Additional Papers

    • March 25, 2009

To complement these proposals, we commissioned several papers that provided a framework for thinking about and evaluating the advantages and disadvantages of various plans to cover the uninsured. Some of these papers focused on a particular set of reform ideas, such as those featuring insurance exchanges and mostly voluntary participation in the health care system, or the value of Medicaid to our overall health system, while others focused on more cross-cutting issues that all reform plans must address.

Tax Credits for Individual Health Insurance: Effects on Employer Coverage and Refinements to Improve Overall Coverage Rates
Rick Curtis and Ed Neuschler
Tax credits like those proposed by the Bush Administration could help make individual health insurance affordable for the many uninsured people who do not have access to employment-based health coverage.

Medicaid: What Any Serious Health Reform Proposal Needs to Consider
Christine Ferguson, Patricia Riley and Sara Rosenbaum
Christine Ferguson, Patricia Riley and Sara Rosenbaum argue that reformers who would replace or significantly change the structure of Medicaid need to understand and consider carefully the crucial roles that Medicaid plays in state government.

Mobilizing, Framing, and Leading: Three Policy Thought Experiments for Covering America
Edward F. Lawlor and Ann Dude
Edward Lawlor and Ann Dude look at three successful non-health-related policy reforms to see what lessons can be learned about reformulating health reform strategies to enhance the chances for achieving universal coverage.

When Worlds Collide: Public Policy, Private Markets, and the Price of Health Insurance
Katie Merrell
Katie Merrell reviews characteristics of public policy and private markets forpersonal health insurance to understand how they affect the cost of insurance at different income levels.

Building Quality Improvement into Health Coverage Expansion Proposals
Jack A. Meyer and Sharon Silow-Carroll
The purpose of this paper is to identify and explain how proposals to expand health insurance coverage can build in features to promote and facilitate health care quality improvement.

Options for Financing Health Coverage Expansion
Jack A. Meyer and Elliot K. Wicks
Anyone proposing major reforms to extend health insurance coverage to the millions of Americans who are uninsured will have to decide whether to use existing financing sources, add new ones, or substitute one single source for the diverse array of funding streams under the current system.

Ends and Means in Health Insurance Policy
Bruce C. Vladeck
Bruce Vladeck provides a general critique of the reform proposals in the first volume in this series. He argues that too many of the authors have falsely assumed that access to the kind of insurance they propose will ensure access to adequate health care.

Decision Points and Trade-Offs in Developing Comprehensive Health Coverage Reforms
Elliot K. Wicks
It is useful to make explicit the decision points and the kinds of tradeoffs reformers must make in designing policies to cover the uninsured. That is the purpose of this paper, which is the first in a series that will deal with issues that need to be addressed in designing comprehensive coverage expansion.

Coping with Risk Segmentation: Challenges and Policy Options
Elliot K. Wicks
Risk segmentation and the consequent wide variation in premiums create at least two kinds of problems. First, some high-risk people are not able to afford coverage.

History and Primer on Cost Containment Efforts and Implications for Future Prospects
Elliot K. Wicks
The purpose of this paper is to outline the range of cost control options from which policy reformers might choose. The United States has a long history of trying various costs containment strategies, none of which has proved very successful. It is therefore useful to review what has been tried and to consider all the available options.

Prospects for a Reduction in the Number of Uninsured Americans
Elliot K. Wicks and Jack A. Meyer
A major purpose of this paper is to look at the evidence to try to determine whether the problem of the uninsured is correcting itself and is likely to be solved through the normal operations of the economy, or whether a solution requires significant policy changes.

Covering America: A Commentary on Three Approaches
Michael Chernew
Michael Chernew examines three of the proposals prepared for Volume I of this project. The proposals—by Jonathan Gruber; John Holahan, Len Nichols and Linda Blumberg; and Sara Singer, Alan Garber and Alain Enthoven—can be categorized as "voluntary insurance pool proposals."