“A state can reform its healthcare system, which means lowering costs and increasing access, through 10 steps. Step No. 1: Use Free Care Dollars to Subsidize Private Insurance. … Step No. 2: Create a ‘Pay or Play’ System and Use the Proceeds to Fund a Social Safety Net. … Step No. 3: Enforce Maintenance of Effort Rules for Individuals and Employers.” (06/01/08)