Health Care Reform Glossary

Health care reform is a top goal of President Obama. Here's a glossary of health care reform terms.

Comparative effectiveness research: Scientific studies that would assess the effectiveness of various medical treatments, medications, and devices. A component of health reform, the research aims to improve quality of care and control costs.

Co-ops: Private, nonprofit health organizations, run in states or regionally, to compete with private insurance companies. Co-ops are a compromise proposal in the debate over greater government role in health reform.

Deficit neutral: President Obama’s requirement that a health care overhaul not add to the federal deficit.

Employer benefits exemption: Tax exemption for workers on the value of their health benefits provided by employers. Some reform proposals would remove this exclusion or cap it at a certain amount.

Exchange: A more competitive insurance marketplace, established by the government, where individuals and small firms would shop among health plans for coverage under overhaul proposals.  

Guaranteed access: Reform provision that would bar health insurers from rejecting applicants because of their pre-existing health conditions.

Harry and Louise: Fictional couple who are promoting health reform in ads; in the 1990s, the two starred in TV ads, funded by health insurers, that opposed reform.

Individual mandate: Requiring people to purchase health insurance or pay a penalty.  Reform plans would give subsidies to those with middle incomes and below to afford a policy.

Malpractice reform: Most doctors are seeking to limit their vulnerability to malpractice lawsuits as part of overall health reform legislation.

Medicare: Federal insurance program for people 65 and older and the disabled. It covers about 49 million Americans. Democrats’ proposals would make various Medicare funding cuts to help pay for health reform.

Medicaid: Government insurance plan for the poor and disabled covering roughly 60 million people. Its size would be expanded under health reform plans, though it, too, would be subject to spending cuts.

Pay or play: Requiring employers to provide health insurance for their workers or pay a fee or penalty to the government. Also known as an employer mandate, it would exempt some small businesses under various reform scenarios.

Pre-existing conditions: Medical conditions that exist before a person seeks out a new health insurance policy. Some insurance companies reject applicants for insurance or limit their coverage if they have pre-existing conditions. Reform plans would prohibit insurance companies from denying coverage due to health status.

Public plan or option: A government-run health plan, similar to Medicare, that would compete with private insurance plans in a marketplace or exchange. A major point of contention between reform supporters and opponents.