Word: reformative
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...that's not the only issue causing friction among states. Another is the fact that some good deeds will be punished under the health reform measures: states that expanded Medicaid coverage on their own - say, to include low-income childless adults under 65 - will get less federal aid than those that have been stingier with their Medicaid programs...
...State legislatures may have to act to give state commissioners power to enforce the new rules, a process that could be complicated by political squabbling - not to mention the many Republican state legislators who have already said they plan to challenge the constitutionality of federal health reform. But even if states adopted the new federal rules, most state insurance departments would need to bulk up staff at a time when many are experiencing layoffs because of already strapped state budgets. "We would certainly argue that we're cut to the bone right now," says Kevin McCarty, head of Florida...
...Insurance Exchanges Perhaps the least understood aspect of federal health reform is how private insurance would be sold on the open market if and when the legislation becomes law. Under the Senate bill, states would be responsible for creating and running new insurance marketplaces, also known as exchanges. There, individuals and small businesses would purchase private health insurance, receiving federal subsidies if they qualified. The House bill would establish a national exchange, which states could opt out of if they had the capacity to run their...
...some insurance plans to make sure they meet new federal standards. They may have to determine who is eligible for federal subsidies; they may have to build websites to market and rate plans. All that would require expertise and manpower. Massachusetts, which set up an exchange after enacting health reform in 2006, did so quickly and effectively, but Jon Kingsdale, who runs the program, says, "We had a 10% or less uninsurance rate. It's a well-to-do state. It's a progressive employer community. And ... the fact that a Republican governor championed this was a huge advantage...
...Fight for Federal Aid Around the capital, the special deal that Nebraska Senator Ben Nelson got to secure his vital, filibuster-breaking 60th vote for the health care bill is now known as the Cornhusker Kickback. Even as political favors go, it's a whopper: if reform passes, the Federal Government will pay all of Nebraska's new Medicaid costs forever. And it's fueling envy and outrage in the other 49 states. Led by South Carolina's Henry McMaster, the attorneys general of 13 states - 12 Republicans and one Democrat - have signed on to a letter contending the Nelson...