States Will Shape Health Reform

Did you see the  article in this Sunday’s Washington Post, “States Likely to Shape Health Reform?”  It highlights an issue that we fear is not being taken into account enough as Congress gets closer to passing health reform - the critical role that states may play in implementing national health reform.  The article outlines the differences in the House and Senate (Finance Committee) versions of federal health reform as it relates to states.  The House version calls for a national public plan and a national insurance exchange, while the Finance Committee bill maintains and expands the current role of states in regulating the insurance market.  The Finance Committee bill also explicitly allows for experimentation by states, enabling them to try out other coverage models as long as their residents have access to coverage options at least as good as what they would have otherwise.  Now, Senate leadership is publicly considering a public option compromise that allows states to “opt out” of the public plan.

While the Senate Finance version clearly has a stronger role for states, it is clear that states will need to be prepared for many implementation challenges related to federal reform, regardless of which vision for reform comes out on top.  As we outline in this paper, an essential federal-state partnership will provide the foundation for reforming the health system.  States will need to be prepared to be a strong partner.

As states are struggling with budget deficits and staff cuts, implementation of health reform won’t be easy.  That is why SCI (and groups like us) are gearing up to help states understand the legislation (if any) that ultimately passes and to help state officials gain the expertise they need to effectively implement the reforms.  Stay tuned for more information on upcoming meetings, papers and webinars.