Laying the Foundation for Health Reform

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Executive Summary

This year’s edition of State of the States, “Laying the Foundation for Health Reform,” outlines the significant, wide-ranging efforts undertaken by states in 2010 in spite of major budget challenges and rising demand for public health care programs. These include:

• Establishing committees and task forces to study the impact of the Affordable Care Act and develop strategic plans for responding to its provisions;
• Implementing state-based pre-existing condition insurance plans;
• Working with insurance carriers and the public to implement insurance market reforms included in the ACA;
• Improving premium rate review processes and considering the impact of medical loss ratio requirements;
• Collecting data and planning for state-based health insurance exchanges;
• Reducing costs and improving outreach and enrollment efforts in Medicaid and the Children’s Health Insurance Plan; and
• Undertaking efforts to improve the health care delivery system and promote population health.

Table of Contents

• Letter from the Director
• Executive Summary
• Chapter 1: Surveying the Landscape
• Chapter 2: Using Federal Reform to Accomplish State Goals
• Chapter 3: Policy and Politics: The Process of Implementation
• Chapter 4: First Hurdle: Pre-Existing Condition Insurance Plans
• Chapter 5: Laying the Foundation for State-Based Exchanges
• Chapter 6: Insurance Regulation Reform
• Chapter 7: Medicaid and the Children’s Health Insurance Program Present Opportunities and Challenges
• Chapter 8: State Efforts Improve Quality, Contain Costs, and Improve Health
• Looking Forward