Rising college prices and student debt, the growth and collapse of online for-profit colleges, and expansions of federal grant, loan, and loan forgiveness policies have increased calls for more accountability in our higher education system. And there is significant consensus among lawmakers that the existing set of quality assurance policies for federal aid programs are not protecting students and taxpayers. But although these conditions have generated many proposals for policies to hold colleges accountable, none have won broad support among lawmakers. To help advance the reform debate, we review and compare recent proposed policies that address accountability and, drawing on interviews we conducted with former congressional staff members and higher education advocates, what factors have prevented policymakers from enacting reforms, and what conditions may be necessary to bring about policy changes. The report reveals that lawmakers, researchers, and advocates have put forth a wide range of reform proposals to strengthen quality assurance rules for federal aid programs. This variety implies that there is considerable disagreement over what reforms are needed and disagreement over the underlying problem. Some proposals focus on graduation rates, while others assess how colleges spend money. The most common approach among the proposals is to judge colleges on how their students fare in repaying their student loans, suggesting a possible place for consensus. The report also shows there are many political and design roadblocks to reform despite broad support for more accountability. The current political environment makes bipartisan policymaking difficult. Additionally, higher education is an open-access and diverse system of institutions, making policymakers reluctant to pass policies that might reduce access, particularly for low-income students and students from underrepresented ethnic and racial groups. Still, the individuals we interviewed all discussed several major design issues that will further frustrate reform efforts, such as whether students who do not receive federal aid should be included in the policies and whether some fields and institutions should be exempt. Regardless, many of the recent reform proposals illustrate the need to improve assurance for aid programs and should ultimately encourage lawmakers to work toward reforms that strengthen our higher education system and federal aid programs.