SPG synthesis report - State Coverage Initiatives

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State Lead Agency North Carolina Department of Health and Human Services North Dakota Department of Health Oklahoma Health Care Authority Oregon Office for Oregon Health Plan Policy and Research Pennsylvania Governor’s Office of Health Care Reform Puerto Rico University of Puerto Rico, School of Medicine Rhode Island Department of Human Services South Carolina Department of Insurance South Dakota Department of Health Tennessee Department of Commerce and Insurance Texas Department of Insurance Utah Department of Health (Division of Health Care Financing) Vermont Agency of Human Services (Office of Vermont Health Access) Virgin Islands Office of the Governor Virginia Department of Health Washington Office of Financial Management (Governor’s Budget Office) West Virginia Health Care Authority Wisconsin Department of Health and Family Services (Division of Health Care Financing) Wyoming Department of Health Governance Structures Most states and some Governors specifically established a core steering committee complemented by advisory panels with diverse membership to review and recommend coverage options. Examples of these structures include the following: • Arizona established a legislatively-sponsored committee, The Statewide Health Care Insurance Plan Task Force, charged with designing an accessible and affordable health care coverage plan. The Task Force included six legislators from both rural and urban districts, and three representatives appointed by the Governor, one each from the health care provider, consumer advocacy, and business communities. During the first phase of SPG planning, a Technical Advisory Committee composed of representatives from the physician community, insurance companies, hospitals, and relevant state agencies provided guidance and feedback on proposed approaches. • California established the Health Care Options Project (HCOP) designed to meet legislative requirements calling for the examination of options for providing health care coverage to Californians. Decision-making authority was lodged with the Secretary of Health and Human Services, with input and advice from a wide range of experts, state officials, and stakeholders. The Secretary first convened several groups of advisors to provide guidance on the best ways to develop options and the design of the public input process. A cross-section of stakeholders were invited to join a public advisory group, including providers, associations, insurers, health planners, 46
consumers, businesses, local government, and labor interests, as well as legislative staff. The advisory group was charged with providing input to HCOP on selecting health care coverage options to be explored, and organization of a series of five statewide symposia to gain public input, among other tasks. The advisory group also assisted a modeling contractor in discussions of the design and assumptions used for an economic analysis of coverage options. • In Colorado, the Governor’s Office served as the lead agency for the SPG project. The HRSA grant was administered through its Project Management Team, a public/private partnership with private sector representation by the Colorado Coalition for the Medically Underserved. The Coalition was composed of over 150 individuals and organizations representing health care providers, consumers, businesses, government agencies, philanthropic organizations, and others. The governance structure of Colorado’s Project Management Team as well as its Strategic Planning Group represented a bipartisan approach to addressing the issue of the uninsured. • In Maryland, staff from key state agencies and branches involved in issues surrounding the uninsured served on the Health Care Coverage Workgroup, which held facilitated meetings on a regular basis to provide input and feedback. The project was staffed by individuals from the Maryland Department of Health and Mental Hygiene’s Medicaid and Public Health Divisions as well as a large contingent from the Maryland Health Care Commission. The 28-member Workgroup included representatives from the State’s medical provider, insurance, health plan, business, health care advocacy, and health care research communities. To ensure public feedback from as diverse a constituency as possible, the Workgroup held meetings in different areas of the state. • Pennsylvania formed four Advisory Work Panels comprised of approximately 20 members each, with representation from unions, businesses, health care providers, consumers, consumer advocacy organizations, and academia. The panels provided advice on the policy options considered by the states and focused on the following four topic areas: 1) affordable health coverage for small businesses; 2) publicly funded health care coverage; 3) quality; and 4) cost. • In Rhode Island, a Directors’ Health Care Group represented leadership from key state agencies including the Department of Health, the Department of Labor, and the Health Insurance Commissioner who chaired the group. The Directors’ Health Care Coverage Group was supported by five issue groups that handled topics from wellness to health information to state health care purchasing. The state found that the “silos” of state government were a barrier to progress at the beginning of the project but that the creation of the Directors’ Health Care Group greatly facilitated collaboration and integration of efforts across state agencies. Rhode Island also formed a Small Employer Advisory Group, an informal group of employers who provided feedback on insurance affordability and other topics. 47
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 and 20: challenges, including low employer
Page 21 and 22: Chapter II: The Diagnostic Work of
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: Table 3-1 lists the lead agency ide
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
Page 83 and 84: APPENDICES
Page 85 and 86: State Cumulative number of new Cove
Page 89 and 90: Cumulative number of new Coverage S
Page 91 and 92: Cumulative number of new Coverage S
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State Cumulative number of new Cove
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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
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Individual/small market reform Cons
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Implemented Delaware-implemented (s
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Reed, J.A. et al. "International Ap
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Duncan, P. et al. "The Florida Heal
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Economic Analysis of the Effects of
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Commission to Study Maine's Hospita
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Health Economics Program, Minnesota
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Nebraska Carlson, E. et al. "Reacti
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White Paper on Uninsurance in New M
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Oregon Health Policy and Research,
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Sheils, J. et al. "Covering VHAP an
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Richardson, S.K. "Health Insurance
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HRSA STATE PLANNING GRANTS FINAL RE
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whether legislation or waivers were
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SPG synthesis report - State Coverage Initiatives

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