Association health plans possible: health care reform not likely in election year.(Practice Trends)

Hoping for substantive health care reform this year? Think again.

Health care reform doesn't usually happen in years where presidential elections loom large, according to several experts. "Reforming health care, holding down health care costs, and expanding coverage are good issues to run on, but they are difficult and divisive problems to address once you're in office," said Robert Reischauer, Ph.D., president of the Urban Institute, a liberal Washington think tank.

Grace-Marie Turner, president of the Galen Institute, a conservative health policy organization in Alexandria, Va., agreed. "So much depends on how much the issue plays out as an important issue in the presidential debates," she said. "As the economy and taxes continue to dominate [the discussion] along with jobs and terrorism, it is unlikely health care will rise to a level demanding congressional action."

The problem is further complicated this election year by the fact that Congress is so narrowly divided between Republicans and Democrats, said Leighton Ku, Ph.D., senior fellow in health policy at the Center for Budget and Policy Priorities, a liberal policy group in Washington. "In a situation where things are so tightly balanced, both sides want a short, noncontroversial session so they can proceed onto an election that they know will be tight and important."

If any health care issue is to be addressed this year, it will be the uninsured, Ms. Turner predicted. "There are new numbers on the uninsured coming out in September, and they are invariably going to show an increase in the number of uninsured people." because it takes a while for insurance to catch up with an economic recovery, she said.

The issue of the uninsured could show up in several forms, she continued. One is an effort to legalize a new form of association health plan ...