California HealthCare Foundation – Supporting ideas and innovations to improve health care for all Californians.

Coverage Expansion Resource Center

The Coverage Expansion Resource Center offers resources to better understand the trade-offs made with different types of health insurance coverage expansion proposals in an effort to foster constructive dialogue.

August 2004

It is challenging for policymakers and the general public to compare features or assess trade-offs among proposals for expanding health insurance coverage in California and across the nation. The online Coverage Expansion Resource Center was created in 2004 to help focus the complex debate over how to cover the uninsured on core issues — the attributes of coverage expansion proposals and the trade-offs inherent in alternative approaches to reform.

The Coverage Expansion Resource Center provided a framework for evaluating coverage expansion proposals in a consistent manner and facilitating objective comparisons. It was developed by CHCF and the Economic and Social Research Institute in conjunction with a national advisory group. The framework examined key attributes of health coverage expansion proposals and the inherent trade-offs necessary when choosing one approach over another.

The attributes considered include:

  • Coverage: Who is covered and how comprehensive is the coverage?
  • Cost and Efficiency: Is the proposal efficient and economically practical?
  • Fairness and Equity: Does the proposal promote fairness and equity?
  • Choice and Autonomy: How much choice does the proposal permit?

The six models of coverage expansion that were considered in this 2004 effort were:

  • Status Quo
  • Medi-Cal and Healthy Families Expansion
  • Simple Tax Credit Without an Individual Mandate
  • Enhanced Tax Credit with an Individual Mandate
  • Pay or Play Employer Mandate
  • Single Payer

Available under Document Downloads are four files that represent the former online resource center (deactivated in early 2010): a project overview; a framework attribute overview; and comparisons of the model attributes and trade-offs.