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Previous Volume 350:330-332 January 22, 2004 Number 4 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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For at least 25 years, states have served as laboratories for health care reform initiatives, advancing strategies that have later been enacted by the federal government. In the 1970s, Hawaii led the way when it required most employers to provide health care coverage for workers or to pay a tax so that the government could do so. Hawaii received an exemption from Congress when the Employee Retirement Income Security Act (ERISA) was enacted, allowing it to continue its pay-or-play experiment, which substantially reduced the number of uninsured in that state. In the 1980s and 1990s, states advanced Medicaid reforms and . . . [Full Text of this Article]

Source Information

From the Governor's Office of Health Policy and Finance, Augusta, Maine (T.R.); and the Muskie School of Public Service, University of Southern Maine, Portland (E.K.).

This article has been cited by other articles:

• Weintraub, W. S., Shine, K. (2004). Is a Paradigm Shift in US Healthcare Reimbursement Inevitable?. Circulation 109: 1448-1455 [Full Text]