Word: carefuls
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...Some states that have already tackled substantial health reform could be better positioned than others. Massachusetts, the only state to have enacted universal health-care reform, already has a working exchange and many of the insurance-market reforms called for in federal legislation (such as guaranteeing coverage to anyone who applies and prohibiting premium pricing based on health status). Cantwell based her amendment on a program that already exists in her home state of Washington; called Basic Health Plan, it pools non-Medicaid-eligible low-income residents, steering them into less costly managed-care plans. Critics point out that premiums...
...interest groups like small insurers and health systems. "There's no question that lobbyists win cheaper on the state level," says Len Nichols, a health economist at the New America Foundation. "With a set of [Arkansas] Razorbacks tickets for one weekend and they've got it." (See what health-care reform really means...
...States also may be better at innovating on delivery and payment reform, working with local health-care providers to make care more efficient and affordable. "It's very hard for the feds to experiment," says Rhode Island's Koller. "What we can do much better is work with providers and work with the delivery system...
...Much of the reason Baucus molded his bill to give states more control was to allay concerns of moderate Democrats (and Republican Olympia Snowe) that the Federal Government was inserting itself too deeply into the health-care system. But if the states aren't up to the task, those same politicians could find themselves blamed for health-care reform that doesn't deliver, with less tools than they might have...
...more about health care...