Health Affairs

How Federalism Could Spur Bipartisan Action On The Uninsured

Abstract

National efforts to greatly reduce the number of uninsured Americans have made little progress for decades because achieving majority support for any one approach has proved to be impossible. While as authors we remain unreconciled on the best solutions, we share the belief that federally supported state experimentation is a promising way to make progress. States should be allowed to try widely differing solutions with federal financial support under legislated guidelines, including specific protections and measurable goals. Congress would enact a "policy toolbox" of federal initiatives that states could include, and funding to states would be linked to success in reaching the goals.

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