SPG synthesis report - State Coverage Initiatives

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coverage under the SPG program. As a result, many states readjusted their focus and applied their SPG funds toward maintaining coverage, making the best use of their existing infrastructure and resources for coverage, and modest expansions. 20
Chapter II: The Diagnostic Work of the Planning States The SPG program served as a critical resource for states, enabling them to build their capacity to collect, analyze, and interpret important state-level data on the uninsured. The states collected quantitative and qualitative information on the uninsured and used it to develop strategies to meet the coverage needs of their populations. Many states chose to spend a majority of their grants on state-level data collection and all states made the development of a base of information about the dimensions of the problem a foundation of their work. Recognizing the importance of providing technical support services to the grantees in the areas of data collection and analysis, HRSA allocated some SPG funds to the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota to provide technical assistance to build state capacity and ensure quality in state-level data collection and interpretation. With the support of HRSA SPG funding, states developed state-specific data that enabled them to frame coverage policy decisions, and to deepen their understanding of the characteristics of the uninsured. This process resulted in a greater understanding among policy makers about the importance of state-specific data and the inadequacies of current federal data sources. As a result, states were able to undertake better informed policy discussions. Limitations of Federal Data Sources A variety of national resources are available to states, some of which are federallysponsored surveys, and others of which are privately-sponsored surveys. The strengths and weaknesses of these sources are described in greater detail in SHADAC’s publication A State Perspective on National Survey Data on the Uninsured. 9 In summary, states have a several national data sources at their disposal, but each comes with its own limitations: • Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS was established to provide previously unavailable national data on health status and risk behaviors to states. States conduct the BRFSS using monthly telephone surveys with a common sampling methodology and core questions, including questions on health insurance, thereby allowing for comparisons across states. An advantage of the BRFSS is that states conduct it themselves, maintaining control over the questions and analysis. For coverage discussions, however, the survey’s principal weaknesses are that it is focused on working-aged adults and does not sample children. • Current Population Survey (CPS). Each year, the March Supplement of the CPS labor force data on the civilian noninstitutional population 16 years and older includes questions related to health insurance coverage. While the CPS is the most frequently used source for rates of uninsurance, it was not originally designed to produce state estimates of uninsurance. As a result, for many states, the sample size is quite small and may include only a limited number of counties for a given state. 21
Page 1 and 2: HRSA State Planning Grants Program:
Page 3 and 4: Introduction The Health Resources a
Page 5 and 6: State Initial Year Funded for Plann
Page 7 and 8: � Premium Assistance: 10 states
Page 9 and 10: Pilot Planning States In 2004, HRSA
Page 11 and 12: State Pilot Grants Award Amount Yea
Page 13 and 14: A critical resource for states’ d
Page 15 and 16: The Planning Grant States The origi
Page 17 and 18: State Policy Environments In order
Page 19: challenges, including low employer
Page 23 and 24: Other national data sources include
Page 25 and 26: groups in the policy making process
Page 27 and 28: State Household Uninsured or Consum
Page 29 and 30: Ketsche, P. "Employment Based Healt
Page 31 and 32: supporting this proposal. The state
Page 33 and 34: 10 employees offered health insuran
Page 35 and 36: State CPS Estimate 2-year average:
Page 37 and 38: and 34 years of age, and one of eve
Page 39 and 40: State Percent of Private-Sector Est
Page 41 and 42: the stigma of public programs, sayi
Page 43 and 44: Modeling and Actuarial Studies Many
Page 45 and 46: Table 3-1 lists the lead agency ide
Page 47 and 48: consumers, businesses, local govern
Page 49 and 50: • The Vermont Ethics Network (VEN
Page 51 and 52: Chapter IV: Policy Options The SPG
Page 53 and 54: Policy Options: Emerging Themes As
Page 55 and 56: For purposes of the following overv
Page 57 and 58: establishment of working committees
Page 59 and 60: • In 2002, Illinois received appr
Page 61 and 62: • New Mexico worked through the G
Page 63 and 64: Options “Off the Table” Some st
Page 65 and 66: • Learn from the experiences of o
Page 67 and 68: • Keep expectations realistic. St
Page 69 and 70: Chapter VI: Recommendations to the
Page 71 and 72:
• Research on public input proces
Page 73 and 74:
an effort to successfully engage st
Page 75 and 76:
Michigan is developing an initiativ
Page 77 and 78:
Commission reflect the same element
Page 79 and 80:
To achieve the reforms that lead to
Page 81 and 82:
whether federal action on the unins
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APPENDICES
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State Cumulative number of new Cove
Page 87 and 88:
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Cumulative number of new Coverage S
Page 91 and 92:
Cumulative number of new Coverage S
Page 93 and 94:
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State New Mexico North Dakota Cumul
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State Virginia None Cumulative numb
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Table B1. Summary of SPG Consumer F
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Table B2. Summary of SPG Employer F
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Table B3. Summary of SPG Household
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Table B4. Summary of SPG Employer S
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Indiana-implement in 2007 Iowa Kent
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Individual Coverage Mandate Conside
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Considered North Dakota South Carol
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Colorado Idaho Massachusetts Minnes
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Buy-in to employees health plan or
Page 201 and 202:
Individual/small market reform Cons
Page 203 and 204:
Implemented Delaware-implemented (s
Page 205 and 206:
Reed, J.A. et al. "International Ap
Page 207 and 208:
Duncan, P. et al. "The Florida Heal
Page 209 and 210:
Economic Analysis of the Effects of
Page 211 and 212:
Commission to Study Maine's Hospita
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Health Economics Program, Minnesota
Page 215 and 216:
Nebraska Carlson, E. et al. "Reacti
Page 217 and 218:
White Paper on Uninsurance in New M
Page 219 and 220:
Oregon Health Policy and Research,
Page 221 and 222:
Sheils, J. et al. "Covering VHAP an
Page 223 and 224:
Richardson, S.K. "Health Insurance
Page 225 and 226:
HRSA STATE PLANNING GRANTS FINAL RE
Page 227:
whether legislation or waivers were
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