Access to health care has become a hot topic across the country, and state legislatures are stepping to the fore to develop solutions to the problems of rising costs and the growing number of uninsured Americans.
State Initiatives Lead Health Reform 'Parade'
By Leslie Champlin
1/24/2007
"Health care has become a huge issue at the state level," says Diana Ewert, AAFP senior manager for state government relations.
True, according to the National Conference of State Legislatures, or NCSL. "Health care reform was hot in legislatures across the nation in 2006, and the forecast for this session may be even hotter," says an NCSL analysis of potential 2007 legislation. "Fueled by the increasing number of uninsured Americans, the declining number of employers offering insurance to their employees, the improved fiscal conditions in the states and the lack of federal action, states are leading the way in health care reform."
The signs are everywhere. More than 3,600 health-related bills already have been introduced in state legislatures across the country this session, according to Ewert. A number of states will hear from commissions charged with making recommendations on expanding coverage and reforming health care, according to the NCSL. At press time, 19 governors had called for health system reform in their state-of-the-state addresses, and seven legislatures had already responded with bills proposing universal access, tax benefits for small businesses, expansion of existing Medicaid and State Children's Health Insurance Program funds, or a combination of all these elements.
"Much of the legislation is aimed more at expansion of eligibility for State Children's Health Insurance Programs," said Greg Martin, AAFP state government relations analyst. "Some are going for a universal coverage proposal or new Medicaid state plan amendments that allow them to experiment more."
Several states are looking at pioneers such as Maine's Dirigo Health Reform Act, Massachusetts' mandatory coverage and Vermont's Catamount Health as models from which to tailor their own plans.
At press time, three bills related solely to universal access had been introduced in state legislatures. In California, Assembly Bill 53 "declares the intent of the legislature to enact legislation that would provide universal health coverage regardless of age, income, employment or health statues," says the NCSL analysis. In New Hampshire, House Bill 88 would establish a committee to study a single-payer system, and, in Minnesota, Senate Bill 14 offers a constitutional amendment that would establish a universal health system intended to provide affordable access to medical care for all residents.
Spurring many states' proposals is a growing recognition that high-quality care depends on medical homes and care coordination. Although the definitions of medical home and care coordination vary from state to state, "this interest shows an emerging awareness of the role of primary care" in cost-effective medical health care, said Martin.
State initiatives to increase access to and improve the quality of health care also could get a boost under federal legislation recently introduced by a bipartisan group of U.S. senators and representatives. The legislative package -- known as the Health Partnership Act, or S. 325, in the Senate and the Health Partnership Act Through Creative Federalism, or H.R. 506, in the House -- acknowledges states' abilities to develop and implement effective innovations in the face of Congress' inability to pass significant health reform legislation, according to its sponsors. If passed, it would provide federal support to state-based initiatives and seek to clear the regulatory and bureaucratic paths for quick implementation.
The renewed interest in solving health-related problems comes at a time when more Americans rank health care as a priority the government should address. A January Gallup poll found that health care ranked fourth among top concerns; 86 percent of Americans said it was extremely or very important that President Bush and Congress address health care issues in 2007.
True, according to the National Conference of State Legislatures, or NCSL. "Health care reform was hot in legislatures across the nation in 2006, and the forecast for this session may be even hotter," says an NCSL analysis of potential 2007 legislation. "Fueled by the increasing number of uninsured Americans, the declining number of employers offering insurance to their employees, the improved fiscal conditions in the states and the lack of federal action, states are leading the way in health care reform."
The signs are everywhere. More than 3,600 health-related bills already have been introduced in state legislatures across the country this session, according to Ewert. A number of states will hear from commissions charged with making recommendations on expanding coverage and reforming health care, according to the NCSL. At press time, 19 governors had called for health system reform in their state-of-the-state addresses, and seven legislatures had already responded with bills proposing universal access, tax benefits for small businesses, expansion of existing Medicaid and State Children's Health Insurance Program funds, or a combination of all these elements.
"Much of the legislation is aimed more at expansion of eligibility for State Children's Health Insurance Programs," said Greg Martin, AAFP state government relations analyst. "Some are going for a universal coverage proposal or new Medicaid state plan amendments that allow them to experiment more."
Several states are looking at pioneers such as Maine's Dirigo Health Reform Act, Massachusetts' mandatory coverage and Vermont's Catamount Health as models from which to tailor their own plans.
At press time, three bills related solely to universal access had been introduced in state legislatures. In California, Assembly Bill 53 "declares the intent of the legislature to enact legislation that would provide universal health coverage regardless of age, income, employment or health statues," says the NCSL analysis. In New Hampshire, House Bill 88 would establish a committee to study a single-payer system, and, in Minnesota, Senate Bill 14 offers a constitutional amendment that would establish a universal health system intended to provide affordable access to medical care for all residents.
Spurring many states' proposals is a growing recognition that high-quality care depends on medical homes and care coordination. Although the definitions of medical home and care coordination vary from state to state, "this interest shows an emerging awareness of the role of primary care" in cost-effective medical health care, said Martin.
State initiatives to increase access to and improve the quality of health care also could get a boost under federal legislation recently introduced by a bipartisan group of U.S. senators and representatives. The legislative package -- known as the Health Partnership Act, or S. 325, in the Senate and the Health Partnership Act Through Creative Federalism, or H.R. 506, in the House -- acknowledges states' abilities to develop and implement effective innovations in the face of Congress' inability to pass significant health reform legislation, according to its sponsors. If passed, it would provide federal support to state-based initiatives and seek to clear the regulatory and bureaucratic paths for quick implementation.
The renewed interest in solving health-related problems comes at a time when more Americans rank health care as a priority the government should address. A January Gallup poll found that health care ranked fourth among top concerns; 86 percent of Americans said it was extremely or very important that President Bush and Congress address health care issues in 2007.
