A special briefing on health care, “Health Care Reform: Opportunities for New Directions”, was held yesterday at the Legislative Office Building in Hartford. Spectators almost filled the room. Speakers included Congressman Christopher Murphy, 5th District; Joy Johnson Wilson, Health Policy Director for the National Conference of State Legislators; and Enrique Martinez-Vidal, Vice President of State Coverage Initiative for the Robert Wood Johnson Foundation and Academy Health. The briefing was sponsored by the Annie E. Casey Foundation and the Universal Health Care Foundation of Connecticut.
Congressman Murphy thinks there are excellent prospects for reform at the federal level because of the economy, the desire of the American people, and a President who has made health care reform a priority. The downturn in the economy has led more people to see health care reform as urgent, especially as more people are losing their jobs and their employer-sponsored health coverage along with them. Because their constituents see reform as important, this is reflected in Congress. There are different types of health reform plans at the federal level, including single payer, making it easier for groups to combine for the purposes of providing health care, and some type of mandate (either individual or employer).
According to Congressman Murphy, a public plan, which would compete in the private market, would test out a single payer system on a smaller scale. He also said that the work on health care reform that is being done in states like Connecticut is pushing the federal government to take action. When asked about the timetable for reform, Mr. Murphy stated that they are hoping for something by the end of the summer. But to use the reconciliation process, Congress won’t be able to vote until October 15, 2009.
Ms. Johnson Wilson spoke about challenges and opportunities for states, some of which are overlapping. The economy presents a challenge because of limited funding and all of the other problems that come with a recession but an opportunity because it forces us to concentrate on the problem of health care reform and reduce inefficiencies. The American Recovery and Reinvestment Act (ARRA) of 2009 has placed more restrictions on funding than did previous federal economic assistance to states.
On the federal level, some areas of consensus are: the expansion of Medicaid, improving quality, expanded use of health information technology, refocusing on primary care and preventive health, and increasing transparency and accountability. Some of the areas on which there is disagreement are: a public plan option, individual or employer mandates, and changing the tax treatment of health care premiums in the employer-based system. According to Ms. Johnson Wilson, draft bills for health care reform will be available in the next 2-3 weeks. The goal is for the bills to be reviewed on the floor before the recess in August. Congress will have to find offsets for some of the spending on health care.
Enrique Martinez-Vidal gave some examples of insurance market reforms that states are working on, including extending coverage for dependants past the age of 18, eliminating pre-existing condition exclusions when someone is going from one insurance policy to another (including the individual market), and merging the small group and individual markets. Some of the cost containment and quality improvement goals for the states are: an emphasis on preventive care and primary care, care management for chronic illness, health information technology, and value-based purchasing.