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Universal Health Care's Next Steps - PA & IL Plans

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Thursday, March 15, 2007

Conference Calls

Conference Call: Stopping "Fast Track"

This is a reminder that tomorrow Friday, March 16th at 1pm EST, Progressive States Network will be sponsoring a conference call to discuss the campaign for state resolutions opposing "fast track" reauthorization, as discussed in Monday's Stateside Dispatch, and how states can make their voices heard in the trade debate.

IMPORTANT: We have rescheduled the call one hour earlier, to 1pm EST.

RSVP at: http://tinyurl.com/34gucn.

Valuing Families

by Adam Thompson

Universal Health Care's Next Steps - PA & IL Plans

Illinois gained headlines in 2005 for its first-in-the-nation plan to provide health care for all children in the state, called AllKids.  Pennsylvania followed suit in 2006 with its own Cover All Kids plan.  Now the Governors of each state have proposed comprehensive health care reform packages with the goal of universal access to health care.  The plans build on reforms in Maine, Vermont and Massachusetts, but go further in key areas of affordability and system reform.

Illinois Covered: Illinois Governor Rod Blagojevich announced Illinois Covered, a blend of Medicaid expansions for adults, employer "pay or play" mandates, and premium assistance to help the state's 1.4 million uninsured obtain quality and affordable health care within three years.  Illinois Covered stands out because of its proposals to ensure affordable access for the uninsured:

  • First, the program provides premium subsidies to individuals and small business employees with incomes up to 400% of the poverty line, or $80,000 for a family of four, far more extensive subsidies than in Massachusetts and other proposed programs. 
  • Second, the plan limits premium payments to a percentage of annual income.  For instance, premiums for participants up to 400% of poverty are capped at 2.5% to 3.5% of income for an individual and 5% to 7% of family coverage.   Directly tying premium payments to income is a model for other states to replicate. 

Gov. Blagojevich estimates his package of reforms will cost $2.1 billion, including fees for firms not providing health care and other taxes on business transactions.  Although numerous polls show that Americans are willing to pay more in taxes for universal health care, few politicians have been willing to act, so Gov. Blagojevich deserves credit for putting real money on the table for reform. 

Prescription for Pennsylvania: Governor Ed Rendell's Prescription for Pennsylvania is one of the most detailed and comprehensive packages to achieve universal access to quality and affordable health care and to improve the health care delivery system. By one count, it includes 47 different ideas to cut health care costs.  The Governor's plan aims to take on the estimated $7.6 billion in unnecessary and avoidable health care costs to help expand coverage for the state's 767,000 uninsured.

Key provisions include:

  • Premiums for low income individuals and employees of small businesses, provided on a sliding scale below 300% of the poverty line, in a program called "Cover All Pennsylvanians". 
  • Requiring insurers in the small group market spend at least 85% of premiums on medical care, versus profits and administration, helping to ensure affordable insurance.
  • Adding adjusted-community-rating to the small group and individual markets, which prevents insurers from including factors other than age, family or firm size and geographic region when setting premium rates.

  • Requiring insurers to provide dependent coverage up to age 30, because 49% of the state's uninsured are between the ages of 18 and 34.

What sets the plan apart from other states is its array of aggressive proposals to improve quality and reduce the costs of the health care delivery system, from requiring hospitals to implement infection control programs to improved management of chronic diseases, like Vermont's Blueprint for Health.  Additionally, Gov. Rendell wants to establish pay for performance and will start by requiring state programs to identify "Preferred Providers" who meet evidence-based standards for care, all part of his cost control plan.

Elsewhere: Going beyond plans that build on the current system of employer-based coverage, a plan to create a single-payer health care system in Connecticut made it through the state legislature's typically conservative Insurance and Real Estate Committee.  And in Oregon, the Senate Special Committee on Health Care Reform is currently holding town hall meetings on a number of health care reforms, including the committee's own SB 329 and former Governor John Kitzhaber's SB 27, the Oregon Better Health Act, which seeks federal authority to allocate Medicaid, Medicare and other public dollars being spent in the state in a way that provides health care to all Oregonians.

