Journal of the American Medical Association   |  March 23, 2010

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ON JANUARY 20, 2010, SCOTT BROWN WON THE Massachusetts Senate seat held by Edward Kennedy for 46 years, ending the Democrats’ filibuster-proof supermajority and stalling healthcare reform. Lawmakers in both parties called for bipartisan health insurance protections to supplant the more comprehensive packages, which currently include an individual purchase mandate. Piecemeal reform could impose a tax on high cost plans, prohibit health status underwriting, require continuation coverage for individuals younger than 25 years, and fund state health insurance exchanges.1 Although incremental reform would provide some protection for vulnerable individuals, it could have serious, unintended consequences.

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