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New postings and analysis from Health Affairs, the leading journal of health policy. Health Affairs publishes new research each week online at For more information, contact Chris Fleming at 301-347-3944.

Kaiser Executives Present Plan To Expand Coverage In California

Through the participation of individuals, employers, government, and health care providers, California could achieve near-universal coverage in two years, despite challenges that dwarf those facing Massachusetts and many other states, George Halvorson, Kaiser Foundation Health Plan president and CEO, and coauthors say in an article published Dec. 12 on the Health Affairs Web site. Halvorson and fellow Kaiser executives Steve Zatkin and Jay Crosson lay out a coverage expansion plan that combines an individual mandate administered through the state income tax system with new premium subsidies for low-income Californians. The proposal's release was praised by the incoming chairman of the House Ways and Means Health Subcommittee, Rep. Pete Stark (D-CA), in a press release.

A Perspective on the Halvorson article by Rick Curtis and Ed Neuschler of the Institute for Health Policy Solutions can be read at

Researchers Document Erosion Of Private-Sector Retiree Health Coverage

The principle behind health savings accounts, that out-of-pocket payment restrains excess health spending, is sound, but the $5,450 maximum deductible for HSA-eligible insurance policies leaves too much spending unaffected, Martin Feldstein says in the Nov/Dec issue of Health Affairs. A better design, he argues, would require substantial coinsurance up to a higher amount, such as $10,900, or twice the current maximum deductible. "Although there must be a lower limit on the coinsurance rate to make sure that it has a favorable incentive effect, a 100 percent coinsurance rate (that is, a deductible) on a low amount is certainly wrong," Feldstein states. The Harvard economist also suggests allowing hospitals to have easy access to the HSA balances of people who have not paid for treatment within some period, such as three months, after the time of care.

Print editions of Health Affairs may be ordered for $35 each from Health Affairs' Customer Service at 301-347-3900 or online at

On The Health Affairs Blog: Global Health, Epogen, and More

All readers are welcome to comment on Health Affairs' new blog. Recent posts include:


Health Affairs, published by Project HOPE, is the leading journal of health policy. The nonpartisan, peer-reviewed journal appears bimonthly in print, with additional online-only papers published weekly as Health Affairs Web Exclusives at The full text of each Health Affairs Web Exclusive is available free of charge to all Web site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. The abstracts of all articles are free. The Nov/Dec 2006 issue was supported by the California HealthCare Foundation. Web Exclusives are supported in part by a grant from the Commonwealth Fund.


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