"[1] The state could cover all residents under a Single Payer option with little change in overall health care costs, but doing so would require cuts to provider payment rates that could worsen access to care, and implementation hurdles may be insurmountable. [2] A state-managed plan (the Health Care Ingenuity Plan) featuring competition among private plans would also achieve universal coverage and would sever the employer-health insurance link, but the provider payment rates would likely be set too high, so health care costs would increase. [3] Adding a state-run option to the [ACA] Marketplace (the Public Option) would be the easiest of the three options to implement, but because it would not affect many people, it would be an incremental improvement to the Status Quo."

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