Incremental Universalism for the United States: The States Move First?Jonathan Gruber Journal of Economic Perspectives, 2008, vol. 22, issue 4, pages 51-68 Abstract: The latest wave of health care proposals and laws in the United Sates has been marked by what I call "incremental universalism"—that is, getting to universal health insurance coverage by filling the gaps in the existing system, rather than ripping up the system and starting over. In this paper, I provide an overview of "incremental universalism" as an approach to healthcare reform, explore the issues it raises, and examine how these issues are being addressed at the state level, focusing primarily on the healthcare reform plan enacted by Massachusetts in April 2006. This sweeping bill altered insurance markets, subsidized insurance coverage for a large swath of the population, introduced a new health insurance purchasing mechanism (the "Connector"), and mandated insurance coverage for almost all citizens. The Massachusetts experience has led to similar proposals in a number of states, including a major (but ultimately failed) effort in California. I am far from an objective observer in discussing the Massachusetts law. I was one of the architects of the law and since 2006 have been a member of the board overseeing its implementation. Despite this bias and the fact that the ambitious Massachusetts plan is still in relatively early stages of implementation, I can say that some early results point to major successes for this reform. Date: 2008 There are no downloads for this item, see the EconPapers FAQ for hints about obtaining it. Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: http://EconPapers.repec.org/RePEc:aea:jecper:v:22:y:2008:i:4:p:51-68 Ordering information: This journal article can be ordered from Access Statistics for this article Journal of Economic Perspectives is edited by David Autor More articles in Journal of Economic Perspectives from American Economic Association |
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