The responses display the long standing policy dichotomy between reforming healthcare vs. increasing access and affordability as the first policy priority. The two are not mutually exclusive in the long run. I agree with Ramey; BHP offers an opportunity to those who currently can't afford to purchase health insurance. Not availing such opportunity would be a disservice to the public welfare. On the other hand, Wulsin is also on target that the BHP (and other programs) must all be captured under a seamlessly administered Exchange to avoid Weinberg's self inflicted “metastasizing complexity” with incremental changes. Access and affordability are the key issues to consumers; and as Grgurina notes, price/income elasticity is the determining factor here. If BHP eligibles have pentup demand with unmet needs per Komisnki, then perhaps we ought to reconsider in the short term the continued advocacy of preconditioning only comprehensive benefit offerings at the expense of access/affordability.