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States Seeking Universal Health Coverage

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Four states currently offer insurance to all uninsured adults, and almost half of all states in the nation are aggressively pursuing the issue in light of the upcoming election. A current survey of the national picture offers the following:

Pennsylvania Governor Ed Rendell dedicated much of his recent statewide campaigning to the concept of broadening affordable insurance for all state citizens, the most recent addition to his goal of healthcare reform in the Keystone State. His plan offers initiatives which have been considered by other states, including allowing individuals the opportunity to purchase state-sponsored health insurance from private insurers for less than $300 per month, with low-income workers able to have their premiums subsidized.

Gov. Rendell's plan also would allow employers with 50 or fewer employees to enroll in the plan, which would leave employers with a $130 per month premium per employee. Employees would be able to cover the remainder by themselves or opt for subsidized coverage if they qualify as low-income by the state's standards. Most of the subsidized coverage would be paid for by increases in cigarette taxes and a 3% payroll assessment on businesses not offering employee coverage.

Neighboring Massachusetts, arguably the nation's most progressive state, is in the process of enforcing a 2006 law which mandates (yes, mandates) that all state residents have health insurance. The state will be forced to heavily subsidize such coverage, with the aim of covering 95% of the state's 500,000 uninsured citizens within three years. Part of the plan to enforce the law assigns penalties to citizens who remain voluntarily uninsured — surely to make things much more difficult in practical terms than in political terms.

Out West, a Colorado state commission has been set up to explore the most viable options for establishing universal healthcare; its findings will be due in January.

California Governor Arnold Schwarzenegger, a longtime proponent of universal healthcare, is seeking to pass a bill with the Democratic congress guaranteeing coverage for the state's nearly 7 million uninsured, one of the largest populations of uninsured citizens in the nation.

Jennifer Tolbert, a policy analyst for the Kaiser Commission on Medicaid and the Uninsured in Washington, observed, "There is clearly broad interest across the country and in many states in developing broad strategies to address the problem of the uninsured."

With the recent stall in Washington regarding expanding the State Children's Health Insurance Program, 30 states have had to reconsider how feasible it would be for them to expand coverage without federal backing. Lawmakers have promised a fight to expand coverage, with virtually every major presidential candidate rolling out his or her own health plan, though it seems for now that the impetus for change will have to emerge locally.

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