Affording Shared Responsibility For Universal Coverage: Insights From California

This paper presents key insights from California's recent experience in developing a plan for universal health coverage with "shared responsibility" among individuals, employers, and governments. A major challenge was finding an acceptable balance among the goals of affordability, equity, and cost to the state. Although reform did not pass, the state's approach-particularly differences from Massachusetts regarding modest-income workers and related employer and public roles-provides important insights for federal reform. [Health Affairs 28, no. 3 (2009): w417-w430 (published online 24 March 2009; 10.1377/hlthaff.28.3.w417)]