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Expect States to Take Control of Health Reform
By:SWilliams - - 07/09/2010

46 states face budget shortfalls. Can they afford health reform? Read More..


Health Reform, Is Your Company's Plan Grandfathered? Be careful.
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Employers who offer health coverage have many new requirements to understand related to the recently passed Affordable Care Act. Most of the major changes do not become effective until January 1, 2014 particularly given the "grandfathered" status. However, maintaining this status may be more diffic... Read More..


What's Next for ONC's Agenda with EHR's, Certification and more?
By:DWillcutts - - 01/21/2010

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NHIN Re-thought? ONC's Dr. David Blumenthal is re-envisioning
By:DWillcutts - - 01/21/2010

The six year effort by the government to create a National Health Information Network through efforts such as RHIOs is getting a fresh look. Is there practicality coming out of Washington? Or is this another twist in the road to a far off dream? At first glance, having a focus on smaller providers'... Read More..


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Expect States to Take Control of Health Reform

SWilliams - - 07/09/2010

46 states face budget shortfalls. Can they afford health reform?


According to the Center on Budget and Policy Priorities, 46 states face budget shortfalls. With the unemployment rate averaging close to 10% nationwide and economic recovery pacing gingerly, additional spending requirements could devastate an already precarious condition.

For many states, health reform could not have come at a worse time. In the Lyceum newsletter Perspectives, Ed Haislmaier writes:

   

The broad effects of health reform legislation, if implemented as enacted, will be to impose significant new Medicaid costs on state taxpayers, disrupt state health insurance markets and the current coverage of tens of millions of Americans, and usurp state authority. (Read article here.)

In response, states should pursue aggressive strategies that protect their citizens and take control of health reform. Haislmaier, a senior research fellow at the Heritage Foundation in Washington DC, proposes six approaches:

  • Shift non-elderly Medicaid and CHIP enrollees into premium support.
  • Refuse to administer the new federal high-risk pools.
  • Decline federal “premium review” grants.
  • Implement state health insurance market reforms and exchanges based on state, not federal, designs.
  • Insist that federal officials explain publicly how they will administer health reform.
  • Conduct and publicize “benchmark” analyses.

Haislmaier’s article, excerpted from a longer study published on July 1st (read here), could provide an important roadmap for states as they tackle crushing budget deficits. He argues, for example, that states possess an immediate opportunity in designing their own insurance exchanges:

   

By enacting their own insurance market reforms and creating their own exchanges, or similar administrative mechanisms, based on their own designs now, states can make it politically more difficult for federal officials to implement provisions of the new federal legislation (such as minimum federal benefit standards) that will drive up premiums and reduce coverage choices.

Strategically, states should assume one of two scenarios: a new Congress that repeals health reform or a protected fight against implementing the legislation as enacted.

In either case, states would be wise to apply their own reform while they can. If the latter, harsh economic reality will likely force aggressive action, regardless of political intent.

Although few believe the former, political climates can shift quickly. All eyes will focus on the mid-term election.

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