As states face another economic downturn and growing budget deficits,
expanding access to coverage may seem like an impossible goal.
However, there are steps states can take to generate revenue and
"stretch" health care dollars to ensure access to health care. These include using existing tobacco-settlement dollars dolely for health care, instituting employer pay-or-play requirements, improving prescription drug purchasing, improving chronic care management, and ending corporate tax loopholes.
Politics, particularly in small states, makes for strange bedfellows.
The latest effort to derail Maine's first-in-the-nation 2003 Dirigo
Health Reform initiative bears this out. The president of the State Chamber of Commerce and a former member of the Dirigo Health Board of Directors is now treasurer of a lobbyist-driven political action committee waging a campaign to sap Dirigo Health of its funding.
One year after implementation, Massachusetts new health care law has
dramatically reduced its rate of the uninsured by half, increasing
coverage in both the public and private sectors for 355,000 previously
uninsured residents, a new Urban Institute study published in Health Affairs shows. The state has improved access to coverage but rising costs are a key challenge as the state moves forward.
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.