Strengthen Employer Responsibility for Health Care

In New York State, 31% of uninsured residents are young adults between the ages 19 and 29. To help this population and reduce the state's uninsured rolls, Governor Paterson wants to require private employers to offer health insurance to workers' dependents who are between the ages 19 and 29.  The proposal would expand eligibility to some 800,000 uninsured New Yorkers and the Governor's Office projects about 80,000 would take advantage of the new rule. According to the New York Times, business groups appear to be supportive of the idea, which would not require employers to help pay for coverage, merely to make it available.

There are stark differences between the two presidential campaigns' approaches to federal-state relationships.  Differences range from the amount of funding appropriated for programs run by the states to whether the candidates would strengthen or weaken state regulatory authority.

In a case with national implications for state health reform across the country, the Ninth Circuit Court of Appeals this week in Golden Gate Rest. Ass'n v. San Francisco upheld the employer responsibility provisions of the San Francisco universal health care plan.  The decision follows a preliminary decision earlier in the year that allowed the plan to be initially implemented.

To close funding gaps in the state's new health care law and encourage more employers to provide health coverage for their employees, Massachusetts Governor Deval Patrick this week proposed raising an additional $33 million from employers with more than 10 workers who don't contribute at least one-third of workers' premiums within the first 90 days of employment and don't have at least 25% of their employees enrolled in insurance plans.  The plan would raise additional funds by assessing fees on insurers' reserve accounts. 

One year after implementation, Massachusetts new health care law has dramatically reduced its rate of the uninsured by half, increasing coverage in both the public and private sectors for 355,000 previously uninsured residents, a new Urban Institute study published in Health Affairs shows.  The state has improved access to coverage but rising costs are a key challenge as the state moves forward.

Incremental steps to improve the health care system can lay the foundation for comprehensive reform that provides health care for all. Comprehensive reforms enacted in Massachusetts, Vermont, Maine and San Francisco were, in large part, the result of pragmatic incremental steps those states had already taken. For example, a Families USA report discusses the many reforms Massachusetts put in place over the years that led to its comprehensive 2006 reform. Not every state is as far along in moving comprehensive health care reform, but each state does have numerous options for increasing access to coverage, reducing the growth of health care costs, and improving the quality of care.