This paper is a summary of a 1999 policy conference, The Kaiser Incremental Health Reform Project, which highlighted both the policy and politics of incrementalism. This paper identifies issues and tradeoffs associated with alternative approaches to expanding health insurance coverage-including enactment and implementation of CHIP and further coverage expansions through public programs and tax credits for the purchase of private health insurance.

Proposals that attempt to expand coverage in the private individual insurance market will only work if private insurance is available and affordable. This paper describes how the current individual marketplace will affect the ability of such proposals to assure equitable access to affordable coverage. This paper is part of the Kaiser Incremental Health Reform Project.

• Issue Paper

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Americans at the end of their working lives are increasingly facing greater uncertainty regarding health insurance and hence access to health care. This paper describes a proposal that would allow older persons not yet eligible for Medicare (under age 65) to “buy into” Medicare coverage.

This paper is part of the Kaiser Incremental Health Reform Project.

• Issue Brief

This paper provides a conceptual analysis of alternative mechanisms (tax credits, public programs, and direct subsidies) for expanding health insurance coverage. The paper, which is part of the Kaiser Incremental Health Reform Project, discusses the likely impacts alternative approaches on a variety of outcomes including efficiency in increasing coverage and integration with existing insurance systems.

• Issue Paper
• Report:

Part of the Kaiser Incremental Health Reform Project, this paper describes a generous tax credit approach to the expansion of health insurance coverage. The design features of refundable, publicly-financed tax credits for the purchase of health insurance are described for a range of sample plans.

• Issue Paper

Enactment of the Children’s Health Insurance Program has been accompanied by concerns that new coverage will “crowd out” private health insurance coverage. Part of the Kaiser Incremental Health Reform Project, this paper reviews existing empirical literature on the magnitude of crowd-out and discusses implications for CHIP.

• Issue Paper

Health News Index September/October, 1999

The September/October 1999 edition of the Kaiser Family Foundation/Harvard Health News Index includes questions about major health stories covered in the news, including questions about the uninsured, Patients’ Rights and health care reform proposals by democratic presidential candidates. The survey is based on a national random sample of 1,033 Americans conducted October 8-12, 1999 which measures public knowledge of health stories covered by news media during the previous month. The Health News Index is designed to help the news media and people in the health field gain a better understanding of which health stories in the news Americans are following and what they understand about those health issues. Every two months, Kaiser/Harvard issues a new index report.

• HNI September-October 1999
• Topline/Survey

This paper explores the major policy compromises embodied in the CHIP program. It focuses on two areas: the relative control of the federal and state governments over the program, and the design of the program in relation to the private, employer-based health insurance market.This paper is part of the Kaiser Incremental Health Reform Project.

Issue Brief (.pdf)

Many proposals for incremental expansion of health insurance coverage would provide subsidies for the purchase of nongroup policies. This paper assesses how subsidy options might play out in regulated or unregulated markets and explores the possible trade-off between two distinct policy goals: maximizing the absolute number of families with insurance or maximizing access for the highest-risk families. This paper is part of the Kaiser Incremental Health Reform Project.

• Issue Paper

This paper discusses ethical issues in incremental approaches to expanding health insurance coverage. Although any reduction in the number of uninsured is morally desirable, there are real moral differences between different policy options. This paper, which is part of the Kaiser Incremental Health Reform Project, examines these moral differences by identifying the values and commitments that ground the different policy options.

• Issue Paper