Paving the Difficult Road to Universal Insurance Coverage: Spotlight on U.S. Innovators

Table of Contents

• Executive Summary
  • Strategic Considerations
  • Stakeholder Implications
• An Old Debate Takes on New Urgency
• Massachusetts Provides a Model
  • Commonwealth Health Insurance Connector
    • Defi ning Minimal Creditable Coverage
    • Defi ning Affordability
  • Commonwealth Care Health Insurance Program
  • Medicaid Expansions and Restorations
  • Commonwealth Choice Health Insurance Program
  • Mandating Coverage for All
  • Employer Responsibilities
  • Learning from the Massachusetts Experience: Implications for Other Reform Efforts
  • Future Challenges
    • Communication
    • Affordability
    • Primary Care Provider Shortage
    • Employer Challenges
    • Sustainability and Cost-Containment
• Maine and Vermont: Other Innovators at the Forefront
  • Maine
    • DirigoChoice
    • Cost-Containment Reforms
    • Maine Quality Forum
    • Learning from the Maine Experience: Implications for Other Reform Efforts
    • Future Challenges for Maine
  • Vermont
    • Catamount Health Insurance Plan
    • Employer Responsibilities
    • Chronic Care Initiatives
    • Learning from the Vermont Experience: Implications for Other Reform Efforts
    • Future Challenges for Vermont
• In Search of a National Solution: Universal Coverage Proposals at the Federal Level
  • Bush Administration Tax Reform Proposal
    • Details of the Bush Proposal
    • Problems with the Bush Proposal
    • Starting a National Discussion
  • Universal Coverage Bills in Congress
    • Medicare for All
    • Healthy Americans Act
    • State/Federal Partnerships
• Future Perspectives
  • Importance of Federal/State Partnerships
  • Potential Pitfalls for State Initiatives
  • A Key Issue: Addressing Costs
    • Controlling Current Costs and Spending Growth
    • Targeting Drug Prices
    • Increasing Patient Cost-Sharing
  • A Long Road Ahead

Tables

• 1. Health Insurance Coverage of the U.S. Population, 2002-2006
• 2. State Universal Coverage Bills, 2007
• 3. Key Elements of Massachusetts' Health Care Reform
• 4. Affordability Scale for Massachusetts Health Insurance Premiums Based on Income Level, 2007
• 5. Coverage Options Offered by Commonwealth Choice Plans
• 6. Maine' s DirigoChoice Coverage Plan
• 7. Vermont' s Catamount Coverage Plan
• 8. Comparison of Key Elements of Universal Coverage Proposals at the Federal Level, 2007
• 9. Key Elements of the Health Partnership Act and Health Partnership Through Creative Federalism Act

Figures

• 1. 2006 Health Insurance Coverage: United States
• 2. U.S. National Health Expenditures per Capita and Corresponding Share of Gross Domestic Product, 1960-2007
• 3. Status of State Initiatives for Health Care Reform
• 4. 2006 Health Insurance Coverage: Massachusetts
• 5. 2006 Health Insurance Coverage: Maine
• 6. 2006 Health Insurance Coverage: Vermont
• 7. Key State and Federal Health Insurance Expansion Activities, 2004-2006
• 8. U.S. National Health Expenditures, by Type of Service, 2005

Sidebars

• Ingredients for Health Care Reform: Key Opinion Leader Insights
• Universal Coverage Mandates: Key Opinion Leader Insights
• Factors Affecting the National Movement: Key Opinion Leader Insights
• All Eyes on California as Governor Schwarzenegger Pitches Universal Coverage Plan