A special feature of the Australian system is compulsory community rating.

Insurance premiums are set by the government, with guaranteed issue and community rating.

The community rating for this school is four out of five stars.

Under Empire's community rating, all individuals and small groups holding the same policy pay the same rate.

But such "community rating" is part of every major reform plan before Congress; these families would pay more no matter which bill passes.

"For a small business like us, community rating is very helpful," she said.

Eight of the 18 employees are over 55, and the company would have to pay higher premiums without community rating.

The academy takes no position for or against community rating, but says policy makers and the public should understand the consequences.

In most cases, they charge the same rates, regardless of occupation or health status, which is called community rating.

This system, known as community rating, is breaking down, however.