The "three-legged stool" of health care reform is wobbling.
To understand why the stool is wobbling, let's go over the three legs. As David Leonhardt elegantly described, health care reform extends health care to tens of millions of Americans by (1) requiring everybody to but health care, to spread costs among sick and healthy; (2) prohibiting insurers from "cherry-picking" health customers or taking away coverage from the sick; and (3) handing money to people who can't afford insurance alone.
Each of the three legs needs the others for the stool to stand. If we force insurers to accept all comers without requiring everybody to buy health care, people will wait until they get sick to buy insurance, which will drive up the cost of care for everybody else. If we require everybody to buy health care without subsidies, we'll saddle low-income families with brutally high costs.
Today, all three legs are teetering. Fist, Republicans and even some Democrats are balking at the "universal mandate" to buy health insurance. Second, the Obama administration is offering waivers to insurance companies to let them keep old policies that reform was supposed to end, like capping annual benefits. Third, Republicans are looking to block funding to set up the exchanges and subsidies system.