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This report was prepared in 2009 and remains here for historical research purposes. Current health care coverage in the United States is mandated by the Patient Protection and Affordable Care Act of 2010.

The United States government, unlike Canada and many Western European countries, does not have legislation mandating universal health care coverage to its citizens.  While the elderly, persons with disabilities, veterans, military service families and the poor are often eligible for government health care assistance, health insurance is often obtained through the work place.  In a few instances, states have attempted to pass their own laws to provide health care to cover all residents or all uninsured residents.  Four states--Hawaii, Maine, Massachusetts, and Vermont--provide examples of differing legislative approaches to providing such broad based care.  

These states have taken diverse approaches toward achieving their goals.  Hawaii requires most employers to offer insurance, while Massachusetts mandates most individuals to obtain some health coverage.  Maine and Vermont have partnered with private companies to provide coverage with subsidized rates for those with incomes 300% and below of the federal poverty level.  What follows is a brief description of those laws, the coverage they offer, employer and individual contributions, and exemptions from the laws.  Citations are to given state sources of law and legislative or executive information about these programs.  As the current debate on health care reform continues, these states programs provide experimental models of government comprehensive health care legislation.

Hawaii


Massachusetts


Maine


Vermont


Current legislation in Congress regarding increased health coverage includes H.R. 3200, America's Affordable Health Choices Act of 2009.

Last Updated: 04/14/2014