This paper focuses on state efforts to extend health insurance coverage to low-income Americans. It reviews the mechanisms available to do so and identifies 13 innovative states that have effectively pushed coverage well beyond levels required by law. 

This publication is part of Assessing the New Federalism, a multiyear Urban Institute project that analyzes the transfer of responsibility — from the federal government to the states — for select social programs.

June 21, 2002

In This Report, You’ll Learn

  1. 1

    State options for offering health insurance to the uninsured.

  2. 2

    Which 13 states are health insurance innovators.

  3. 3

    What these states have done to expand health insurance coverage.

  4. 4

    How the populations in innovative vs. non-innovative states differ.

Key Takeaway

When it comes to expanding health insurance coverage, 13 states have made real progress. The other states? Not so much

In America, 37 states have done little beyond the federally-mandated minimum to extend health insurance coverage. Uninsured rates in these states average about 16% with 30% of their low-income population and 35% of their low-income adults lacking health insurance.

Findings & Stats

Statements & Quotations