More Resources

Growing Economy

by Nathan Newman

Cracking Down on Wal-Mart's Favorite Tax Loopholes

At the beginning of February, we reported on an expose of special loopholes used by Wal-Mart to slash its state taxes by hundreds of millions of dollars per year.  The scam involves Wal-Mart and other companies dividing themselves into separate subsidiaries, buying land and buildings, then deducting the rent paid to itself as a business expense.  But states are moving to eliminate the loophole and reclaim the lost revenue:

  • Maryland State Comptroller Peter Franchot announced plans to go after the loophole, arguing "It's an abuse that allows big companies to cheat on state taxes."
  • Connecticut Attorney General Richard Blumenthal announced an investigation into whether Wal-Mart and other companies were abusing the loophole and exploring what legislation would be needed to close it.
  • Legislation has been introduced in multiple states to deal with the loophole, including in New Mexico, Michigan, Maryland, Iowa, and North Carolina.  Most of the statutes are seeking to enact "combined reporting," an accounting rule which forces corporations to report all their subsidiaries in a unified report, shutting down a range of tax scams. 

Governor Spitzer in New York, Gov. Patrick in Massachusetts and Gov. Rendell in Pennsylvania have also recommended that their states adopt combined reporting as well. 

These states will hopefully soon be joining the twenty states that already use combined reporting -- and have largely avoided being scammed by the Wal-Mart style loophole.  

More Resources

Research Roundup

Research Roundup

Want the simplest way to expand voter turnout?  Enact Election Day Registration (EDR), which increases turnout by 10 to 12 percentage points, according to a new report by Demos, which highlighted how widely successful EDR was in states that used it in the 2006 election.

Surveying 50 of the largest food service and retail companies in America, a new report by ACORN, Working Sick, Getting Stiffed, found that those companies provided paid sick days to only 22 percent of their employees-- meaning the people cooking your food and ringing up your purchases are regularly coming to work sick.  ACORN has also launched a new Paid Sick Days Campaign site supporting their legislative work for sick days legislation.

While there's a lot of noise about using new tolls and privatization of highways to pay for transportation in the states, a new report by the American Association of State Highway and Transportation Officials (AASHTO) finds that such maneuvers can't cover the estimated $11 billion deficit states will face in transportation costs.

Helping states gauge their comparative economic conditions, the US Congress's Joint Economic Committee (JEC) has pulled together a state-by-state Economic Snapshot of costs facing middle class families, trends in state job markets, and changes in household income and poverty levels.  

The Brookings Institution highlights the payoffs from early investments in children in their report, Success by Ten, which proposes major expansions of Head Start and Early Head Start as a way to give all children a chance to succeed.

More Resources

Universal Health Care's Next Steps - PA & IL Plans

IL: Governor Rod Blagojevich - Announcing Illinois Covered
Illinois Covered - Affordable Health Care for All
Chicago Sun-Times - Gov's plan: All insured in 3 years
Pennsylvania Governor's Office of Health Care Reform
PA: Governor Ed Rendell - Prescription for Pennsylvania
Philadelphia Inquirer - Rendell: 47 Ideas to cut health costs
Pittsburgh Post-Gazette - Rendell unveils health care plan
CT: Universal Health Care Foundation of Connecticut - First Victory for Universal Health Care
Hartford Courant - 'Single-Payer' idea stays afloat
OR: We Can Do Better, proponents of The Oregon Better Health Care Act - SB 27
Senate Special Committee on Health Care Reform - SB 329

Cracking Down on Wal-Mart's Favorite Tax Loopholes

Progressive States Network, Reforming the Corporate Income Tax

Institute on Taxation and Economic Policy, Combined Reporting of State Corporate Income Taxes: A Primer

Multistate Tax Commission, Model Statute for Combined Reporting

MD SD 945

Michigan Bill 151

NC S244

Eye on the Right

The plot thickens in Florida's election fiasco of 2006. Yes, it has gotten so bad that when speaking of Florida you need to specify which mishandled election you're referring to. It turns out that the maker of the malfunctioning voting machines warned state and county officials about numerous potential problems that could lead to votes not being cast. In this case, 13 percent of the voters -18,000 people- didn't register votes, many of whom said the machine rejected their ballots. To this, Sarasota Supervisor of Elections Kathy Dent says, "It wasn't any big deal," and "We weren't experiencing a problem." Perhaps Dent doesn't realize that botching an election is the most profound big deal for a democracy.

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The Stateside Dispatch is written and edited by:

Nathan Newman, Policy Director
Mijin Cha, Policy Specialist
Adam Thompson, Policy Specialist
John Bacino, Communications Associate

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Please shoot me an email at jbacino@progressivestates.org if you have feedback, tips, suggestions, criticisms, or nominations for any of our sidebar features.

John Bacino
Editor, Stateside Dispatch

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