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Once regarded as stable and dependable, employer-sponsoredinsurance no longer addresses the needs of many workers in achanging labor market. Private ownership would guaranteeportability of coverage, ensure the critical continuity of care,promote mobility in employment, and allow persons to get off publicprograms without the drastic penalty of losing their healthcoverage.
A health insurance exchange facilitates personal, portableinsurance independent of the place of work; makes efforts to insurethe uninsured more targeted and effective, breaking the cycle ofrotation in and out of coverage and reducing the number ofuninsured; and provides the administrative framework needed toreach the hardest to insure and cover them efficiently andeffectively.
Executive Summary: State policymakers can improve Medicaid by usingthe flexibilities provided by the Deficit Reduction Act of 2005(DRA) to redesign coverage of low-income working families intoa system of premium assistance-a government contribution tohealth insurance-that would reconnect much of the Medicaidpopulation with the private health insurance markets thatserve the majority of Americans.