title: A federalist approach to health reform: the worst way, except for all the others.
abstract: Support for state action should be part of any strategy to expand health insurance coverage. Decades-long political deadlock in Washington has frustrated national efforts to expand coverage. Some states have already undertaken to do this; others show a determination to do so. Regulatory and legislative flexibility would trigger widespread state action. Whether one thinks that ensuring coverage requires a unified national approach or that diverse conditions require different methods in different states, the likelihood of progress will be advanced if states test out various ways to expand coverage. We describe a practical way by which the federal government can promote state action to expand health insurance coverage.
authors.affiliation: Brookings Institution, Economic Studies, in Washington, DC, USA. haaron@brookings.edu
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Aaron
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Butler
mesh_terms: D035082:Federal Government; D005380:Financing, Government / Q000331:legislation & jurisprudence; D033161:Government Regulation; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D013221:State Health Plans / Q000331:legislation & jurisprudence*; D014481:United States