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Ed Fund Briefings: Affordable Care Act Advances At State Level

Posted by Will Rice (will) on Nov 07 2011 at 5:06 PM
FALL 2011 >>

Sometimes good things come in small packages.  Such was certainly the case September 13 at the ADA Education Fund’s annual Jim Jontz lecture on Capitol Hill.  Though held in a modest meeting room in the Rayburn House Office Building, the lecture—which this year took the form of a panel presentation—offered expansive (and hopeful) coverage of how states are implementing the sweeping new federal health care law.

Most inspiring was the news from all three panelists that despite the noisy denunciations of the Affordable Care Act by Tea Party conservatives in Congress and Republican presidential hopefuls on the campaign trail, many states are quietly going about the business of making reform work for their citizens.  And the discussion definitively refuted conservative claims that last year’s reform somehow represented a federal “takeover” of health care.

“Many people thought health care reform was just cooked up in small rooms like this on Capitol Hill,” said the Commonwealth Fund’s president, Karen Davis. “But in fact it was built on innovations that have been tested at the state level.”  She cited Maryland, Massachusetts and Vermont, among other states, as trailblazers in health care reform.

Maryland State Del. Heather Mizeur, who as a Congressional staffer in the ‘90s worked to pass the State Child Health Insurance Program, argued that that earlier law served as a model for health care reform.  S-CHIP represented “a devolution of decision making from the federal government to the states” by setting a framework of what needed to be accomplished and allowing states to demonstrate “their innovator credentials.”

Reporting the sobering statistic released that day that just short of 50 million Americans were currently uninsured—the highest number since 1983—Mizeur predicted that the ACA would cut the number of uninsured in half by 2020, while saving $850M a year in health care costs.

Tara Straw, legislative and policy director for Health Care for America Now, argued that it was a state insurance-rate case that put federal reform over the top. “Things were stalled at the beginning of 2010.  Then what happened? A 39% rate increase request by Blue Shield of California.  People exploded; stories across the country; and all of a sudden, we had new momentum.”

Davis explained that the states are responsible under the law for setting up the health insurance exchanges intended to drive down premiums and improve quality. “That’s why what’s happening at the state level is important:  they’ll decide what plans meet what standards to participate, how easy it is to shop” and other key details.

Straw reported recent positive poll results for health care reform despite the unrelenting criticism directed its way: 49 percent of Americans thought the ACA was a “good start”— and many in the remaining 51 percent thought it didn’t go far enough. But much educational work remains to be done, as 76 percent reported not knowing what reform means to them.

Describing a recently-passed Vermont single-payer system disparaged by its opponents as radical as in reality “a corporate approach to health care” (since it cuts costs and increases efficiency), Mizeur urged reform proponents to be similarly “aggressive in challenging the way people” talk about the federal Affordable Care Act.

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