Article: Efforts to Expand Insurance Coverage in Many States May Reopen a National Dialogue

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Efforts to Expand Insurance Coverage in Many States May Reopen a National Dialogue

Washington policymakers are paying attention to efforts in 20 states to expand coverage, including controversial measures such as mandating health insurance, which is being promoted by Massachusetts Republican Governor Mitt Romney.

Source(s): Julie Appleby, USA Today (November 8); Ricardo Alonso-Zaldivar, The Los Angeles Times (November 13)

Though "health care reform may be dead in Washington," at least 20 states are trying to expand insurance coverage by "squeezing money from existing health programs and taking other politically difficult steps, including some tax increases," reports the Los Angeles Times. A study by the Kaiser Commission on Medicaid and the Uninsured found that 20 states increased health care access in the 12 months that ended in July, and these expansions reversed previous cuts in nine of the states. Measures include efforts by both Republican and Democratic state leaders, such as Illinois Democratic Governor Rod Blagovich's expansion of coverage to the uninsured children of working parents and Massachusetts Republican Governor Mitt Romney's "controversial" proposal to mandate health insurance as part of an effort to cover all of the state's half-million uninsured. Romney is battling Democrats in the State Legislature who contend that employers should be the ones required to provide coverage, but "activists on both sides say chances for a deal appear to be good."

However, with health costs continuing to rise and many state budgets prohibiting deficits, it is unclear whether the states can sustain the efforts they have made. In addition, 14 other states took steps to limit coverage, the study found, primarily by raising premiums for coverage of low-income children. "If any of these states succeeds, it could provide impetus for a national debate in later elections," according to public opinion analyst Robert Blendon of the Harvard School of Public Health. "The fact that a Republican [Governor Romney] is supporting a mandate is a huge leap," he said.

In Congress, Rhode Island Democratic Representative Jim Langevin plans to introduce a bill to create a nationwide insurance program similar to the one that covers federal workers, reports USA Today. However, President Bush is "aloof" to such an idea, according to the Los Angeles Times, and policy experts don't expect major health reform to come out of Washington. "I cannot imagine anything significant going through Congress anytime soon," said Stuart Butler of the Heritage Foundation. according to USA Today. Both articles mention "more limited" proposals in other states, such as Oklahoma, California and Maine, which focus on small businesses with low-wage workers.