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Nov/Dec 2007

States Consider New Recommendations

Colorado: On November 19, Colorado’s Blue Ribbon Commission for Health Care Reform approved recommendations for comprehensive health reform. The reform agenda focused on cost, quality, and access to health coverage. The recommendations stipulate that efficiency improvements should be phased in before coverage expansions. All told, the Commission’s recommendations would expand coverage to almost 90 percent of the state’s 792,000 uninsured residents, at an estimated cost of $1.1 billion. Its 31 recommendations included:

  • Providing premium subsidies for low-income, uninsured workers;
  • Requiring employers to enable employees to purchase health insurance with pre-tax dollars;
  • Reducing administrative costs by standardizing claims forms, insurance application forms and authorization procedures;
  • Creating a “connector” and promoting access to information for consumers;
  • Developing a statewide health information network focused on interoperability;
  • Providing a medical home for all Coloradans;
  • Requiring that every resident of Colorado have at least a “minimum benefit plan;”
  • Creating a Consumer Advocacy Program; and
  • Expanding Medicaid coverage to all legal residents of Colorado in families earning up to 205 percent FPL.

The Commission was established in November 2006 by the state legislature.  Its bi-partisan members were appointed by the Governor Ritter, former Governor Owens, and leaders in the state legislature. The Commission reviewed five health care reform proposals, ultimately selecting the model that most closely resembles the comprehensive reforms undertaken by Massachusetts. The Commission will present its recommendations to the Colorado legislature in early 2008.

Kansas: The Kansas Health Policy Authority recently released the “Kansas Health Policy Authority Board Health Reform Recommendations of 2007.” These health reform recommendations to the governor and legislature resulted from not only deliberations of the Authority’s board, but also meetings of four advisory councils involving 144 members, and a listening tour across 22 communities. The priorities for reform include:

1)     Promoting Personal Responsibility—for healthy behaviors, informed use of health care services, and sharing financial responsibility for the cost of care;

2)     Promoting Medical Homes and Paying for Prevention—to improve the coordination of health care services, prevent disease, and contain the rising costs of health care; and

3)     Providing and Protecting Affordable Health Insurance—Proposals include expanding Medicaid coverage up to 100 percent FPL for adults without children and encouraging Section 125 plans.

In addition, the report included financing options and recommendations for containing health care costs.

Virginia: In September 2007, The Governor’s Health Reform Commission from the Commonwealth of Virginia submitted its final report intended to serve as a roadmap for reform of the health care system in Virginia. Created by executive order in August 2006, the Commission brought together stakeholders from both the public and private sector to develop recommendations for reforming and strengthening healthcare in Virginia and providing coverage to the nearly 15 percent of the Commonwealth’s residents who are uninsured. [1]

Over the past year, the Commission’s tasks have included examining the healthcare workforce, affordability, quality, and accessibility of healthcare in the Commonwealth, the transparency of health information, prevention and wellness efforts, and long-term care. The Commission laid out several recommendations:

  • Establish a health care data workforce center housed within the Department of Health Professions charged with improving data collection and measurement of the healthcare workforce;
  • Increase the retention rates of both medical students and residents through marketing Virginia programs, increasing scholarship and loan repayment programs and funding, and increasing the number of available opportunities for residents;
  • Provide $10 million in state General Funds to the community-based healthcare safety net annually;
  • Include routine dental services as part of any Medicaid eligibility expansion for parents, or include routine dental services for existing parents enrolled in the Medicaid program;
  • Expand eligibility for Virginia’s Family Access to Medical Insurance Security Plan (FAMIS), the Commonwealth’s SCHIP program, from 200 to 300 percent FPL for children and from 185 to 200 percent FPL for pregnant women;
  • Create a private health insurance product for uninsured Virginians with incomes less than 200 percent FPL who have no other access to public or private health insurance;
  • Include the use of meaningful metrics linked to quality improvements that balance both absolute and relative scales;
  • Fund quality improvement through new monies, incorporating both financial and non-financial incentives and rewarding innovation, modernization, and culture change that promote quality in resident care;
  • Develop and implement a single portal for the dissemination of useful, transparent information on healthcare costs and quality to consumers; and
  • Establish a non-profit foundation that will leverage public and private funds to focus on promoting clinical preventive services and healthy lifestyle choices across the Commonwealth.


[1] “Governor Kaine Creates Healthcare Reform Commission,” August 2006,