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The Health Insurance Reform Debate

40 Pages Posted: 15 Dec 2009  

Scott E. Harrington

University of Pennsylvania - Wharton School

Multiple version iconThere are 2 versions of this paper

Date Written: November 24, 2009


This paper provides an overview of the U.S. health care reform debate and legislation, with a focus on health insurance. Following a synopsis of the main problems that confront U.S. health care and insurance, it outlines the health care reform bills in the U.S. House and Senate, including the key provisions for expanding and regulating health insurance, and projections of the proposals’ costs, funding, and impact on the number of people with insurance. The article then discusses (1) the potential effects of the mandate that individuals have health insurance in conjunction with proposed premium subsidies and health insurance underwriting and rating restrictions, (2) the proposed creation of a public health insurance plan and/or non-profit cooperatives, and (3) provisions that would modify permissible grounds for health policy rescission and repeal the limited antitrust exemption for health and medical liability insurance. It concludes by contrasting the reform bills with market-oriented proposals and with brief perspective on future developments.

Keywords: health insurance, health care reform, mandate

JEL Classification: G22, I1, G50

Suggested Citation

Harrington, Scott E., The Health Insurance Reform Debate (November 24, 2009). Available at SSRN: or

Scott E. Harrington (Contact Author)

University of Pennsylvania - Wharton School ( email )

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Philadelphia, PA 19104-6358
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