Word: states
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Dates: during 2000-2009
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...over same-sex marriage has rolled from state to state, almost always stoking fierce debate and bitter acrimony. On Tuesday, Washington, D.C., became the battlefield when council member David Catania, an at-large independent, introduced legislation that would make the nation's capital the latest jurisdiction where gays and lesbians could legally wed, and the only one south of the Mason-Dixon Line...
...While governors are primarily focused on how their already hurting state budgets could be strained by the expansion of the Medicaid program that is proposed in all the health bills, there are other key responsibilities that could fall to them under the Baucus bill. Most important, the all-important exchanges - Web-accessible marketplaces in which individuals and small groups could compare and shop for private insurance - would be established state by state. By contrast, the House bill would create a national exchange. Instead of a national public insurance plan - the controversial "public option" that is included in both the Senate...
...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...
...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...