To help states examine options and craft policies to cover uninsured populations, the federal Health Resources and Services Administration (HRSA) is providing two types of grants: State Planning Grants and, more recently, Pilot Project Planning Grants. This report finds that most states awarded Pilot Project Planning Grants are exploring strategies that build on employment-based coverage, generally through publicly funded premium assistance. Some states uncovered support among employers and providers for tax credits to subsidize the employer and/or employee share of the premium. Others are exploring premium assistance through Medicaid and the State Children's Health Insurance Program (SCHIP). In addition to employment-based strategies, states are improving outreach and enrollment for people eligible for but not enrolled in existing programs; using federal waivers to extend Medicaid/SCHIP coverage to parents and other adults; establishing health savings accounts; reinsuring private coverage; imposing a full employer mandate; and assessing single-payer and multipayer universal coverage models.
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