The Brookings Institution released a study examining state efforts to improve access to health coverage, especially among individuals without access to employer-sponsored health insurance.  The study examines several state efforts with limited-benefit products and health insurance exchanges and compares their efficiency.  The authors suggest that federal support for any program at the state level is highly desirable, and propose a waiver or demonstration system to best allocate federal resources.

From the report: One of the most challenging hurdles that policymakers confront in their efforts to reduce the number of uninsured is how to cover those without access to employer-sponsored health insurance. This group of uninsured, which consists primarily of part-time workers, the self-employed, and many workers in small firms, now accounts for one of the largest and fastest-growing segments of the uninsured population. For example, between 2000 and 2006, the number of uninsured workers in the United States increased by six million, over half of whom (3.4 million) were self-employed or employed by small firms.  While individuals working for firms with fewer than 25 employees and their dependents account for 22 percent of the U.S. population, they make up 37 percent of the nation’s uninsured population.

Full report: Evolving State Approaches to Expand Coverage in the Current Wave of State Access Reform   

Brookings Institution.  (2009).  Evolving state approaches to expand coverage in the current wave of state access reform.  McKethan, A., King, J., Nguyen, N. and Lischko, A.