States Tackling Health Care Reform

Healthcare reform is catching on with regulators in many states. As of this fall, 28 states had introduced or passed reform legislation, or set up a task force to write a reform plan to introduce during their next legislative session, Richard Cauchi, health program director for the National Conference of State Legislators (NCSL), told insideARM. 

“Some (regulators) are concentrating on small employers, helping them get insurance,” Cauchi said. “Others are focused on Medicaid and expanding coverage.”

Regardless of their efforts, what’s different nowadays about state legislators’ efforts to reform health care coverage is the spirit in which they are going about it, Cauchi said. 

“Forty seven million Americans don’t have insurance. That has struck home more this year,” he said. “There’s a commitment to say let’s really try to do this differently. Let’s try to tackle some of the fundamentals of how much insurance is costing both lower income people and higher income people.” 

A popular concept that is showing up in many legislative proposals is the idea of a health care “connector”, which assigns a state agency to negotiate and coordinate with private market insurance to provide one-stop shopping for state residents, Cauchi said. The idea was introduced with Massachusetts’ new comprehensive healthcare coverage law.  

“The connector is something that has excited legislatures in other states” including Iowa and Colorado, Cauchi said. 

Experts estimate that federal action on healthcare reform isn’t likely to happen before 2009 at the earliest. But reform at the federal level should make it easier for states to provide coverage and curtail costs, Cauchi said.  

“Federal ERISA law preempts many insurance plans,” he said. “It’s better for states if there was a federal change that would allow people to have more uniform protections or access.” 

NCSL is a bipartisan organization that serves the legislators and staffs of the nation’s 50 states, its commonwealths and territories by providing research, technical assistance and opportunities for policymakers to exchange ideas on the most pressing state issues.