This week, the Washington State Senate's health committee approved a
bill to achieve health-care-for-all by 2012. Sponsored by committee
Chair Sen. Karen Keiser, SB 5945 as amended
combines immediate steps to expand access to coverage and cut
administrative costs with a planning process to refine proposals for
comprehensive reform by 2012. This action came as the Seattle City Council and Seattle Post-Intelligencerendorsed national single-payer health care, emphasizing the continuing efforts in states to move forward health care reform.
Absent a comprehensive initiative to achieve quality and
affordable health care for all, there are a number of steps progressive leaders
can take to extend coverage to the uninsured and make coverage for the
currently insured more affordable.
Extending coverage to all Americans is an economic as well
as a moral issue, as the costs associated with being uninsured are not borne by
the uninsured alone. In 2005, Families
USA showed that unpaid care for the uninsured resulted in an average
cost-shift of $922 to family insurance premiums. Families USA, at the time, projected these
costs to increase to $1,502 by 2010.
This section discusses many of the leading options states have to extend coverage to working families.
Absent a national health care
policy, states have found ways to expand the reach of Medicaid by
covering more low-income, senior and disabled people and expanding the
list of covered services. Because of state action, 58 million
Americans now have health coverage they would not otherwise possess.
To push back on the states, the Bush Administration put forward several new Medicaid regulations
last year that, if implemented, will shift the burden and costs to
states. This will result in reduced benefits for millions of Americans
unless already cash-strapped states find some way to pick up the slack
- to the tune of $50 billion over five years.
Everyone knows that individuals and small employers face crushing
health insurance costs when they try to buy coverage on their own. But
state legislators in Hartford are about to take a simple yet
far-reaching step to address the problem.
By allowing municipalities and small businesses to buy into the
group plan currently provided to state employees, the recently
introduced Connecticut Healthcare Partnership would give working
families the clout they need to negotiate a better deal for health
Incremental steps to improve the health care system can lay the
foundation for comprehensive reform that provides health care for all.
Comprehensive reforms enacted in Massachusetts, Vermont, Maine and San Francisco were, in large part, the result of pragmatic incremental steps those states had already taken. For example, a Families USA report discusses the many reforms Massachusetts put in place over the years that led to its comprehensive 2006 reform. Not every state is as far along in moving comprehensive health care reform, but
each state does have numerous options for increasing access to
coverage, reducing the growth of health care costs, and improving the
quality of care.
In a new report, Progressive States Network updates a fall 2007 edition of the Stateside Dispatch and discusses the growth of legislative measures to protect consumers from unaffordable health care costs. Individual Health Care Mandates and the Problem of Affordability
uses the experience of Massachusetts' individual mandate as a case
study to demonstrate the need for strong language ensuring
affordability and profiles various legislative models for affordability
Some health care reformers may recall that in 1994 the makers of Sim-City produced a Sim-Health computer program. The program, labeled by some as the "dryest"
simulation game ever made, allowed users to take control of the US
health care system and observe the results of their decisions. Now,
taking a similar yet more user-friendly approach, Community Catalyst and Families USA have teamed up to provide health care advocates with a web-based guide for developing state expansions of health coverage.