On February 1, 2008, SCI, through the Robert Wood Johnson Foundation, awarded development grants to eight states —Arkansas, Kansas, Maryland, Minnesota, New Mexico, Oklahoma, Oregon, and Wisconsin—participating in the Coverage Institute. The primary goal of these grants is to further assist states in the development and refinement of their health care reform plans.
The Coverage Institute, a new technical assistance program, was unveiled in 2007 to help states focusing on substantial and comprehensive care health reform and to develop the capacity of state officials to understand the implications of different programmatic decisions and how those may impact the existing system. Fourteen states were selected to participate in the Institute. Participating states were then eligible to apply for additional funding for options development/micro-simulation modeling or other reform development activities.
The awarded development grants support a variety of activities that can promote the advancement of these states’ health reform plans:
Arkansas: Primarily, funds will provide technical assistance and logistical support to the Governor’s Health Care Roundtable, which is a newly-convened expert panel tasked with developing the Arkansas Health Care Plan.
Kansas: The Kansas Health Policy Authority Board recently completed a slate of 21 recommendations designed to address the rising cost of health care and promote access to affordable health insurance. Kansas will use funds to further refine their proposals related to the individual and small group market. They will convene a stakeholder advisory group, collect data on sole proprietors and micro-firms, and consult with experts. In addition, they will map the chronic disease burden in Kansas and develop recommendations for better care coordination.
Maryland: Maryland has recently passed coverage expansion legislation that will expand Medicaid eligibility and make small business market reforms. Funds will go to support implementation of this legislation. Tasks include: 1) conducting outreach about the new programs through a public-private partnership; 2) hiring a consultant to help with small business subsidy program design; 3) workshops for small business owners about Section 125 tax benefits and other aspects of the small business insurance program; 4) research and analysis to support the work of the Maryland Health Quality and Cost Containment Council; 5) working with a consultant who will facilitate a collaborative process designed streamline Medicaid eligibility and enrollment.
Minnesota: The Governor’s Health Transformation Task Force is working to produce a health reform plan to present to the 2008 legislature. The goals of the task force are to: 1) reduce spending; 2) achieve universal coverage; 3) promote quality; 4) reduce the burden of chronic disease; and 5) achieve administrative efficiency. Funds will be used to provide additional modeling of proposals related to private market reforms, consultant services for an expert in payment reform, and staff project support.
New Mexico: New Mexico is nearing completion of a three-year policy-development process which has resulted in a proposal called HealthSOLUTIONS New Mexico. This plan includes: 1) insurance market reforms; 2) a phased-in coverage participation requirement for individuals and employers; 3) a transition to electronic claims and medical records; and 4) the creation of a Health Coverage Authority to implement the plan. They will use development funds to do modeling of the coverage expansion proposals described above and for staff support.
Oklahoma: Funds will help support the work of the newly-created Oklahoma Health Institute (OHI), which will be charged with developing a plan for health reform. The coverage-related work by the OHI will include population analysis, community meetings, surveys on “willingness to pay,” and a communications strategy designed to engage and educate the public about reform proposals.
Oregon: The state legislature in Oregon has tasked the Oregon Health Fund Board with developing a plan for universal health coverage. A proposal is due for the 2009 legislative session. Funds will pay for an actuary to assess the cost for a basic benefit package for the uninsured. In addition, Oregon will contract for a study of the impact of private market reforms, including employer requirements, a connector or health insurance exchange, and Section 125 plans. Funds will also be used to cover a communications plan that will include internal communications between the administration and the legislature, gathering stakeholder input, and community messaging.
Wisconsin: Wisconsin’s Governor has proposed a plan to cover 98 percent of Wisconsin residents; most of the plan has passed the legislature. This reform includes an expansion of BadgetCare (the state’s Medicaid program) to include all children (those above 200 percent of the federal poverty level pay a sliding-scale premium). The plan also approves the application for a waiver to include childless adults in BadgerCare. The second phase of the proposed plan relates to private market reforms. The bulk of the funding for Wisconsin will pay for consulting services to assess the impact of proposed private market reforms. These include merging the individual and small group markets; increased insurance regulation, particularly guarantee issue and community rating; and, the addition of a connector.
Additionally, two states – Colorado and New Jersey – were awarded options development/micro-simulation modeling grants. Both states will be working with a team from the Urban Institute to develop specific policy options, to delineate a finite number of policy options that will be modeled using a micro-simulation model, and to better understand other key design and implementation issues.
