PSN 2011 Health Care Roundup: Despite Opposition, States Move Forward on ACA, Look to Strengthen Health Security for All

(Note: With legislative sessions largely adjourned in statehouses across the nation, this week’s Dispatch is the fifth in a series of issue-specific session roundups from Progressive States Network highlighting trends in different critical policy areas across the fifty states.)

In 2011 state legislative sessions, lawmakers across the nation in search of common-sense solutions found themselves wrestling with dual challenges on almost every issue: historic budget shortfalls and a charged and starkly changed political climate resulting from an historic wave election in 2010 that saw conservatives take control of 20 new chambers. Both of these factors were front and center on health care measures, as responsible lawmakers joined in the face of these challenges to advance the efficient implementation of the Affordable Care Act, protecting the health security of the most vulnerable and advocating loudly for effective reforms in their statehouses, the courts, and the court of public opinion alike.

From moving forward on implementation of the state-based exchanges at the heart of the ACA in a manner that protects consumers and provides true competition, to fighting to save Medicaid from privatization and families from devastating cuts to their coverage, to defending provisions of the health law that benefit the middle class from attacks launched by ideological groups like the pro-corporate American Legislative Exchange Council (ALEC), state legislators seeking real health security for their constituents braved the storm in 2011 – and promise to turn the tide in 2012:


States Move Forward on Creation of Health Care Exchanges in 2011

Scheduled to come on line in 2014, state-based health care marketplaces, or “exchanges” are central to the Affordable Care Act’s efforts to expand insurance coverage for families and provide choice and competition to consumers. Despite an onslaught of misinformation unleashed in an effort to scuttle implementation of the exchanges, 38 states (as well as Washington, DC) introduced legislation advancing the implementation of exchanges in 2011 sessions – 10 of which were enacted into law. (Read more)


Different Approaches to Exchanges Emerge

Under the Affordable Care Act, states have until 2013 to notify the federal government whether they will be creating their own exchange – the federal government will operate exchanges for the residents of states who choose not to implement their own. Given this knowledge, and with the calendar ticking away, even states that are currently attacking the health law in federal court recognized the need to begin the process of implementing exchanges in 2011. Unsurprisingly, many of those states are now approaching implementation by advancing weak models for these marketplaces that benefit their insurance industry allies. Meanwhile, legislators and policymakers focused on strengthening the health security of families advanced starkly different models for exchanges in 2011 that arm the bodies with the authorities and tools needed to lower costs, expand coverage, and protect consumers. (Read more)


Protecting Medicaid: Ensuring Health Security for Low-Income Families and Seniors

One of the primary ways in which the Affordable Care Act expands coverage is through the expansion of Medicaid to cover individuals with incomes up to 133% of the poverty line. Yet with state budgets under historic pressures in 2011 from revenue declines due to the Great Recession, and with the political debate in Washington D.C. focused on cutting deficits instead of growing jobs, Medicaid found itself on the chopping block both in Congress and in statehouses across the nation in 2011. (Read more)


Defending Against Onslaught of Attacks in States, Courts

In addition to the attempts to defund Medicaid, state lawmakers found themselves playing defense against a slew of attacks on the Affordable Care Act and a number of health care related issues. In the courts, in statehouses, and even in Congress, state legislators came together to stand up and fight for the constitutionality of the ACA and to defend the hard-fought victories for consumers in the law. (Read more)


Turning the Tide on Health Care in 2012

Despite the continuing attacks on the Affordable Care Act, the level of political rancor surrounding health care has declined significantly since the contentious town halls in the summer of 2009. In fact, the latest Kaiser Family Foundation tracking poll shows that, while levels of public awareness about the ACA and its provisions continues to be troublingly low, the temperature surrounding the issue has died down significantly. On the positive side, recent polling also shows that the individual provisions of the ACA continue to be very popular, and that a strong majority of voters do not want to see it repealed or defunded. Consumers and voters are reassured when they are reminded of two central provisions of the law: that it will make their family’s health care more secure by ending denials for pre-existing conditions, and that members of Congress will be required to get their healthcare from the same place as millions of Americans. (Read more)