Americans have become increasingly opposed to President Obama’s health overhaul. The more they learn about it, the less they like it.

The voters of deep blue Massachusetts spoke very clearly during the special Senate election Jan. 19 that they did not want the health reform plan Congress has spent a year developing with its $1 trillion price tag, new budget-breaking entitlements, higher taxes and mountains of red tape and mandates.

A Washington Post poll of Massachusetts voters showed a whopping 89 percent said health care was extremely important (56 percent) or very important (33 percent) in determining their vote in the special election. Among Republican Scott Brown’s supporters, eight in 10 said they were opposed to Washington’s overhaul plan, with 66 percent of them strongly opposed.

The only path to passage of reform legislation now is for the president and the leaders in Congress to scrap the current approach and work with members from both sides of the aisle to come up with a smaller, more reasonable step-by- step approach to reform.

We need to create a path toward ownership of health insurance and genuine competition among insurers. The American people have made it clear they want health insurance that is reliable and more affordable, and that does not exclude people with pre-existing conditions.

Congress could begin by allowing uninsured Americans to buy insurance with pretax dollars and provide targeted subsidies to those who need help in affording premiums.

Congress also could allow people, including small businesses, to buy health insurance across state lines. Right now, small businesses and individuals can obtain coverage only from insurers within their state where there is often little or no competition.

To help those with pre-existing conditions, lawmakers could provide funds to states to help them manage functional, high-risk insurance pools. Such pools are established in more than 30 states and several have developed successful private-public sector partnerships.

Americans are also concerned with the escalating cost of Medicare and Medicaid. A bipartisan crackdown on fraud would lower costs without cutting benefits or reducing the quality of care. Losses to theft from these programs are estimated at $80 billion annually!

Finally, Congress needs to make it clear that those who have health insurance can keep it by enforcing provisions in existing federal and state laws.

There is a great deal of complexity behind these initiatives, but so long as Congress and the president recognize that Americans value private health insurance and don’t want huge disruptions in their medical care or massive new taxes and entitlement costs, a new conversation can begin toward achieving real health reform.

Grace-Marie Turner is president of the Galen Institute, a non-profit research organization focusing on patient-centered solutions to health reform.