A federalist approach to health reform: The worst way, except for all the others

Health Affairs

Volumn 27, Issue 3, 2008, Pages 725-735

  Aaron, Henry J ^a   Butler, Stuart M ^b  

^a BROOKINGS INSTITUTION   (United States)

^b Heritage Foundation   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ELECTION; FUNDING; GOVERNMENT; HEALTH CARE POLICY; HEALTH INSURANCE; LAW; POLITICS; REVIEW; UNITED STATES;

FEDERAL GOVERNMENT; FINANCING, GOVERNMENT; GOVERNMENT REGULATION; HEALTH CARE REFORM; INSURANCE, HEALTH; STATE HEALTH PLANS; UNITED STATES;

EID: 44449121853     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.27.3.725     Document Type: Review

References (15)

1. On the proportion of the population uninsured by state, see U.S. Census Bureau, Current Population Survey, 2005 to 2007 Annual Social and Economic Supplements, "Percentage of People without Health Insurance Coverage by State Using 2- and 3-Year Averages: 2004 to 2006," http://www.census.gov/ hhes/www/hlthins/hlthin06/percent_uninsured_state.xls (accessed 27 February 2008).
2. On per capita expenditures by state, see A.B. Martin et al., "Health Spending by State of Residence, 1991-2004," Health Affairs 26, no. 6 (2007): w651-w663 (published online 18 September 2007; 10.1377/hlthaff.26.6. w651).
3. On regional variation in use of services, see Dartmouth Atlas of Health Care, http://www.dartmouthatlas.org (accessed 27 February 2008).
4. H.J. Aaron and S.M. Butler, "How Federalism Could Spur Bipartisan Action on the Uninsured," Health Affairs 23 (2004): w168-w178 (published online 31 March 2004, 10.1377/hlthaff.w4.168).
5. The descriptions of state initiatives are drawn from recent developments and from M. Voris, "Leading the Way: State Health Reform Initiatives," NGA Issue Brief (Washington: National Governors Association Center for Best Practices, 11 July 2007).
6. For an estimate of U.S. health expenditures, see S. Keehan et al., "Health Spending Projections through 2017: The Baby-Boom Generation Is Coming to Medicare," Health Affairs 27, no. 2 (2008): w145-w155 (published online 26 February 2008; 10.1377/hlthaff.27.2.w145).
7. For an estimate of the GDP of the United Kingdom and France, see Organization for Economic Cooperation and Development, OECD in Figures: 2007 Edition, http://titania.sourceoecd.org/pdf/figures_2007/en/oif.pdf (accessed 27 February 2008).
8. For more details on how state plans could be constructed and approved, see Aaron and Butler, "How Federalism Could Spur Bipartisan Action."
9. Each of the three draft bills introduced in Congress proposes such procedures. See, for example, S 325, the Health Partnership Act, cosponsored by Sen. Jeff Bingaman (D-NM), Sen. George Voinovich (R-OH), and Sen. Sherrod Brown (D-OH).
10. In addition to the bill cited above, the two other bills are HR 506, sponsored by Rep. Tammy Baldwin (DWI) with twenty-seven cosponsors; and S 1169, sponsored by Sen. Russell Feingold (D-WI), Sen. Lindsey Graham (R-SC), and Senator Brown.
11. One bill, cosponsored by Senators Feingold and Graham, would have appropriated $3 billion a year to assist states whose plans were approved. Another bill, cosponsored by Representatives Baldwin and Price, stipulated that state plans should not increase federal spending. And a third, cosponsored by Senators Bingaman, Voinovich, and Brown was silent on this issue.
12. The Baldwin legislation allows some averaging over time, as it requires budget-neutrality over five years rather than annually.
13. E.F. Haislmaier and N. Owcharenko, "The Massachusetts Approach: A New Way to Restructure State Health Insurance Markets and Public Programs," Health Affairs 25, no. 6 (2006): 1580-1590.
14. Henry J. Kaiser Family Foundation/Health Research and Educational Trust, Employer Health Benefits: 2007 Annual Survey, Exhibit 10.1, p. 164, September 2007, http://www.kff.org/insurance/7672/index.cfm (accessed 31 January 2008).
15. The data refer to the average for the two years 2005-2006. Kaiser Family Foundation, StateHealthFacts.Org, "Health Insurance Coverage of Nonelderly 0-64, states (2005-2006), U.S. (2006)," http://www.statehealthfacts.org/ comparebar.jsp?ind=126&cat=3 (accessed 30 January 2008).