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Senator John Kerry's health care plan would expand coverage butwould fall short in transforming health insurance markets andmaking patients the key decision makers in the system. In effect,it would reinforce the status quo, with (according to one estimate)nine of every 10 dollars spent going to employers, insurancecompanies, and state governments, not to individuals.

The best Medicaid policy would mainstream as many individuals andfamilies as possible into private coverage and encourageself-direction for those the Medicaid safety net was intended. Whenconsidering changes in the Medicaid program, federal and statepolicymakers should ensure fiscal control and improve the way thatlow-income individuals and families receive care.

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