Policy Lab

Healthcare Reform in the US

A full record of the simulated debate process, from constituency grievances and reform iterations to viability scoring and the final bill.

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Constituencies

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We began by identifying the main political constituencies involved in this debate.

Progressive DemocratsModerate DemocratsModerate RepublicansConservative Republicans

Grievances

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We then mapped what each group wants, in their own voice.

Progressive Democrats

  1. 1The for-profit insurance model is structurally incompatible with universal coverage
  2. 2Drug prices are set by market power, not cost or value
  3. 3Medical debt is the leading cause of personal bankruptcy in the wealthiest country on earth

Moderate Democrats

  1. 1Premiums and deductibles keep rising even under the Affordable Care Act
  2. 2Drug prices are indefensible and the market will not fix them
  3. 3Coverage is tied to employment, which makes no sense

Moderate Republicans

  1. 1Hospital and Insurer Consolidation Has Destroyed Real Competition
  2. 2Price Transparency Rules Exist on Paper but Not in Practice
  3. 3The Tax Code Distortion Ties Coverage to Employment and Locks People In

Conservative Republicans

  1. 1The Affordable Care Act Destroyed Individual Choice
  2. 2You Cannot Buy Insurance Across State Lines
  3. 3Medicaid Expansion Created Dependency and Crowded Out Private Coverage

Policy Clusters

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Finally, we grouped these grievances into 5 negotiable policy areas.

  1. 01Insurance Market Structure and Coverage Access
  2. 02Drug Pricing and Pharmacy Benefit Manager Reform
  3. 03Provider Markets, Competition, and Access
  4. 04Public Program Adequacy and Fiscal Sustainability
  5. 05Administrative Burden and Care Management Reform

Alignment

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We then analyzed where the constituencies converge, where they clash, and what trade-offs might hold a coalition together.

Coming soon.

Coming soon.