Health Reform Watch: After Verdict, Experts Consider the Individual Mandate

BY Lea Winerman  December 17, 2010 at 12:50 PM EDT

After Verdict, Experts Consider the Individual Mandate

Health reform challenges in court this week have revived a longstanding debate — in order to work, does the law need to include the “individual mandate” that requires all Americans to buy insurance? The federal government argued in court (and in a Washington Post op-ed by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius) that it does, and many health care economists agree.

But after U.S. District Court Judge Henry Hudson ruled the mandate unconstitutional Monday, experts are “pondering plan B,” Kaiser Health News reports. One option floated, according to the New York Times: strong financial incentives to convince people to buy insurance before they get sick.

Either way, it will be years before the issue comes to the fore. Under the law, the individual mandate will go into effect in 2014. Two other judges have ruled the mandate constitutional, and the issue will almost certainly be decided by the Supreme Court no sooner than 2012.

Health Systems Team Up to Share Data, Improve Care

While the courts debate how to expand health insurance coverage, six large health systems announced this week that they will team up to share data on how to achieve the other main goal of the health reform law: lowering costs and improving patient care.

The six — Geisinger Health System in Pennsylvania, the Cleveland Clinic, Intermountain Healthcare in Utah, the Mayo Clinic, Denver Health, and Dartmouth-Hitchcock in New Hampshire — have some of the best reputations in the country for managing patient care. The NewsHour (and many others) have reported on them previously.

They’ll share data on eight common events and conditions — knee replacements, diabetes, heart failure, asthma, weight loss surgery, labor and delivery, spine surgery and depression — and report which treatments work best. The first results, on knee replacements, will come out in February.

Public Opinion on Reform Remains Steady

As 2010 draws to a close, the Kaiser Health Tracking poll [[PDF](http://kff.org/kaiserpolls/upload/8127-F.pdf)] shows public opinion on health care reform split down the middle. Forty-two percent approve of the law; 41 percent want to see it repealed.

There is one group that seems to be reducing its opposition to the law. 40 percent of seniors say they’d like to see it repealed, compared with 52 percent in October and 46 percent in November. But the number of seniors who say they approve of health care reform hasn’t changed much — moving from 32 percent to 34 percent over the past two months. Instead, they survey found, the percentage of seniors who say they “don’t know” what they think of the law has jumped from 16 percent to 26 percent.