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.
The federal health reform law is only the starting point for achieving
health care access for all Americans. Many states are already moving
forward, not only on implementing the basic provisions of the Affordable
Care Act in their states, but are also planning how to build on its
framework to further expand coverage and rein in costs for their
residents. The following are a few models of implementation and
comprehensive reform underway.
This past Tuesday, Maine votersconsidered legislation which would have reformed the state's tax structure and bond measures that will bolster infrastructure investment.By a large margin, Mainers rejected a law passed last June, LD1495, to lower the top income tax rate from 8.5 percent to 6.5 percent for state residents earning less than $250,000 annually by broadening the sales tax to include different services and shifting tax burden to nonresidents by increasing the meals and lodging tax from 7 to 8.5 percent.
Last week, the Massachusetts House unanimously passed the
Revenues and Expenditures Transparency Act, H
2972, to create a searchable, online database that details state
spending and revenue sources. Lawmakers also approved an amendment to
create greater taxpayer accountability by providing increased
transparency around some business tax credits. As House Chairman of the
Joint Committee on Revenue Rep. Jay Kauffman explains,
"[p]ublic access to the way we raise and spend money is essential,
enabling us to make more-informed decisions for the tax-paying
constituents who elect us to serve on their behalf."
In spite of difficult budget decisions, Maine leaders enacted
significant progressive initiatives this year, from first-in-the-nation
health reforms to clean energy bills to consumer protections to campaign