White Paper

"Single-payer" approach. All legal residents covered by Medicare, with expanded and rationalized benefits package and no copayments. Particular emphasis on community medicine. States could choose to opt out for residents under age 65 by designing their own system under federal guidelines.

A new Medical Security System would be created to provide universal coverage, making coverage a "right."

All nonelderly legal residents would be guaranteed comprehensive health insurance as a "right" (at no direct cost) through a public insurance approach designed by each state and monitored by the federal government.

A modified "play or pay" approach that creates incentives for workers and employers to buy into "Medicare Plus," a national program based on Medicare.

Incentives to encourage people to enroll in a public plan that would ultimately be a single payer. Employers offer coverage or pay 6.5 percent payroll tax. Subsidies to limit premiums to 2.5 percent of income.

This paper discusses the role that tax law can play in the implementation of health reform. The tax code has served as the primary vehicle for subsidizing health care in the United States, with subsidies averaging $245 billion per year. Use of the tax code to support or implement health policy is extremely common in proposals at both the federal and state levels.

Although the U.S. spends $2.2 trillion every year for health care - far more than any other nation - Americans are not as healthy as they could or should be.

This paper explores the scope and limits of President Barack Obama's ability to invoke his executive authority to reform health care. Specifically, it identifies ways the Obama administration can use directives to: (1) expand Medicaid and SCHIP coverage through section 1115 waivers; (2) test quality initiatives through Medicare demonstration authority; (3) expand health information technology; (4) allow drug reimportation and experiment with contracting power under Medicare; (5) enhance patient protections and private coverage requirements; (6) lift coverage restrictions on Medicaid and SCHIP; and (7) build on the health insurance program for federal employees.

The increased use of health information technology (health IT) is a common element of nearly every health reform proposal. While health IT has the potential to decrease costs, improve health outcomes, coordinate care, and improve public health,  increasing the use of health IT raises concerns about security and privacy of medical information.

This paper examines insurance discrimination based on health status defining discrimination as how the insurance industry differentiates among individuals in designing and administering health insurance and employee health benefit products. The paper provides a brief overview of discrimination practices, the federal law, and federal reform options to manage discriminatory practices in the insurance and employee health benefit markets.