The mission of The Century Foundation (TCF) is to conduct research, develop solutions, and drive policy to make people’s lives better, including through access to affordable health care. Good health is the foundation of learning, working, and a quality life. Strong policies and a well-functioning system have and can further advance the health of Americans.

National health reform is a signature initiative of TCF. TCF has:

  • Pinpointed problems: TCF reports have explored flaws and gaps in the health system and specific policies that lead to poor health outcomes, disparities, wasteful spending, and barriers to health care—as a means of targeting solutions.
  • Prevented harm: Rapid TCF analyses of legislation to deeply reduce public funding, undermine effective policy, and reduce health coverage have contributed to their modification or defeat.
  • Elevated ideas: Reflecting a belief in bold solutions, TCF has led projects to identify different types of public plan options and draw lessons from the Affordable Care Act to inform the next wave of significant proposals.
  • Convened people: TCF has held conferences, convened and participated in networks and coalitions, and led teams within TCF and across organizations to advance health reform

Starting in 2025, the TCF Health Care Reform Team, directed by Jeanne Lambrew, PhD, has embarked on a new initiative dedicated to comprehensive improvements of the U.S. health system. Its goal is to secure policy that makes health care universal, affordable, and accessible. It will tackle excessive complexity that drives up spending alongside profits for some, as well as irrational differences in health coverage premiums, cost sharing, benefits, and rules. While it will complement efforts to defend effective policies and advance modest improvement, this initiative’s focus is large-scale reform.

The TCF health reform initiative aims to achieve its goal by identifying and developing policy vision, ideas, and solutions; conducting analyses that explore ideas from multiple vantage points (e.g., economic, operational, health system, and patients’ perspective); developing and participating in networks of scholars, activists, and others with shared goals; contributing toward a movement toward major change; and working with policymakers to make it happen.

Individuals, foundations, and organizations interested in supporting this work should contact [email protected].