Overview

The uninsured population of the United States disproportionately comprises lowerincome workers and their families, whose employers offer no health benefits. In most states, these workers are ineligible for Medicaid, even if their children are, and Medicaid is generally not available to lower-income workers without children. Thus, there is a need for a coverage initiative that fosters greater access to affordable benefits through employment, particularly in light of the strong support that employment-based coverage enjoys among the public.

Under this proposed program, states would organize a group health insurance market for small firms with low-wage workers. States would both stabilize the cost of coverage for participating employers and subsidize premiums for low-income workers. This program would be an extension of the State Children's Health Insurance Program (SCHIP) and states could volunteer to participate. The laws governing SCHIP are sufficiently flexible to permit this type of initiative.

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