2,000 Pages Is a Pretty Big Graveyard for Burying Loopholes

Health insurers could be allowed to bypass some key reforms Senate bills would include loopholes for proposed 'exchange' By David S. Hilzenrath Sunday, November 15, 2009 Nobody wants to spend a lot of time and energy -- and taxpayer money -- and end up where they started. But that's what could happen with one of the principal elements of health reform, the "exchange" or "gateway." Legislators are designing this new insurance marketplace to protect consumers from many of the pitfalls and inequities in the current system. But even as they focus on the details of how the marketplace will work, senators have indicated that they would allow insurers to continue operating outside it, much as the health-insurance lobby has sought. One Senate bill would preserve the possibility that insurers could tailor policies to draw healthy individuals out of the new markets, leaving coverage less affordable for those who stay behind. "It's a leak in the system," said Karen L. Pollitz, a professor at Geo…