To eliminate disparities in access to coverage, expansion programs cannot include costly co-pays or other financial barriers to accessing care.  These are especially hurtful to low-income communities.  Better options include: raising income eligibility limits for Medicaid, expanding access to the State Children's Health Insurance Program, and creating public/private expansions that provide sliding-scale premium subsidies with no or limited cost-sharing.

A "medical home," or primary care setting where one's health care needs are looked after and care is coordinated, is an important part of health care access and a strategy for eliminating disparities.  Patients with a medical home are more likely to get reminders to receive preventive care, such as screenings for cholesterol, breast cancer, and prostate cancer.  To promote medical homes, states need to reform primary care reimbursement by measuring and rewarding medical homes, testing care delivery models, and maximizing the potential of health information technology.


Commonwealth Fund - Closing the Divide: How Medical Homes Promote Equity in Health Care
Partnership for Prevention - A National Profile on Use, Disparities, and Health Benefits
Commonwealth Fund - Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care
Commonwealth Fund - Disparities in Health Care Are Driven by Where Minority Patients Seek Care