From: Reuters
Published January 25, 2008 02:11 PM

States lead in rush to reform health care

By Carey Gillam

KANSAS CITY, Missouri (Reuters) - Matt Oglevie makes a good living as a self-employed house painter, is healthy and has no family to worry about. But he has been looking for a night job so he can get health insurance.

"I've got to have something. I've gone too long on my luck," said 37-year-old Oglevie.

Like Oglevie, an estimated 47 million Americans gamble daily that they won't suffer a major illness or injury and often go without needed medicine. With rapidly-rising health care costs, the number of uninsured has grown from 43 million in 2006.


U.S. lawmakers have argued over reform plans for years, and the spiraling problem is a hot topic in the 2008 presidential campaign with leading Democrats and Republicans alike acknowledging changes are needed.

But state leaders say they are tired of waiting for answers from Washington and at least a dozen states are trying to pass far-ranging health reforms this year.

"The list is very long of states that have made health reform a policy priority," said Laura Tobler, health policy analyst with the National Conference of State Legislatures.

"It isn't coincidental that the presidential candidates are also talking about health reform," said Tobler. "People on the street are pushing for reform."

Kansas Gov. Kathleen Sebelius, a Democrat, is one of several state-level leaders across the country who this month rolled out a reform proposal. Sebelius called for a $227 million health policy reform plan financed in part by a proposed $61 million increase in taxes on tobacco products.

Like many other states, the Kansas plan would encourage employer-provided health plans and expand existing programs for the poor and children. It would also increase wellness programs, pay physicians more for preventive services, and try to cut costs through standardizing record keeping.


"The states can't wait for the federal government," said Marcia Nielsen, executive director of the Kansas Health Policy Authority. "The issue of rising health care costs are impacting families in their everyday lives. The federal government has really let us down."

Missouri's Republican Gov. Matt Blunt has launched a program to give uninsured people benefits comparable to those offered to state employees. The cost of the coverage is based on income, with a married couple earning $20,000 paying about $85 a month.

In Colorado, where roughly 800,000 are uninsured, workers would receive help from their employers. Low-income residents would receive subsidies to buy private coverage.

In California, Gov. Arnold Schwarzenegger is pushing one of the most aggressive measures -- a $14 billion health plan aimed at covering nearly all of the state's estimated 6.7 million uninsured.

Vermont has already set up a subsidized plan for uninsured residents to try to obtain universal coverage, while Massachusetts in July began requiring residents to have health insurance, while mandating that insurers accept all who apply.

Many factors have contributed to the growing number of uninsured, but experts say chief among them is the decline in employer-sponsored insurance plans that began in a 2001 economic downturn. The trend has left workers shouldering hefty private-pay premiums of hundreds or thousands of dollars a month, or going without.

Paying for health care directly has become increasingly out-of-reach for average Americans as costs for doctor visits, medicine and medical tests continue to outpace inflation and wage increases.

The U.S. Centers for Disease Control and Prevention reported last month that in 2005 19 million people did not get needed prescribed medicine, and 15 million did not get needed medical care due to cost. Health care spending in the United States totaled $2 trillion in 2005, a 7 percent increase from 2004, the CDC said.

(Editing by Maggie Fox and Vicki Allen)

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