Health Care Financing for All Americans

Access to health care financing can be achieved by using a combination of public and private initiatives aimed at every American who wants access to health care but is currently denied access. Small-employer market reforms that would guarantee the availability and affordability of coverage to small employers and their employees should be enacted. A private, not-for-profit reinsurance mechanism should be established to absorb losses for high-risk individuals and high-risk employer groups insured by carriers. State risk pools should be established to provide coverage to high-risk individuals who cannot obtain coverage through an employer. Tax assistance should be provided to small employers who make health care coverage available to their employees. The Medicaid program should be extended to cover all poor and near-poor Americans and to provide primary and preventive care for the near poor.

(JAMA. 1991;265:3296-3299)