An Emerging Middle Ground?

An Analysis of Health Reform Positions

With various versions of health care reform legislation being passed around Capitol Hill, and outspoken advocates pressing agendas on all sides, most recent news reports have highlighted the most contentious issues. But a new report suggests that health reform discussions so far have yielded more agreement than may at first meet the eye. The report identifies and explores eight areas in which diverse business, medical and consumer interests are beginning to find middle ground and earn the support of bipartisan lawmakers.

Although there is still much to be debated and decided, the authors say there is movement among the parties across several key elements of reform, including:

  1. the nature of private insurance market reforms;
  2. the need for, and the structure of, a health insurance exchange;
  3. whether and how a government-sponsored “public plan” should be created;
  4. how best to leverage Medicaid and/or public programs to expand access;
  5. whether an individual mandate is needed;
  6. the scope and authority of government involvement in comparative effectiveness research;
  7. sequencing and scope of payment reform; and
  8. whether to limit the tax exclusion on employer-based coverage as a reform financing mechanism.

The report provides a side-by-side explanation of the different perspectives for each issue and then identifies “the middle ground” around which consensus may be forming.

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