California Lewin Group 2002

Cost and Coverage Analysis of Nine Proposals to expand Health Insurance Coverage in California

By: The Lewin Group, Inc
Published: March 31, 2002
Sponsored by: California Health and Human Service (CHHS) Agency
Financed by: U.S. Health Research and Services Administration (HRSA), SB 480, and the California Endowment.

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In February and March of 2002, The California Health and Human Services (CHHS) Agency
sponsored four symposia around the state to introduce nine proposals to expand health insurance
coverage in California. This was done as part of a grant from the U.S. Health Resources and
Services Administration (HRSA) devoted to the development to proposals to expand health
insurance coverage. As part of this effort, The Lewin Group was engaged to analyze the cost and
coverage impacts of these proposals.

Each of the proposals is detailed and complex. To simplify the discussion, we have divided these
plans into three groups. Five of the proposals would attempt to expand voluntary coverage
incrementally through existing public and private sources of coverage (Figure 1). Another two
of the plans would establish an obligation for employers to contribute to the cost of covering
their workers and their dependents. We also analyzed three plans that would achieve universal
coverage by creating a single-payer public program to administer health insurance coverage for
all Californians.