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...potential for such a lack of uniformity across the country has only recently become apparent. Just last week, during the markup of the bill, at least two amendments were tacked on to the legislation giving states further latitude. Senator Maria Cantwell of Washington drafted an amendment that would allow states the option of pooling residents earning 133% to 200% of the federal poverty level into a group outside the exchange. States would get money from federal subsidies that are available to these low-income earners - who wouldn't be poor enough to qualify for Medicaid even under the proposed expanded...
...Going one step further, Oregon Senator Ron Wyden got an amendment passed that would allow states to opt out of parts of federal health reform if they could "provide health-care coverage that is at least as comprehensive" as provided for in the Baucus bill and prove their state proposal "would lower health-care-spending growth, improve the delivery-system performance, provide affordable choices for all its citizens, expand protections against excessive out-of-pocket spending, provide coverage to the same number of uninsured and not increase the federal deficit." Another Finance Committee member, Delaware Senator Thomas Carper, is reportedly...
...much power federal health reform gives to states to manage exchanges - as envisioned in the Baucus bill - is a key element for controlling the cost of private health insurance for individuals and small businesses. "It's not whether they can or can't [establish an exchange]," says Alan Weil, executive director of the National Academy for State Health Policy, a nonpartisan, nonprofit organization. "It's whether they will do it in an active way. An insurance exchange could just be a website that posts products, and you could do that with two people and an IT person...
...risen dramatically since the program launched in the early 1990s, but Cantwell and Baucus say they have been assured informally by the Congressional Budget Office that if states chose to pool residents in this way, the Federal Government would save money. (Read "Baucus Open to Changes in Health-Care Bill...
...Earlier this year, the Connecticut legislature overrode a governor's veto to pass a comprehensive health-reform bill that aims to provide health insurance to 98% of its residents by 2014, in part through the creation of a statewide self-insured health plan. Derek Slap, a spokesman for the president of the state senate, says, "The hope is that it will dovetail very nicely with health reform nationally." Rhode Island, which has some of the most stringent insurance-market regulations in the country, already has guaranteed issue in the small group market (requiring insurers to accept all applicants) and strict...