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Massachusetts health care — wonky, with a healthy dose of reality

States Are Staying Active in Expanding Health Access

States Are Staying Active in Expanding Health Access

November 24, 2007

The wave of state health access expansion activitiy is continuing. Here are summaries from three states moving ahead (edited from Wednesday's Kaiser Health Policy Report):

Maryland: Gov. Martin O'Malley (D) on Monday signed into law legislation to increase taxes by $1.4 billion and expand Medicaid eligibility to more than 100,000 residents in five years and offer subsidies to as many as 37,000 small businesses to offset the cost of providing coverage. The legislation increases Medicaid eligibility for adults from 40% of the federal poverty level to 116%. The measure provides $30 million in subsidies for small businesses with <10 workers and their employees. The expansion will cost $600M+ annually. Legislators added language stating the expansion would occur only if voters approve a constitutional amendment on the November 2008 ballot to legalize slot machines. The law also includes a $1 per pack increase in the cigarette tax, and increases to personal and corporate income taxes. The changes take effect Jan. 1, 2008.

Colorado: The Blue Ribbon Commission for Health Care Reform on Monday voted 20-2 to approve recommendations that include requiring state residents to obtain health insurance or pay a tax penalty. The panel also recommend expanding eligibility for state health programs. The panel's recommendations will be presented to state lawmakers on Jan. 31, 2008. The commission reviewed five proposals, and the recommendations are similar to the MA health insurance law. The package would cost $1.1B and would expand coverage to 696,000 of the state's 792,000 uninsured residents. Residents would be required to obtain private insurance, unless they qualify for public programs, such as Medicare and Medicaid. The state would provide subsidies to help residents purchase private insurance. The proposal would bar insurers from denying coverage to sick applicants and would require employers to offer pretax plans for employee health coverage. Gov. Bill Ritter (D) and state Democrats have discussed a tax increase to pay for a health system overhaul.

Rhode Island: Lt. Gov. Elizabeth Roberts announced the "Mission: Healthy Rhode Island" initiative, consisting of a series of meetings to consider proposals and make recommendations to the 2008 General Assembly. Roberts at a meeting on Friday told about 60 reps from state businesses, hospitals, insurance agencies, labor, advocacy and not-for-profit groups and state lawmakers that the state's expected $450 million budget shortfall should not hinder discussions about ways to stabilize health costs and provide low-cost coverage to uninsured residents. Roberts said the state will study other states' efforts, adding, "We are looking at what other states have done and what is doable in Rhode Island." She said she would not seek to change the employer-sponsored health care system. She noted budget limitations could limit efforts to expand coverage because one-third of the state's expenses are allocated for health care programs such as RIteCare and Medicaid.