States Start Down Long Road of Health Care Reform Implementation

Several states are beginning consideration of how to implement the new federal health care reform law, which is creating an opportunity for family physicians in these states to work with government officials on how to enact various provisions of the law.

At least five states -- Colorado, Connecticut, Maine, Maryland and Wisconsin -- have formed committees to start putting federal health care reform provisions in place, and other states are likely to follow suit.

According to family physician Lisa Marraché, M.D., of Waterville, Maine, the federal government has set out guidelines for health care reform. "But they are allowing the states to decide for themselves how they are going to implement it."

This has enormous implications for family physicians, said Marraché, who is the assistant majority leader for the Maine Senate. "Although you want to know what is happening on the federal level, it is going to be at the state level where (health care reform) greatly impacts your practice."

In many states, family physicians will have the ability to influence the implementation of health care reform by engaging these newly created committees, according to Robin Richardson, M.A., the AAFP's state government affairs analyst.

"This is the time for family physicians to step forward and tell lawmakers what they want to see in their state," said Richardson. "These are the details that will affect how practices are run and how physicians will be paid. The federal bill may have passed, but states have just started working on this."

For example, in Maine, Gov. John Baldacci has created a health reform steering committee to ask advice of agencies across the state government on how to implement health care reform provisions. The legislature also has formed a committee on implementing health reform that is composed of state representatives who want to hear from the public, including family physicians, said Marraché.

In Wisconsin, Gov. Jim Doyle has created a health care reform office to develop an implementation plan for enacting national health care reform measures. And according to Larry Pheifer, executive director of the Wisconsin AFP, his chapter has already told the governor's office it is interested in working with the newly created health reform office.

"We have been very involved in a lot of legislative activities," said Pheifer. "Any time the governor has a workgroup or task force, we are always trying to make sure we have family physicians represented."

For her part, Marraché acknowledged that it still is early in the implementation process for states, but she emphasized that now is the time for family physicians to get involved in the process.