A new policy brief from Health Affairs and the Robert Wood Johnson Foundation explores a key aspect of landmark health reform legislation passed by the House of Representatives: the proposal for a government-run public health insurance plan. The brief lays out details of the plan, including who could enroll, who could receive subsidies to buy coverage, and the anticipated impact on health insurance premiums.

The brief also describes pros and cons of the House proposal, such as why public plan supporters think it is necessary and why critics believe the idea will backfire. Supporters say that a public plan would offer more affordable coverage, could stimulate competition, and could lead the way in improving the entire health insurance market. Those opposed question the public plan’s ultimate financial stability and are concerned that despite legislative language to the contrary, taxpayers may some day have to bail it out.

This Health Policy Brief updates an earlier brief about the public plan that was originally published in June 2009. Subsequent policy briefs will explore another version of the public plan expected to emerge in legislation in the Senate, as well as any changes to the House version over time.

The free Health Policy Briefs are geared to policymakers, congressional staff, news media, and other readers who may not have a background in health issues but want to better understand the basics of proposed changes in the nation’s health care system. The briefs provide jargon-free overviews that include arguments from competing sides of a policy proposal and the relevant research supporting each perspective.


Health Policy Briefs offer more context than fact sheets and are more digestible than most backgrounder papers. The information is objective and reviewed by Health Affairs authors and other specialists with years of expertise in health policy.

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Previous policy briefs have addressed these issues:

–How the new legislation will make it easier for individuals and small businesses to purchase health insurance;

— Whether Congress should require most Americans to have health insurance or face penalties if they don’t;

— The misconceptions and truth about the role of government in health care, lowering the growth in Medicare spending, and advance care planning;

— whether employers should be required to provide health coverage to workers;

— legislative proposals to expand Medicaid and the Children’s Health Insurance Program;

— proposals to raise billions of dollars to pay for health reform by taxing tax employer-sponsored health benefits.

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The briefs are also available from the RWJF’s Web site.

P.S. Please feel free to forward to any of your colleagues who are tracking health issues. And after you’ve taken a look, we would welcome your feedback.