Washington Health Policy Week in Review
Bipartisan Bill Aims to Allow States to Test Different Health Coverage Plans

By Kate Barrett, CQ Staff

SEPTEMBER 6, 2006 -- Georgia Republican Tom Price and Wisconsin Democrat Tammy Baldwin on Wednesday implored staffers from both sides of the aisle to back a House bill to allow states to act as laboratories where lawmakers could test methods to reduce the number of uninsured Americans.

In a rare joint event, advocates from the conservative Heritage Foundation and the left-leaning Brookings Institution joined the lawmakers to make the case for HR 5864.

The bill, introduced by Price and Baldwin in July, would allow states to propose health care coverage plans to a newly created commission, which would in turn compile a slate of proposals and submit them to Congress for expedited consideration.

The bill contains a budget neutral provision, requiring that the slate of programs have no net cost beyond the five-year grant appropriation.

Price, an orthopedic surgeon, said that with 46 million Americans uninsured, the bill "breaks the logjam, tests rival plans, and expands coverage to folks across the nation."

"The whole system is much too political," he said.

Stuart Butler, vice president for domestic and economic policy studies at the Heritage Foundation, said the bill is "designed specifically for a situation where there is disagreement."

Indeed, while Baldwin has long advocated a single-payer approach, Price immediately said Wednesday that he was "adamantly opposed" to such a system. The lawmakers agreed, however, that the best way to figure out which method works best would be to see them play out at the state level.

"I'm so confident in the outcome of this that I don't mind if Wisconsin, for example, wants to go headlong off the cliff," Price joked.

Henry Aaron, senior fellow in economics at the Brookings Institution, called the effort "refreshing beyond words."

Under the measure, state proposals could be statewide, multi-state, or limited to certain regions. States could propose federal waivers to the commission as well, which would be comprised of 19 members, including the Secretary of the Department of Health and Human Services and selected appointees from the state and federal level.

Baldwin said the National Governor's Association has been involved in crafting HR 5864, which currently awaits consideration in the House Energy and Commerce Committee.

With time running out in the 109th Congress, Price and Baldwin do not necessarily expect Congress to pass HR 5864 this year, and plan to reintroduce the bill again next session if needed.

"The most pragmatic approach for the balance of the session was to educate our colleagues," said Baldwin, who serves on the Energy and Commerce panel. That way, come January, she explained, "We could hit the ground running no matter who's in charge."

In the Senate, George V. Voinovich, R-Ohio, and Jeff Bingaman, D-N.M., in May introduced S 2772, which would create a similar commission.

Among a handful of differences, the Senate bill does not contain the budget neutrality provision the House bill requires.


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