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Improving Individual Health Insurance Markets

October 12, 2017

In the U.S. health care system, the individual healthcare insurance marketplace has always been something of an afterthought. Most Americans of working age receive coverage through their employer. Older Americans and those with disabilities typically get benefits from Medicare. Fewer than one in ten Americans purchase coverage directly from statewide individual marketplaces, established through the Affordable Care Act, or purchase unsubsidized plans outside these markets. Nevertheless, this represents tens of millions of individuals who depend on the quality and choice of the products in the individual market.

International Healthcare Systems and the US Health Reform Debate

August 17, 2017

The ongoing challenges within the US healthcare system include its high costs, uneven access, and tremendous complexity. These deficits regularly generate calls for full-scale health reform from both sides of the political aisle. Republicans in Washington DC have consistently proposed to repeal the Affordable Care Act (ACA) and replace it with a less regulated system; most progressives in California would like to do away with the ACA in favor of "single-payer" healthcare modeled on the Canadian system. When considering the desirability of reforms, whether they come from the right or the left, it makes sense to look at how other developed countries are tackling their own healthcare challenges.

A Pragmatic Approach to Medicaid Reform: Increasing Sustainability, Flexibility, and Value for Medical Spending

April 16, 2017

A series of proposals at the federal level have focused on Medicaid, the healthcare coverage program for low-income people that goes by the name "Medi-Cal" in California. There has been an intense focus, in particular, on the budgetary cost of coverage through this program. Therefore, whether one believes enrollment in the program needs to be expanded or curtailed, it is essential to increase the affordability of the care that the program finances. This brief lays out some key statistics and considerations—particularly related to the impact of Medi-Cal on the state economy—that policymakers should take into account. It also advances a series of policy recommendations aimed at increasing both the quality of the care Medicaid finances, as well as the fiscal sustainability of the program.

The Economic Impact of the Affordable Care Act on California

May 21, 2012

Estimates job creation, gross state output, Medicaid expenditures, and effects of increased labor force participation if federal healthcare reform had been fully implemented in 2010. Analyzes regional variations due largely to socioeconomic differences.