Congress should keep SCHIP focused on uninsured children from low-income families and broaden the options available to middle-income families whose children are uninsured.

Massachusetts has committed to restructuring its health system around the principle that individual consumers, not employers or government, should be the key decision-makers and owners of insurance in the health care system. That is a very significant shift in the health policy debate, and it is worth replicating elsewhere the core design elements that effect such a profound change.