Health Affairs

Health Affairs, 28, no. 3 (2009): w446-w456 (Published online 24 March 2009) doi: 10.1377/hlthaff.28.3.w446 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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The Long And Winding Road: Reflections On California’s ‘Year Of Health Reform’

Marian R. Mulkey and Mark D. Smith

California’s recent failed attempt to expand health coverage broadly offers lessons for future coverage expansion efforts. Policy efforts are most likely to advance if they are bipartisan; address the needs of both insured and uninsured residents; deliver short-term progress within the context of long-term goals; rely on broad and sustainable financing; strike a balance between specificity and flexibility; and occur within a clearer framework of state and federal responsibilities.

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