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March 24 2010

Health Care Reform in Transition: Incremental Insurance Reform Without an Individual Mandate

Author Affiliations

Author Affiliations: O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC.

JAMA. 2010;303(12):1188-1189. doi:10.1001/jama/2010.375

On January 20, 2010, Scott Brown won the Massachusetts Senate seat held by Edward Kennedy for 46 years, ending the Democrats' filibuster-proof supermajority and stalling health care reform. Lawmakers in both parties called for bipartisan health insurance protections to supplant the more comprehensive packages, which currently include an individual purchase mandate. Piecemeal reform could impose a tax on high-cost plans, prohibit health status underwriting, require continuation coverage for individuals younger than 25 years, and fund state health insurance exchanges.1 Although incremental reform would provide some protection for vulnerable individuals, it could have serious, unintended consequences.

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