Policymakers have come to understand that the issues facing the states cannot be remedied by focusing solely on coverage and access issues; however, there is also increasing recognition that coverage expansions are necessary to have an effective and efficient health care system. Most recently, Consequently, many states are have combining coverage expansions with strategies aimed at improving the health care delivery and financing system while controlling costs as well. Likewise, states are demonstrating an increasing awareness that reform efforts targeted to cost containment can also promote healthy behaviors and more effective management of chronic conditions. In addition to substantially expanding coverage to millions of currently uninsured citizens, PPACA includes many opportunities for states to improve the delivery system and increase the value of care.
