Health Affairs Explores California’s Year of Health Reform

A March 2009 Web Exclusive from the journal Health Affairs features three articles exploring California’s recent attempt to expand health coverage and identifying lessons for the future.

The first of the articles, “The Long and Winding Road: Reflections on California’s ‘Year of Health Reform’,” by California Health Care Foundation Senior Program Officer Marian Mulkey and founding president and CEO Mark D. Smith, analyzes California’s 2007 efforts, when the state came close to enacting sweeping legislation that, if fully implemented, would have expanded health insurance coverage to about 3.6 million of California’s 5.1 million uninsured residents.

Mulkey and Smith conclude that California’s experience offers important insights for future coverage expansion efforts, namely that policy efforts are more likely to advance if they are bipartisan, address the needs of both insured and uninsured residents, deliver short-term progress within the context of long-term goals, rely on broad and sustainable financing, strike a balance between specificity and flexibility, and occur within a clearer framework of state and federal responsibilities.

Two accompanying articles by Rick Curtis and Ed Neuschler, president and senior program officer with the Institute for Health Policy Solutions (IHPS), examine California’s efforts to design a universal health coverage approach based on “shared responsibility” among individuals, employers, and government, and they identify implications for possible federal health reform efforts. The foundation funded these reports for IHPS, an independent, nonprofit organization focused on developing transformative solutions to health system problems.

All three pieces are available on the Health Affairs site free of charge through the External Links below.