Abstract: Fifty years ago, America began a grand experiment by transferring to the federal government the fiscal responsibility for individuals with mental illnesses. During that half-century, it has become increasingly clear that the experiment has been a costly failure, both in terms of human… Read more
Abstract: During its five years of operations, Florida’s Medicaid Reform Pilot has been a decided success. It has improved the health of enrolled patients, achieved high patient satisfaction, and kept cost increases below average, saving Florida up to $161 million annually. Since then, Florida… Read more
Abstract: This spring, after living under the costly failures of Obamacare-like health care legislation for two decades, the Maine Legislature enacted a set of patient-centered, market-based health care reforms. The Maine experience is both a warning of Obamacare’s likely effects and a practical demonstration… Read more
It's time for common sense; I'm Ernest Istook. State governments typically love to accept money… Read more
Federal Judge Roger Vinson recently struck down the massive Patient Protection and Affordable Care Act (PPACA) as unconstitutional.[1] With a total of 28 states challenging official Washington, the issue of the new law’s constitutionality is doubtless headed for final resolution in the U.S. Supreme Court. But the fundamental… Read more
Abstract: Implementation of the Massachusetts health care reform has largely failed to address the needs of small businesses and their employees. Given that small businesses generate most new jobs, this breakdown also constitutes poor economic policy. As other states take up health care reform… Read more
Abstract: Obamacare is on the march, and state policymakers must decide by 2014 how they will respond to this encroachment on states’ rights to control their own health insurance markets. The state of Utah has been on the reform path since 2005. With its system of defined contributions (as… Read more
THE ISSUE: The health care system needs reform, but not the types of changes enacted under the new health care law. The Patient Protection and Affordable Care Act moves the health care system in the wrong direction. This highly unpopular… Read more
Abstract: Americans who receive health insurance through their jobs generally have little flexibility: 86 percent of employers in the country offer only one plan. This system of “defined benefits” has worked well for expanding group coverage, but severely limits options for individuals, and has… Read more
Abstract: The sweeping health care bill pushed by congressional Democrats and President Barack Obama has been signed into law. The enormous expansion of federal power that will result from “Obamacare” will have far-reaching effects on the traditional roles… Read more
State and federal lawmakers are focusing increasingly on health care reform, and a growing number are expressing serious interest in "patient-focused" or "consumer-centered" approaches. This is certainly a positive development. Lawmakers of both parties are now more inclined to advocate making the patient the focus of America's health care system. However, the vocabulary of health care policy is… Read more
Abstract: The nationalized health care system pushed by President Barack Obama and congressional Democrats has been signed into law. Policymakers and private citizens across the country are rebelling against what they see as an intrusion of the federal government into state and individual rights. On April… Read more
When President Bill Clinton first ran for office in 1992, he made health care reform a preeminent domestic policy issue. At the time, there were about 37 million uninsured Americans, and many of those who had health insurance lived in fear of losing their coverage, especially if they changed jobs. One year… Read more
State officials can dramatically improve the functioning of their state health insurance markets, establish portability and personal ownership in health insurance coverage, and make major improvements in how they finance health care for the uninsured. Massachusetts, a state with a conservative Republican governor and liberal Democratic legislature, has recently enacted comprehensive health care reform. Not surprisingly, many… Read more
Massachusetts's experiment in health market reform is already showing progress. The average Massachusetts resident without health insurance will soon be able to obtain coverage for $175 per month through the state's Connector, a health insurance exchange for individuals and small businesses.[1] Because the Connector can accept pre-tax defined contributions, many will… Read more
In the debate over health care reform, some federal and state lawmakers are asking whether some type of reinsurance system might make health insurance more affordable. In exploring that rather arcane area of insurance practice, policymakers should have a strong understanding of the concepts involved and the potential benefits and limits of "reinsurance" mechanisms for… Read more
Abstract: In sharp contrast to the recently enacted federal health care reform, Utah is taking a targeted approach to expanding coverage while moving the system in a more patient-centered direction. Utah's approach promises to increase the number of… Read more
The political math was simple and should have been fool-proof: Proponents of a high-earner income tax in the state of...… Read more
Last spring, the National Governor's Association (NGA) and the Council of Chief State School Officers (CCSSO) began...… Read more
Senior Research Fellow, Health Policy Studies