Ten years after the passage of the Affordable Care Act (ACA), the cost of health care continues to rise faster than wages, and millions of Americans are uninsured or underinsured—a toxic combination during a global pandemic. While further action on the Hill has stalled, several state legislatures have sought to go beyond the ACA by exploring and enacting a diverse array of public option proposals.
In social protection, Costa Rica has a well-established social assistance network to protect vulnerable groups, but it does not adequately reach the very poor. Costa Rica is not likely to be able to rely on favorable economic conditions to reverse these trends. Macroeconomic projections do not show signs of the consistent growth that characterized the past ten years, and which allowed the government to continue increasing investment in the social sectors.
The operation presented here is the first PBL operation of a series of three under the programmatic approach with the overall objective to contribute to the improvements in effectiveness, efficiency, transparency and accountability of the country's social safety net programs through (i) reform of cash grants provided by MPSD; (ii) an improved targeting system for MPSD non contributory social protection programs; and (iii) capacity development and implementation of monitoring and evaluation of systems in the MPSD.