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                                                                                                   Spring 2009 |

                                                                                                  For the most current information on our
                                                                                                  strategy, please visit our Web site at

       Health insurance coverage is essential for good health and should be                          Lack of coverage often leads to
       available to all Americans. Coverage should: (1) be affordable;                           unnecessary suffering, delayed diagnoses
                                                                                                 and premature death. Americans living
       (2) include necessary, appropriate, and effective health care services;
                                                                                                 without health care coverage are much
       (3) be continuous and portable; (4) promote high-quality and                              less likely to obtain preventive care; get
       cost-effective health care; and (5) be based on shared responsibilities                   timely diagnoses for illnesses, including
       between the public and private sectors and individuals. To achieve                        cancer; receive treatments for chronic
       this goal of coverage for all Americans, we support health care policy                    illnesses such as diabetes and asthma;
                                                                                                 and take prescription medications as
       research and analyses to protect and sustain policy development and                       recommended by physicians.
       dialogue around health care reform proposals at the national level.                           Not only is achieving affordable
       At the same time, we encourage the development and implementation                         and stable coverage for all critical to
       of policies and programs that expand health coverage and maximize                         improving the health of Americans but
                                                                                                 it is vitally important to the financial
       enrollment in existing coverage programs at the state level.                              interests of American families and the
                                                                                                 nation’s economy. Medical debt is among
                                                                                                 the leading contributors to personal
       THE PROBLEM                                 insurance to their employees. Having          bankruptcy in the United States, affecting
       Americans’ lack of meaningful access        a job, even a full-time job, doesn’t          both the uninsured and the insured.
       to affordable and stable health care        necessarily guarantee coverage. In fact,      Moreover, escalating health care costs put
       coverage has been a central concern of      eight out of 10 uninsured Americans are       an ever-increasing strain on households,
       the Foundation since its inception 35       in working families.                          businesses, state and federal budgets.
       years ago. According to the U.S. Census        Rising costs also strain the ability of
       Bureau, today 46 million Americans,         the federal and state governments to fund     OUR APPROACH
       including more than 9 million children,     vital public coverage programs, forcing       Over three decades, RWJF has
       are uninsured, and the problem is           governments to scale back coverage for        commissioned a significant body of
       growing. As health care costs rise, fewer   those adults who are least likely to obtain   research and funded local and state
       individuals and families have insurance,    affordable health care coverage through       demonstration projects that have explored
       and fewer businesses can afford to offer    their jobs.                                   the potential of various local, state and

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       private-sector options for expanding             consumers in the design of those policies       in order to help them move health care
       coverage. Results of our research and            and programs and maximize enrollment            reform forward at the state level; the State
       fieldwork have led us to conclude that           in existing coverage programs.                  Health Access Data Assistance Center
       while health care is delivered locally,                                                          (SHADAC), a program to help states
       federal policy change is necessary               WHAT WE FUND                                    monitor rates of health insurance coverage
       to achieve sustainable coverage for              In light of an evolving environment and         and to understand factors associated with
       all Americans.                                   promising opportunities, we are working         uninsurance; State Health Access Reform
           Following the health care reform             in several areas to accomplish our goal of      Evaluation (SHARE) which supports
       debates in the early 1990’s, the public          ensuring that everyone in America has           evaluations of health policy reform at the
       and political leaders expressed widespread       affordable and stable health care coverage.     state level and is working to develop an
       pessimism about whether health care                                                              evidence-based resource to inform future
                                                        National Reform. Within the complex
       coverage for all was possible. Since 2000,                                                       state health reform efforts; and Consumer
                                                        political and policy environment
       RWJF has persistently sought to change                                                           Voices for Coverage which is supporting
                                                        surrounding health care reform at the
       this misperception and has worked to                                                             state-based consumer advocacy networks
                                                        federal level, we focus our work on
       galvanize support for change through                                                             to bring the views of real people into the
                                                        activities designed to facilitate reasoned
       major national campaigns focusing on the                                                         discussions around coverage issues.
                                                        decision-making and maximize the
       need to expand health coverage and enroll
                                                        potential for federal action. We convene        Maximizing Enrollment in existing
       millions of children in existing coverage
                                                        broad-based and bipartisan voices serious       coverage programs such as Medicaid
       programs for which they are eligible.
                                                        about health care reform and covering           and the Children’s Health Insurance
       Today, in public opinion surveys health
                                                        all Americans and conduct research              Program (CHIP). An estimated 7 out
       care consistently scores high on lists of
                                                        and analysis on factors that affect the         of 10 uninsured children are eligible but
       domestic policy issues facing our country.
                                                        availability of affordable, stable coverage.    not enrolled in these public coverage
           With a new Congress and President,
                                                            Working with prominent research             programs. Our work in this area includes
       health care reform including coverage
                                                        organizations, RWJF conducts and                our efforts to provide technical assistance
       expansion is high on the national
                                                        supports research and analysis on health        and free materials to support the work of
       agenda. In just the first weeks of this
                                                        coverage trends, health care policy             local organizations conducting enrollment
       administration, Congress passed and the
                                                        options, the impact of uninsurance,             activities and a new program, Maximizing
       President signed a reauthorization of the
                                                        characteristics of the uninsured, and the       Enrollment for Kids, focused on improving
       Children’s Health Insurance Program
                                                        relationship between health coverage            systems, policies and procedures used by
       which will cover 4 million additional kids.
                                                        and labor markets. We are particularly          states to enroll and retain eligible children
       We expect a robust debate to continue on
                                                        interested in commissioning, conducting         in CHIP and Medicaid.
       coverage in the coming months and years
                                                        and disseminating innovative research
       and are prepared to support those seeking
                                                        and policy analysis that will reveal the        WHAT WE DON’T FUND
       bipartisan common ground solutions to
                                                        fundamental barriers to changing health         We do not fund direct health care
       this growing problem.
                                                        care policy and achieving affordable and        services to individuals, or direct subsidies
           There is also renewed interest in
                                                        stable health care coverage for all.            for health insurance. The foundation
       addressing increased health care coverage
                                                                                                        does not accept unsolicited proposals
       at the state level. In addition to the well      State Expansions. Even as the federal
                                                                                                        for its work in coverage. We expect to
       publicized initiative in Massachusetts,          government prepares to consider health
                                                                                                        issue special solicitations for proposals
       many other states have made or are               care reform, we maintain a focus on state
                                                                                                        and ideas periodically this year. If you
       preparing to make great strides in               policy because innovations at the state
                                                                                                        are registered to receive content alerts
       covering more of their residents. We             level may guide policy development and
                                                                                                        through the Foundation’s Web site, at
       aim to accelerate the pace of change by          test the feasibility of reform at the federal
                                                                                              , you will receive notices
       working collaboratively with states to           level. Our work in this area includes:
                                                                                                        of funding opportunities through
       help them plan and implement policies            State Coverage Initiatives, a program
                                                                                                        these alerts.
       and programs designed to expand health           that provides timely, experience-based
       coverage, strengthening the voice of             information and assistance to state leaders

       Route 1 and College Road East, P.O. Box 2316, Princeton, NJ 08543-2316                                       

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