Governors are proposing ambitious health reform initiatives to improve the current health care system. The continually rising cost of health care and ever increasing number of uninsured individuals has increased momentum for reform to contain costs and increase coverage for the uninsured, particularly at the state level.

Governors are proposing health system reforms that encompass both coverage and health system improvements that are aimed at enhancing the overall health care system, including:

  • Innovative coverage approaches using both public and private expansions. State public program expansions use the Medicaid and State Children's Health Insurance Program (SCHIP) programs to increase coverage to additional individuals, particularly children. States are expanding access to private insurance through small business incentives, premium assistance programs to help workers buy their employer-sponsored health insurance, and health savings accounts (HSAs).
  • Reforming the private insurance marketplace. States are approaching reforms through participation requirements to encourage employers and individuals to obtain health insurance. States are also encouraging employers to set up Section 125 plans to allow their workers to deduct their health insurance premiums pre-tax, and are utilizing a "connector" model, which provides access to more affordable and portable insurance. Additionally, states are using a state-defined benefit package to allow individuals to receive basic health services through private insurers.
  • Improving the health care system. States are using quality improvement and measurement, such as pay-for-performance evaluations, quality measures, and the development of electronic data exchange, to improve the efficiency and quality of patient care in the health care system. States are also using prevention and wellness benefits, such as the early treatment of preventable diseases, to contain costs and improve the value of coverage.
This Issue Brief explores the innovative ways states are approaching health reform to expand access to affordable coverage and improve the health care system and the health of the population. In addition, a snapshot of many state health reforms is included in the appendix.