State legislatures were busy this past year proposing, debating, and in many cases passing health care reforms. According to Laura Tobler, program director of the Health Program at the National Conference of State Legislatures, states are leading the way in health reform. She adds that the 2007 legislative session saw a rise in interest—across party lines and across the country—in both incremental and system-wide health reforms.
"While the media has focused on universal or near universal coverage, more laws passed to implement incremental reform covering some of the uninsured," she says. "In addition, state laws to improve quality and prevent disease as well as to encourage a focus on wellness and reduce health disparities are very much a part of the movement in the states."
Below we highlight four states where the recent legislative sessions resulted in the passage of major health care bills related to expanding coverage, reducing health disparities, creating new purchasing mechanisms, promoting health, and/or improving quality: Colorado, Washington, Kansas, and Texas.
A bipartisan health care reform bill (SB 11) intended to expand access to coverage and improve the performance of the health care system. It directs the Kansas Health Policy Authority to study health reforms in other states and develop a plan for universal coverage for Kansas, to be presented before the 2008 legislative session. It also creates a program, starting in 2009 and phased in over four years, that will subsidize health insurance premiums for families with income up to the federal poverty level (FPL). Subsidies of about $3,200 per family per year are estimated to cost about $77 million in premium assistance, for 24,000 families, by 2012. Other provisions of the law include:
- allowing state residents to set aside pretax income to use toward health expenses;
- offering $500,000 in no-interest loans and grants to small businesses banding together into associations to purchase coverage at a lower cost;
- making loan guarantees for up to $15 million in loans to safety net clinics so they can continue to serve the uninsured and low-income residents;
- providing grants for care to groups unable to obtain health insurance;
- hiring a Medicaid inspector general to investigate and reduce fraud and waste; and
- providing additional health screenings for newborns.