Health Insurance Mandate — Under President Obama’s plan, individuals would be required to enroll in a health insurance plan or pay a government fine and certain employers would be required to provide it to employees or pay a tax. Supporters of the mandate say it would reduce the cost of health care by providing coverage for everyone, rather than shifting the cost of paying for those without insurance onto those who have it. But many oppose the idea of mandatory insurance as unconstitutional. Others believe that the costs of providing subsidies or full coverage for those who can’t afford private insurance could do further damage to the already enormous national debt.
Public Option — The president wants the Department of Health and Human Services to offer health insurance to anyone who wants it. The government would oversee its own plan, which would compete with private insurers in a health insurance exchange and would reimburse doctors at or near Medicare rates. Proponents say such a plan would expand coverage to everyone and force private insurers to offer more affordable coverage through increased competition. Critics say it would drive private insurers out of business and lead to a European-style takeover of health care by the government.
Health Care Co-ops — The Senate is close to completing a bipartisan health care proposal that would not rely on a government-run plan, as the president prefers, but would instead create a national health insurance co-operative that would sell health insurance to the public, much like mutual life insurance programs. It would be run not by the government, but rather a private, nonprofit group. The government would provide a few billion dollars in startup money, but the co-op would ultimately be self-sufficient. Proponents believe the co-op would lower health insurance costs by providing competitive plans chosen by the co-op, but opponents say it would essentially mimic a government plan.
Trigger — A trigger would require health insurance companies to make certain reforms within a certain number of years or face the creation of a government-run health care system. The trigger option would draw in the support of Democratic moderates and some Republicans who fear the public option creates a path to complete government takeover of health care. But most liberal Democrats fear it will not reform the system.
