympia Snowe's trigger plan, but I think the feds will pass the issue onto the states through expanding Medicaid eligibility.

  • A powerful individual mandate.

The good news for insurers is that health reform will likely include an individual mandate. The bad news is that I don't think it will have much teeth.

Many members of Congress are against an individual mandate with a heavy fine for those who don't buy insurance. Opponents of the idea don't want the government telling Americans what to do and/or don't want to place financial burdens on individuals who choose to not buy health insurance, particularly those who can't afford it.

This opposition is coming from both sides of the political spectrum, so I think ultimately Congress will pass a wishy-washy individual mandate that will sway many, but not all, of the 47 uninsured Americans to acquire health insurance.

  • Taking away health insurers anti-trust exemption.

Democrats added this idea to the health reform debate shortly after America's Health Insurance Plans released a study that charged current reform proposals would cost Americans more money.

From the start, taking away the exemption has been used as a weapon and bargaining tool against the health insurance industry.

It's not going to be part of the final health reform bill.

If my predictions come true, you can see that health insurers will dodge a bullet with health reform. Yes, there will be more regulations, which aren't ideal for insurers, but there will be avenues to bring in new, younger, and healthier members, such as insurance exchanges, a limited individual mandate, and Medicaid expansion.


Les Masterson is an editor for HealthLeaders Media.

Follow Les Masterson on Twitter.


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