Federal Bills Would Fund State Health Reform Initiatives

Acknowledging that Congress is unlikely to enact health care legislation that would reduce the number of uninsured Americans, a bipartisan group of federal lawmakers on Jan. 17 announced two proposals that throw the issue to the states.

The identical bills -- known as the Health Partnership Act, S. 325, in the Senate and the Health Partnership Act Through Creative Federalism, H.R. 506 (at the Library of Congress' THOMAS Web site, type "S 325" or "HR 506" in the search bar after selecting " Bill Number"), in the House -- would provide federal funding for state initiatives to expand health care coverage to the uninsured.

U.S. Sens. Jeff Bingaman, D-N.M., and George Voinovich, R-Ohio, and U.S. Reps, Tammy Baldwin, D-Wis., and Tom Price, R-Ga., had introduced the same legislation last year, but those bills died in their respective houses before the end of the 109th Congress.

If passed, the bills would authorize grants to individual states, groups of states or parts of states to develop and implement programs that would increase access to health insurance. Participating states would submit plans for expanding health care coverage to a bipartisan State Health Innovation Commission, which would send its recommendations to Congress for funding appropriations. The grant application process probably would take six months, said House bill co-sponsor Price during a Jan. 17 news conference announcing the legislation.

Among state proposals that could be considered are tax credits, expansion of Medicaid and the State Children's Insurance Program, creation of pooling arrangements similar to the Federal Employee Health Benefit Program, development of single-payer systems, expansion of health savings accounts, or a combination of all these options.

States would report their programs' progress to the State Health Innovation Commission, which then would report to Congress about whether the states were meeting the goals of the act and recommend further action lawmakers should take regarding overall health care system reform.

The Health Partnership Act proposals follow introduction of the Healthy Americans Act, or S. 334, (PDF file: 166 pages / 289 KB. More about PDFs.) announced by Sen. Ron Wyden, D-Ore., in December. Wyden's proposal would require businesses to drop health benefits and instead increase wages by the amount of health insurance premiums; require all residents to use their increased wages to buy their own health plans; provide subsidies to help low-income workers pay premiums; establish Health Help Agencies to educate residents about private health plans, administer enrollment and assist income-eligible enrollees with sliding scale premium reductions; establish a Medicare primary care management fee for physicians designated as providing beneficiaries a medical home; and establish a Medicare chronic disease management program by 2008.