States find alternate routes to health coverage


WASHINGTON--Despite continued state financial pressure, rising insurance premiums, and increasing numbers of uninsured, state officials worked hard in 2004 to keep health care coverage on their agendas, according to a new report, State of the States: Finding Alternate Routes, released today. This annual report, produced by The Robert Wood Johnson Foundation's State Coverage Initiatives program (SCI), tells the story of state health coverage activities from the previous year. As the only report to provide a comprehensive analysis of state activities in health care coverage, State of the States is an important resource for states to learn from one another how to improve and expand health coverage in these challenging times. View the report at

2004 marked the first year in several years that financial conditions in many states showed signs of improvement. However, the fiscal crisis that began in 2001 remains palpable. "State officials continued to foster debate on strategies to expand health insurance" says Alice Burton, SCI program director. "States are finding alternate routes to expand coverage and make existing programs work most effectively in this changing environment," says Burton.

Most states endured another bad budget year without making deep cuts to their Medicaid programs. This reflects Medicaid's essential role as a source of health coverage for vulnerable populations. However, a combination of surging costs, enrollment, and uninsured has created a "perfect storm" that has driven many Medicaid leaders to rethink the way their programs are structured and how they operate. Going forward, how Medicaid evolves will impact states' ability to maintain or expand coverage.

States pursued innovative strategies to maintain or expand coverage. In some cases, states found new revenue sources to increase health care coverage. Residents in several states approved ballot initiatives to increase tobacco taxes to support health initiatives. Other states continued to reach out to the private-sector to build partnerships, with many seeking new opportunities for collaboration. Many of these strategies seek to bolster employer-sponsored insurance by helping small employers offer coverage or enabling low-income workers to purchase insurance.

States also tailored their coverage approaches to address the underlying reasons for private-sector cost increases and the erosion of private health insurance coverage. Strategies focused on making insurance affordable, whether through legislation to allow insurers to sell scaled-back benefit plans, or by revisiting the concept of state-sponsored reinsurance.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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