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Massachusetts health care — wonky, with a healthy dose of reality

CA Health Reform Process Deepens

CA Health Reform Process Deepens

October 18, 2006

More evidence of the impact of Massachusetts health reform on other states' policy processes. The Institute for Health Policy Solutions has produced a report (funded by the California Health Care Foundation) on policy options to cover all Californians. Click here to obtain the set of three reports -- one on each option. Here are excerpts of the summary:

Momentum is growing in California—in both the public and private sectors—to make health coverage affordable and available for all, or nearly all. To help inform the development of solutions, CHCF funded a project to identify workable coverage models. The results of this effort, available in both an executive summary and a detailed analysis, highlight three alternative approaches to coverage:

Basic Individual Mandate, requiring individuals to obtain coverage and making government subsidies available for low-income Californians;

Pay or Play Plus, combining an individual mandate and subsidies with required employer contributions;

All-Consumer Choice Exchange, replacing today's employer-by-employer coverage system with a "choice pool" funded primarily by payroll fees on all employers and workers.

The report finds that requiring individuals to participate in coverage is essential to any approach to bring all (or virtually all) of the uninsured into coverage. All three models include subsidies for low-income Californians, tax sheltering of worker contributions, and a health insurance exchange for those not eligible for employer coverage. The alternative coverage approaches presented feature varying degrees of employer responsibility.