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Price competition seems to have increased health insurance coverage for low-income people by giving Medicaid agencies better value for their money, according to this paper. Many states have used these savings to expand eligibility for Medicaid or other public coverage. On the other hand, this new competition also threatens hospitals? traditional ability to support charity care. The most important emerging policy issue identified is how to weave a competition-era safety net for the growing share of poor Americans who lack coverage.