State Legislators Mobilize to Promote Priorities for Reform

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State Legislators Mobilize to Promote Priorities for Reform

To promote robust health reform and address states' core priorities in the process, state legislators have waged a steady campaign to help maintain grassroots support for reform and advance key priorities.  Now, the same group of state legislators working with Progressive States Network are taking their message directly to lawmakers in Washington DC.

Armed with letters signed by more than 1000 state legislators from all 50 states, a delegation of state legislators, mayors and other civic leaders will converge on Washington DC to bring their message of reform to their congressional colleagues.  These state leaders will also highlight a statement for reform passed at this summer's convention of the National Conference of States Legislatures (NCSL), the body representing every state legislature in the country.  The NCSL convention adopted an amendment to its official health policy statement with the support of 38 states (over 75% of states represented at the convention).  The amendment included the key priorities promoted by the legislator letter, including the creation of a public health insurance option.

The State Leaders' Lobby Day will be held on the Hill on October 13th and 14th where they will meet with leadership and members of the Senate and House.  State legislators will continue their march for reform and share with their congressional colleagues states' priorities for reform (link to current version of lobby priorities), including:

Create a Floor, Not a Ceiling - As with Medicaid and SCHIP, reform ought to create necessary standards of accessibility and affordability for all states while enabling states to go further if they choose. Where federal and state laws intersect, reform should not pre-empt or prevent state laws that provide stronger consumer protections, coverage expansions, and industry and medical standards than what it is enacted by Congress.  Structures should protect states' ability to create a more robust public option than the federal standard.
A Public Option - State legislators are committed to the necessity of a robust public option to provide more choice for Americans and businesses, and create competition in the insurance market. 
Ensure Reform is Sustainable During All Economic Conditions - Because of states' financial vulnerability to economic downturns, the federal government must create a system of counter-cyclical funding so that states have the  necessary financial resources to ensure health care for all is sustainable during downturns.  This is evidenced by the current downturn and declining state revenue, underscoring the need for an extension of the existing enhanced federal match to maintain state health programs. Because reform requires a robust state-federal partnership (governing exchanges, Medicaid expansions, reimbursing providers), reform must provide states with the necessary financial support to implement new programs and achieve the access, cost and quality goals of reform.  States that have already expanded Medicaid to or beyond new mandated levels ought to receive the same level of support as states that have not take similar action.
Ensure Affordability of Coverage - The cost of health care must be limited to an affordable percentage of income for all families.  Through their experience governing Medicaid, SCHIP and other access programs, state legislators understand the difficulty families and small businesses face in affording quality and affordable coverage.
Provide for Shared Responsibility - Government, individuals, the industry, taxpayers and businesses must all equitably participate in reform.  Just as a mandate on all Americans to have insurance is included in the bills in the House and Senate, a similarly robust requirement on employers to contribute to health care for their employees must be included.  Reform must protect the ability of states to set a higher mandate for employer responsibility than the federal floor.
State Flexibility to Implement Reforms Early, Show Results - It's important to immediately demonstrate the positive impact of reform.  Reform should support states that are primed to act early on key reform provisions, including Medicaid expansions with enhanced federal funding, programs to build the health care workforce, and establishing the public option and insurance exchanges. This will help states reinforce public support for reform and maintain public programs financed with state-only funds as states face continued deficits.


Conclusion

Whatever happens this fall on federal health care reform, it will be the start of comprehensive reform, not the end.  As states like Maine, Massachusetts, and Vermont have shown, implementation of reform is the bigger test.  States will need to build on a new federal framework state-by-state and, with that in mind, both legislators and advocates will need to work to assure that state capacity to continue expanding coverage and protecting consumers is strengthened by new federal rules.  In a dynamic and constantly evolving health care system, a vibrant and innovative federal-state partnership will remain the key to expanding quality, affordable health care to all Americans.