Is Incremental Change Working? Or Is It Time to Reconsider Universal Coverage?

Current and proposed approaches to reducing the uninsured population generally build on the existing system of public and private coverage. Approaches include establishing new tax credits for individuals and employers to defray the cost of health insurance, expanding private group coverage through employers or other group-purchasing arrangements, expanding eligibility for federal and state public programs, and creating new public programs. Some proposals combine various approaches to expanding coverage, while others aim to insure all Americans using a single approach, such as a national government-run system or mandatory employment- based or individual coverage within the private insurance market.

This Issue Brief was prepared for The Commonwealth Fund/John F. Kennedy School of Government Bipartisan Congressional Health Policy Conference, January 15–17, 2004.