Washington State Health Services Act: implementing comprehensive health care reform.
In 1993, Washington State enacted the Health Services Act of 1993 (HSA) to guarantee universal access to health care through an employer mandate, with caps on premiums as the primary cost-control mechanism. The HSA represents the Nation's first formal experiment with managed competition. This article reports the results of a case study of the HSA's implementation. The study concludes that the Washington State initiative can be replicated in other States, but that implementation is complex, requires sustained public education, and requires cooperation from the Federal Government through program waivers. A major implementation challenge is to facilitate competition and minimize regulation.
Jacobson
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PD
RAND, Santa Monica, CA 90407, USA.
D016536:Competitive Medical Plans / Q000331:legislation & jurisprudence*; D003363:Cost Control; D003625:Data Collection; D006264:Health Benefit Plans, Employee / Q000331:legislation & jurisprudence*; D017048:Health Care Costs / Q000639:trends; D018166:Health Care Reform / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D006297:Health Services Accessibility / Q000191:economics / Q000639:trends; D006301:Health Services Needs and Demand / Q000191:economics / Q000639:trends; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D008913:Minority Groups; D011057:Politics; D013221:State Health Plans / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States; D014861:Washington