An increase in state reform efforts seeking to help small business owners and their employees. Because of declining coverage rates for small businesses and the difficulty of finding affordable coverage, many states developed interventions to aid the small business market. These include providing premium subsidies, offering reinsurance programs, restructuring benefit plans, providing tax cuts and credits, or some combination of these approaches.

To demonstrate what is possible, the report looks at Massachusetts' efforts to implement its health reforms of 2006. Throughout 2008, policymakers watched uninsurance rates fall as various aspects of the reform took effect. Massachusetts' mixed approach of public and private programs and shared responsibilities struck a compromise among advocates from very diverse ideological perspectives. This general strategy was incorporated by all states that developed or proposed serious reforms last year, including California, Colorado, Connecticut, New Jersey, Oregon, and others.

"Massachusetts demonstrated that not only is comprehensive reform possible, but it can be accomplished in a bipartisan manner," said Martinez-Vidal. "Many of the states have already tested innovative models for improving their health care system. They have practical and political lessons that are of tremendous benefit to people now considering the same issues on Capitol Hill."

The full report is available online at www.statecoverage.org.

State Coverage Initiatives

The State Coverage Initiatives (SCI), a national program of the Robert Wood Johnson Foundation administered by AcademyHealth, provides timely, experience-based information and assis
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