Health Purchasing Coalitions Struggle to Gain Bargaining Clout: Small Size and Lack of Support from Health Plans are Factors

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During the health care reform debate in the early 1990s, health purchasing coalitions (HPCs) were touted by some as a “magic bullet” that would cure the many ills of the health insurance market. Other proponents of HPCs, including the Clinton administration, suggested that as part of a plan for comprehensive health care reform, HPCs could help remedy a number of problems prevalent in the small-group market, including limited choice, high insurance costs, and increasing numbers of uninsured workers. However, purchasing coalitions have not been widely established and have met with limited success where they have been implemented.