Health reform: what will it take to pass?

The health care reform debate has begun in earnest, but the outcome for 1994 is highly uncertain. Divisions among Democrats on health care reform are very serious, with conservative Democrats closer to mainstream Republicans than to their own congressional leadership on the key issues of spending limits, price controls, and employer mandates. Because 1994 is an election year, and given the commitment of the president to reform, passage of legislation that is somewhere between a less regulatory form of managed competition and incremental reform is possible. But because of the divisions within Congress and the president's overly ambitious starting point, near-term passage is not inevitable.