Near universal health care coverage could be achieved without a complete overhaul of the health system, according to a report released today by the Urban Institute and the Commonwealth Fund. The report analyzes eight health care reforms and their potential effects on insurance coverage, national health care costs, and spending by federal and state governments, consumers and employers. The plans fall along a continuum — from improvements to the Affordable Care Act to a single-payer reform similar to Medicare for All proposals. One of the plans modeled in the report — which, among other actions, would enable workers to opt for subsidized non-group coverage instead of their employer’s insurance plan, improve the ACA’s subsidies to help people afford coverage and cover people in states that have not expanded Medicaid — would achieve near universal coverage of all Americans and improved affordability.

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