TY - JOUR
T1 - Options for dialing down from single payer
AU - Glied, Sherry
N1 - Funding Information:
This research was funded, in part, by the Commonwealth Fund (grant 20181866). I thank Linda Blumberg for useful comments.
Publisher Copyright:
© 2019 American Public Health Association Inc.. All rights reserved.
PY - 2019
Y1 - 2019
N2 - There are formidable institutional obstacles to passing a single-payer health program in the United States. Advocates should consider incremental improvements that may better match legislative realities. There are three potential directions for incremental coverage policy. One possibility is to build on the successes of the Affordable Care Act; this might include rolling back regulatory changes, further incentivizing Medicaid expansion, enhancing coverage in the Affordable Care Act marketplaces, and imposing regulations on private employer-based insurance to ensure that all Americans have access to affordable coverage that provides adequate financial security. A second direction is to offer more publicly sponsored insurance options, which might involve offering a public option to those eligible for marketplace coverage, creating a Medicare or Medicaid buy-in program, lowering the eligibility age for Medicare, or developing a public plan that serves as adefault for those who do not choose to buy alternative private coverage. A third direction is to build on federalism, offering states incentives to expand coverage. Federal and state legislators could also consider incremental cost-containment steps, such as rate setting.
AB - There are formidable institutional obstacles to passing a single-payer health program in the United States. Advocates should consider incremental improvements that may better match legislative realities. There are three potential directions for incremental coverage policy. One possibility is to build on the successes of the Affordable Care Act; this might include rolling back regulatory changes, further incentivizing Medicaid expansion, enhancing coverage in the Affordable Care Act marketplaces, and imposing regulations on private employer-based insurance to ensure that all Americans have access to affordable coverage that provides adequate financial security. A second direction is to offer more publicly sponsored insurance options, which might involve offering a public option to those eligible for marketplace coverage, creating a Medicare or Medicaid buy-in program, lowering the eligibility age for Medicare, or developing a public plan that serves as adefault for those who do not choose to buy alternative private coverage. A third direction is to build on federalism, offering states incentives to expand coverage. Federal and state legislators could also consider incremental cost-containment steps, such as rate setting.
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U2 - 10.2105/AJPH.2019.305299
DO - 10.2105/AJPH.2019.305299
M3 - Article
C2 - 31536411
AN - SCOPUS:85072903488
SN - 0090-0036
VL - 109
SP - 1517
EP - 1520
JO - American journal of public health
JF - American journal of public health
IS - 11
ER -