Strategies to Extend Coverage to Uninsured

Based on an innovative model from Washington state, states have the opportunity to help veterans improve their benefits and save millions of dollars for their own budgets.

While the new Affordable Health Care law provides a variety of funding opportunities for states, one provision in the health law that could shift billions of dollars from cash-strapped states to the federal government.  Under the National Medicaid Drug Rebate Program created by the Omnibus Budget Reconciliation Act of 1990, drug manufacturers are required to enter into agreements that provide rebates for Medicaid purchased drugs, establishing a 15% minimum level of rebates.  Up until now, the rebates were divided between the states and the federal government.  But under the new health reform law, a significant portion of the rebates will go solely to Washington beginning this year.

One of the immediate benefits of the Affordable Care Act is the Early Retiree Reinsurance Program.  Beginning June 1, 2010, this new reinsurance reimbursement program is available to group health plan sponsors who provide medical coverage to early retirees and their spouses, surviving spouses and dependents.

The choice of whether or not to establish high-risk insurance pools represents the first major decision that states are facing with the March 2010 passage of the Patient Protection and Affordable Care Act (PPACA). While twenty-nine governors -- 22 Democrats and 7 Republicans -- decided to create the pools themselves, most conservative governors failed to take advantage of the option to shape health care for their constituents and instead just kicked the issue back to the federal government, which will establish its own high-risk insurance pool in states that fail to take action.

In the weeks following the signing of the Patient Protection and Affordable Care Act, lawsuits challenging the constitutionality of health care reform were joined by multiple, conservative Attorneys General from states across the nation, despite widespread condemnation that such challenges were frivolous, wasteful, and almost certain to fail in the courts.  In early April, Secretary of Health and Human Services Kathleen Sebelius commented that she believed the lawsuits had "more to do with politics than policy."

Progressive States Network has a new analysis of the progress of state health care legislation which indicates the failure of conservative attempts to obstruct reform at the state level.  This resource, located at http://ALECFail.com, will be updated as more sessions end.  Many more nullification bills are expected to fail this session, as state leaders and legislators across the country defeat the right-wing agenda attacking health care reform.

Even as right-wing state legislators and attorneys general from various states unleash a barrage of attacks in an attempt to halt federal health reform before it starts, progressive state legislators and officials have been pushing back, highlighting the benefits that states will receive and the increased provision of quality and affordable care for families through the Patient Protection and Affordable Care Act. 

This Dispatch will outline strategies that include crafting outreach and education initiatives that integrate city and state government agencies with grassroots organizations and local media to ensure 'Hard-to-Count' residents are included in the Census; enacting state legislation that mandates prisoners are counted in their home districts rather than in that of their prisons, and proactively considering principles for redistricting legislative districts that move beyond uniquely partisan concerns to addressing the needs of district residents.  This Dispatch will also aim to provide some of these best practices and highlight resources, all with a view toward preparing states to engage effectively with the 2010 and – looking forward — 2020 Census.

Highlighting the outrage at insurance industry abuses pushing Congress towards a final decision on federal health care reform, state legislators continue to advance their own insurance reforms, even as they lay the groundwork for implementing the policies that will emerge in a federal bill. 

This week, President Obama released his blueprint for comprehensive health care legislation.  The plan 's release means Obama can outline the specifics of what he wants to see in a final bill for the first time.  Many political observers see the decision to outline specifics as not only a jump start to move health care reform across the finish line but also as a stamp of approval for the Senate to use a majority vote through the reconciliation process, a strategy which appears to be gaining momentum.