Health care issues were central in the governors' "state of the state" addresses this year, as states continue to grapple with increasing numbers of uninsured residents, rising health costs, and an economy facing recession. The following themes and plans emerged from a review of 26 governors' addresses given in January 2008. [1]
Expanding Coverage to Children: Several governors, including those from Arizona, Colorado, Georgia, Iowa, New York, and Vermont, discussed plans to expand access to SCHIP or make coverage more accessible for children in other ways, such as allowing them to be covered by their parents' health insurance up to age 25. Another initiative is the Arizona KidsShare program, which would allow parents to purchase coverage from the health plans that participate in KidsCare, the state's SCHIP program, at the same cost as SCHIP enrollees, but without any subsidy from the government.
Making Coverage Accessible for Small Business: Governors in Georgia, Iowa, Mississippi, and South Carolina discussed initiatives designed to make health coverage more affordable for small businesses to offer to their employees. Governor Purdue of Georgia, for example, announced that the state will invest $17 million in the Health Insurance Partnership program, which assists small businesses in purchasing insurance for their employees. In Iowa, Governor Culver expressed support for the development of purchasing pools to help small businesses and associations purchase coverage at more affordable large group prices. And in Mississippi, Governor Barber proposed the creation of a state health insurance exchange that would help small business employees purchase private coverage, using state funding for initial operating costs.
Universal Coverage: Over the past year, many states tried to move toward universal coverage, often as an extension of expanding coverage to children. This year, governors of Colorado, Maryland, Missouri, New Mexico, California, and Wisconsin reiterated the need to cement the work done last year—through commissions and task forces, economic modeling, stakeholder meetings, legislative proposals, and other efforts—and continue down this road.
Prevention, Wellness, and Disease Management: Many states continue to look toward disease prevention and management of chronic conditions as strategies to improve the health outcomes of their citizens and contain costs. Governors in Colorado, Delaware, Iowa, Nebraska, Rhode Island, and Vermont spoke of developing disease management programs, supporting smoking cessation initiatives, and battling obesity among adults and children.
Health Information Technology: A number of states, including Idaho, Iowa, Maryland, Nebraska, New Mexico, New York, Rhode Island, Vermont, and Washington, plan to develop HIT systems to improve communication among providers and patients. For example, Governor Richardson of New Mexico discussed the need to shift from paper to electronic medical records within the context of reforms that would make the delivery system function more efficiently and improve access to coverage. Governor Gregoire of Washington urged legislators to approve an online database that would allow physicians and pharmacists to track patients' prescriptions in order to improve medication safety.
Access to Prescription Drugs: Several governors discussed initiatives to make prescription drugs more affordable and accessible for their constituents. Governor Manchin of West Virginia announced the creation of the WVRx program. Beginning in March, the program will provide free prescriptions to uninsured, employed individuals, using supplies donated by manufacturers. In Maine, Governor Baldacci proposed that a purchasing pool be created among three state employee groups, in order to leverage their purchasing power to lower prescription drug costs.
In addition to the above issues, governors spoke of reducing health disparities, reforming long-term care, and expanding public reporting of health care cost and quality information.
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Reference
[1] The states reviewed for this summary were: Alaska, Arizona, California, Colorado, Delaware, Georgia, Idaho, Iowa, Kentucky, Maine, Maryland, Massachusetts, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, Rhode Island, South Carolina, South Dakota, Vermont, Virginia, Washington, West Virginia, and Wisconsin.
