This report identifies general approaches proposed at the state level to reform health insurance, and describes specific strategies to illustrate the breadth of possible reform options. Selection of State Health Insurance Reforms

While the states have implemented a wide range of reforms to address concerns about both coverage and the health care delivery system, most health reform discussions focus primarily on health insurance. Under this broad policy area, coverage and cost concerns are paramount. The primary objective related to coverage is reducing the number of uninsured persons. Reforms may target a specific group (e.g., small businesses), or address the uninsured population as a whole. Cost reforms primarily address concerns about the affordability of health insurance for individuals, families, and employers. This typically results in policies that invest public resources to assist consumers and firms with the cost of health insurance. Since an all-inclusive analysis of state reforms is beyond the scope of this report, these descriptions include examples of both common and innovative initiatives to illustrate the breadth of reforms. The selected strategies reflect the current diversity of reform approaches, in terms of scope of reforms, policy levers used, and populations affected. The reform strategies have been identified according to targeted stakeholder groups: consumers, employers, purchasers of health coverage, and health plans. In addition, the report explores key design and implementation challenges related to coverage and cost, and provides a succinct state example for each reform strategy.
States have taken the initiative to propose and enact health care reforms to address perceived problems related to health insurance coverage, health care costs, and other issues. These reform efforts vary in scope, intent, and target demographic group. While not all members of Congress agree in the need to reform health care, many have expressed interest in learning about these state efforts to inform ongoing debate at the national level.
Each state has implemented a unique set of reform strategies to address concerns about health insurance and the health care delivery system. However, most health reform discussions, at both the state and federal level, focus primarily on insurance. Under this broad policy area, coverage and cost concerns are paramount.
The primary objective related to coverage is reducing the number of uninsured persons. Related reforms may target a specific group, or address the uninsured population as a whole. Cost reforms primarily address concerns about the affordability of health insurance for individuals, families, and employers. This typically results in policies that invest public resources to assist consumers and firms with the cost of health insurance.
This report identifies general approaches proposed at the state level to reform health insurance, and describes selected reform strategies. These descriptions are intended to be illustrative, not exhaustive. They include examples of both common and innovative initiatives to reflect the diversity of reform approaches, in terms of scope, policy levers used, and populations affected. The reform strategies have been identified according to targeted stakeholder groups: consumers, employers, purchasers of health coverage, and health plans. In addition, the report explores key design and implementation challenges related to coverage and cost, and provides a succinct state example for each reform strategy.
This report will be updated as circumstances warrant.