By John Sawyer
Even for those of us who spend “all day every day” following the latest developments in the health reform debate, keeping up with the flow of terminology that gets tossed around can be a challenge. This week, as the Senate HELP Committee released its draft bill, and as the debate over the “public option” heated up, new terms were entering the health reform lexicon at a more and more rapid pace. Here’s a quick rundown on a few of them:
- Exchange: Modeled after the Massachusetts health reform effort, most health reform proposals call for the creation of insurance “exchanges”, where individuals and certain small businesses could access information about (and purchase) a variety of health insurance products. The plans offered in these exchanges would be overseen by some sort of “health board” which would have some say in benefits that must be offered.
- Gateway: the term used in place of “exchange” in the Kennedy/HELP Committee draft bill – actually, the full name is “American Health Benefits Gateways”. That bill calls for establishing the Gateways at the State and Regional level, with some level of subsidy to go to Americans making up to 500% of the poverty level, in order to purchase coverage through a Gateway.
- Public Option: The source of most controversy (and least specific details) thus far in the health reform debate. Many Democrats have advocated including a government-run health plan in the Exchanges, to compete with private insurers and/or offer a fallback option for those who can’t afford the private product. Republicans (along with health insurers, many doctors and businesses) by and large oppose the idea on the premise that it would undermine, and even eliminate, the private insurance system in this country.
- Co-ops: An idea that emerged out of Senator Kent Conrad’s (D-ND) attempts to find a “potential compromise” on the public plan question, this proposal would create non-profit, member-driven co-operatives that could provide insurance through the Exchanges and compete with private for-profit insurers. While the proposal is very new and details are sparse, Republican like Senate Finance Committee Ranking Member Charles Grassley (R-IA) have warmed to the idea. Ezra Klein from the Washington Post has a good interview on the topic with Conrad here.
We’ll be back next week as a new batch of terms makes its way into the debate. Until then, let us know in the comments if there are concepts or terms you’d like to know more about!