Cost and Quality

Cost and Quality

cost and quality main page


NCSL has 20+ briefs and articles with options, examples and experiences of how states can contain costs in health. The cost of health, health care in the United States for years has been a highly visible topic of discussion for consumers, employers, state and federal policymakers and the media. This project researched and compiled a series of briefs providing options, examples of successful and experimental efforts to control health costs. Two major meeting sessions in August 2014 and 2013 added new reports and opinions.




Funding ongoing Medicaid programs is one of the greatest challenges for states. The state’s share of the joint state-federal program accounts for an average of 15 percent of state general funds and about 21 percent of total state spending when federal funds are added to the mix. Cutting benefits, limiting eligibility and reducing provider reimbursements have been the three “usual suspects” used by states for short-term Medicaid cost containment.




Health care in the United States is a $2.9 trillion industry, accounting for nearly 18 percent of the gross domestic product, up from 14 percent in 2000.  Health care inflation outpaces inflation in other markets.  Federal, state and local governments share the financial burden of health care with employers and individuals.  For example, state and federal governments spent $413.9 billion on Medicaid alone in 2011.  But the return on investment has been disappointing in some areas.  The U.S. spends twice as much on health care per capita compared to other industrialized nations but isn’t the healthiest nation, by far.  Americans have shorter lives, higher infant mortality rates, higher incidence of chronic diseases and more than many other high-income nations.  Cost and quality are central to much of today's health policy discussion. State policymakers are interested in stabilizing health spending and ensuring quality health services to ultimately improve the health of all Americans and create a sustainable health care system.  NCSL has timely reports, articles, videos, webinar archives and more, with a focus on the state role in improving the value of health care.




Read about Heath Affordability/ Premium Assistance Programs, budget and sequestration as reported by the Congressional Research Service.




State Actions Related to Transparency and Disclosure of Health and Hospitals Charges.


Share this: 



  • State Actions to Address Health Insurance Exchanges

    Read this NCSL report for March 2015 information on state actions and responses to implement exchanges as outlined in the Affordable Care Act. This material includes links to activities, with 2015 deadlines and enrollment figures by state. It also includes state information about insurers and premiums.

  • Health Insurance Premiums and Premium Costs by State

    Actual health insurance premiums and rates presented nationally and by state for 2014 and 2015. Table includes historical trends and links to the best sources, including a Commonwealth Fund-designed interactive map.

We are the nation's most respected bipartisan organization providing states support, ideas, connections and a strong voice on Capitol Hill.

NCSL Member Toolbox


7700 East First Place
Denver, CO 80230
Tel: 303-364-7700 | Fax: 303-364-7800


444 North Capitol Street, N.W., Suite 515
Washington, D.C. 20001
Tel: 202-624-5400 | Fax: 202-737-1069

Copyright 2015 by National Conference of State Legislatures