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December 22, 1993

Health Care UnreformThe New Jersey Approach

Author Affiliations

From the Robert Wood Johnson Foundation, Princeton, NJ.

JAMA. 1993;270(24):2968-2970. doi:10.1001/jama.1993.03510240080037

INTEREST in health care reform at the level of the states is greater now than ever. Unprecedented numbers of states are giving serious study and beginning implementation of bold new approaches to health care financing.1,2 Some proposed state reforms are comprehensive, such as those under development in Colorado, Oregon, Vermont, and Washington. Others take substantial incremental steps, including those in Minnesota, New York, and Florida. One other state, New Jersey, took action to change its financing system with lightning speed. New Jersey was thrust into the forefront of health care reform when, in May 1992, a federal judge overturned that state's long-standing program of financing hospital care for the indigent. By November 30, 1992, the state government had designed and adopted a sweeping change of its hospital financing system.

The federal court decision was based on a suit brought by labor unions challenging whether the state was permitted to