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For Policy Makers Looking To Expand Coverage, Lessons From The Demise Of The ACA’s Multi-State Plan Program"

Health Affairs Blog, September 30, 2019

In this blog post, Jon Foley, Kristi Martin, and Rob Shriver describe why the Multi-State Program (MSP) ultimately did not achieve its mission and was forced to shut down. Created through the Affordable Care Act as a last minute alternative to a public option, the MSP was intended to be implemented by the Office of Personnel Management in a manner similar to the Federal Employees Health Benefits program.  The authors conclude that the limits imposed upon the program through its establishing legislation along with the weight given to the positions of state insurance regulators in its implementation prevented OPM from delivering on the law’s direction.

“Taking Medicare For All Seriously"

Health Affairs Blog, June 11, 2019

In this blog post, Jon Foley reviews Medicare for All legislation introduced by Rep. Jayapal in the context of other countries' health systems which share goals of universal coverage and access. He finds that this MFA proposal is unprecedented in scope compared to systems in other developed countries and probably unworkable. He suggests changes to the current system that are less far reaching but more sustainable.


Social Equity and Primary Health Care Financing: Lessons from New Zealand

Australian Journal of Primary Health 24(4) 299-303

In this article, Jon Foley reviews the development and implementation of the Primary Health Care Strategy in New Zealand from 2001 until 2018. He describes the enduring features of the Strategy, critiques of the Strategy, and the lack of rigorous evaluation of some of the unique aspects of the Strategy, such as efforts to incorporate population health concepts in primary care service delivery and interventions addressing social determinants of health.

Payers, Providers, and Patients – Oh My!

"Multi-State Plan Program"

Payers, Providers, and Patients - Oh My! Podcast, December 12, 2019

In this episode of "Payers, Providers, and Patients - Oh My!" from the law firm Crowell and Moring, hosts Payal Nanavati and Joe Records sit down with former regulators of the MSP Program (including Westcott Partner's  Jon Foley) to discuss the goals and design of the Affordable Care Act’s MSP Program—and what can be learned from its ultimate failure.

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"Using TRICARE Reform Pilots to Inform National Healthcare Reform Discussion"

Institute for Defense Analysis, July, 2018 | D-9125

The TRICARE health benefit offered by the Department of Defense (DoD) to military members, their families, and military retiree families is an important element of military compensation, but has challenges with cost to the government and beneficiary satisfaction. The Congress has directed DoD to implement pilots to begin exploring ways to comprehensively reform TRICARE. This paper outlines how that reform could take place, drawing from the of the Federal Employees Health Benefits Program, a large national health exchange dating to 1959.

Principled Proposals for Postal Reform are Not a Bailout

FedWeek, May 28, 2020

In this opinion piece, Jon Foley outlines a path forward for the United States Postal Service. The COVID-19 pandemic has highlighted the hurdles faced by USPS and re-invigorated long-standing conversations about how to save the agency. Foley looks to postal services in other countries as models and argues that an infusion of funds is necessary and appropriate. Further, the U.S. Office of Personnel (OPM) is well-poised to administer a separate postal employee health benefits program.


“Proactive Strategies to Address Health Equity and Disparities: Recommendations from a Bi-National Symposium”

Journal of the American Board of Family Medicine, May-June 2018 vol. 31 no. 3 479-483

In this summary of papers delivered at a forum of scholars and practitioners from Canada and the United States, Jon Foley describes the use of population-based primary care funding, which includes race, ethnicity and deprivation, to support the development of interventions to address social risk factors in New Zealand.  The paper highlights the benefits of cross national information sharing to improve health equity and reduce disparities.