On February 1, 2008, SCI, through the Robert Wood
Johnson Foundation, awarded
development grants to eight states —Arkansas, Kansas,
Maryland, Minnesota, New Mexico, Oklahoma, Oregon, and
Wisconsin—participating in the Coverage
Institute. The primary goal of these grants is to further
assist states in the development and refinement of their
health care reform plans.
The Coverage Institute, a new technical assistance program,
was unveiled in 2007 to help states focusing on substantial
and comprehensive care health reform and to develop the
capacity of state officials to understand the implications of
different programmatic decisions and how those may impact the
existing system. Fourteen states were selected to participate
in the Institute. Participating states were then eligible to
apply for additional funding for options
development/micro-simulation modeling or other reform
development activities.
The awarded development grants support a variety of
activities that can promote the advancement of these states’
health reform plans:
Arkansas: Primarily, funds will provide
technical assistance and logistical support to the Governor’s
Health Care Roundtable, which is a newly-convened expert panel
tasked with developing the Arkansas Health Care Plan.
Kansas:
The Kansas Health Policy Authority Board recently completed a
slate of 21 recommendations designed to address the rising
cost of health care and promote access to affordable health
insurance.
Kansas will use
funds to further refine their proposals related to the
individual and small group market. They will convene a
stakeholder advisory group, collect data on sole proprietors
and micro-firms, and consult with experts. In addition, they
will map the chronic disease burden in
Kansas and
develop recommendations for better care coordination.
Maryland:
Maryland has
recently passed coverage expansion legislation that will
expand Medicaid eligibility and make small business market
reforms. Funds will go to support implementation of this
legislation. Tasks include: 1) conducting outreach about the
new programs through a public-private partnership; 2) hiring a
consultant to help with small business subsidy program design;
3) workshops for small business owners about Section 125 tax
benefits and other aspects of the small business insurance
program; 4) research and analysis to support the work of the
Maryland Health Quality and Cost Containment Council; 5)
working with a consultant who will facilitate a collaborative
process designed streamline Medicaid eligibility and
enrollment.
Minnesota:
The Governor’s Health Transformation Task Force is working to
produce a health reform plan to present to the 2008
legislature. The goals of the task force are to: 1) reduce
spending; 2) achieve universal coverage; 3) promote quality;
4) reduce the burden of chronic disease; and 5) achieve
administrative efficiency. Funds will be used to provide
additional modeling of proposals related to private market
reforms, consultant services for an expert in payment reform,
and staff project support.
New
Mexico: New
Mexico is nearing completion of a three-year
policy-development process which has resulted in a proposal
called HealthSOLUTIONS New
Mexico.
This plan includes: 1) insurance market reforms; 2) a
phased-in coverage participation requirement for individuals
and employers; 3) a transition to electronic claims and
medical records; and 4) the creation of a Health Coverage
Authority to implement the plan. They will use development
funds to do modeling of the coverage expansion proposals
described above and for staff support.
Oklahoma:
Funds will help support the work of the newly-created
Oklahoma Health Institute (OHI), which will be charged with
developing a plan for health reform. The coverage-related work
by the OHI will include population analysis, community
meetings, surveys on “willingness to pay,” and a
communications strategy designed to engage and educate the
public about reform proposals.
Oregon:
The state legislature in
Oregon has
tasked the Oregon Health Fund Board with developing a plan for
universal health coverage. A proposal is due for the 2009
legislative session. Funds will pay for an actuary to assess
the cost for a basic benefit package for the uninsured. In
addition, Oregon
will contract for a study of the impact of private market
reforms, including employer requirements, a connector or
health insurance exchange, and Section 125 plans. Funds will
also be used to cover a communications plan that will include
internal communications between the administration and the
legislature, gathering stakeholder input, and community
messaging.
Wisconsin:
Wisconsin’s Governor has proposed a
plan to cover 98 percent of Wisconsin
residents; most of the plan has passed the legislature. This
reform includes an expansion of BadgetCare (the state’s
Medicaid program) to include all children (those above 200
percent of the federal poverty level pay a sliding-scale
premium). The plan also approves the application for a waiver
to include childless adults in BadgerCare. The second phase of
the proposed plan relates to private market reforms. The bulk
of the funding for
Wisconsin will
pay for consulting services to assess the impact of proposed
private market reforms. These include merging the individual
and small group markets; increased insurance regulation,
particularly guarantee issue and community rating; and, the
addition of a connector.
Additionally, two states –
Colorado and
New
Jersey – were awarded options
development/micro-simulation modeling grants. Both states will
be working with a team from the Urban Institute to develop
specific policy options, to delineate a finite number of
policy options that will be modeled using
a micro-simulation model, and to better understand other
key design and implementation issues.
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