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States as Policy Laboratories: The Politics of State-Based Single-Payer Proposals.
Am J Public Health. 2019 11; 109(11):1511-1514.AJ

Abstract

Although the focus for most single-payer advocates is in Washington, DC, and on proposals for Medicare for all, there are also efforts in a handful of states to enact a state-based single-payer program. Moreover, the odds of legislative passage are better in a state like New York than at the federal level.Even if enacted, however, state-based single-payer proposals face a distinct set of obstacles, including (1) the need to obtain federal permission (via waivers) to repurpose federal dollars, (2) the federal Employee Retirement Income and Security Act, and (3) the burden of state-only action in an interconnected 50-state economy.The most likely result of the energized single-payer movement will be incremental public insurance expansions at the federal and state levels, including state programs to permit the uninsured to buy into the Medicaid program. Such an outcome is consistent with the most plausible path (incrementalism) to a US version of universal coverage.

Authors+Show Affiliations

Michael S. Sparer is with the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31536399

Citation

Sparer, Michael S.. "States as Policy Laboratories: the Politics of State-Based Single-Payer Proposals." American Journal of Public Health, vol. 109, no. 11, 2019, pp. 1511-1514.
Sparer MS. States as Policy Laboratories: The Politics of State-Based Single-Payer Proposals. Am J Public Health. 2019;109(11):1511-1514.
Sparer, M. S. (2019). States as Policy Laboratories: The Politics of State-Based Single-Payer Proposals. American Journal of Public Health, 109(11), 1511-1514. https://doi.org/10.2105/AJPH.2019.305294
Sparer MS. States as Policy Laboratories: the Politics of State-Based Single-Payer Proposals. Am J Public Health. 2019;109(11):1511-1514. PubMed PMID: 31536399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - States as Policy Laboratories: The Politics of State-Based Single-Payer Proposals. A1 - Sparer,Michael S, Y1 - 2019/09/19/ PY - 2021/11/01/pmc-release PY - 2019/9/20/pubmed PY - 2020/3/3/medline PY - 2019/9/20/entrez SP - 1511 EP - 1514 JF - American journal of public health JO - Am J Public Health VL - 109 IS - 11 N2 - Although the focus for most single-payer advocates is in Washington, DC, and on proposals for Medicare for all, there are also efforts in a handful of states to enact a state-based single-payer program. Moreover, the odds of legislative passage are better in a state like New York than at the federal level.Even if enacted, however, state-based single-payer proposals face a distinct set of obstacles, including (1) the need to obtain federal permission (via waivers) to repurpose federal dollars, (2) the federal Employee Retirement Income and Security Act, and (3) the burden of state-only action in an interconnected 50-state economy.The most likely result of the energized single-payer movement will be incremental public insurance expansions at the federal and state levels, including state programs to permit the uninsured to buy into the Medicaid program. Such an outcome is consistent with the most plausible path (incrementalism) to a US version of universal coverage. SN - 1541-0048 UR - https://www.unboundmedicine.com/medline/citation/31536399/States_as_Policy_Laboratories:_The_Politics_of_State-Based_Single-Payer_Proposals L2 - https://www.ajph.org/doi/10.2105/AJPH.2019.305294?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -