By Mikel Chavers
When Alan Weil talks about state health reform he always mentions the trilogy—Maine, Massachusetts and Vermont. As executive director for the National Academy for State Health Policy, he’s seen health reform initiatives that span the spectrum.
And a lot of it’s happening in the states, Weil said.
“It’s clear that the structure of the federal bill draws on state’s experience,” Weil said.
But the approaches are all different, even those in the trilogy, he said in a health policy workshop Thursday afternoon.
The Massachusetts health care reform plan, he said, tackled issues of coverage first, and will tackle cost later. Maine, on the other hand, is working on costs and coverage simultaneously, he said. In Vermont, the state started with chronic care management—there is a community-based organization designed to help people manage their chronic conditions, Weil said.
Washington Basic Health offers an important example, particularly because the national health reform plans includes an option for states to opt-in to a state-subsidized health care option, Cody said.
Washington is proof of how that works.
In the 22 years of operation, the program has put people on waiting lists three times, including now, said Cody.
“But that’s where we are today with the economic situation,” he said. “The recession has created numerous challenges on our state budget.”
And with zero federal matching dollars, that meant the program had to take a more than 40 percent budget reduction this year, according to Cody. That translates to covering fewer low-income folks who need health insurance coverage.
Participants in the state-subsidized plan share the responsibility for paying for the low-cost coverage and pay on average $60 a month in premiums, Cody said.
“Without this program in the state a lot of people would simply choose to go without health insurance,” he said.