While the federal government still has a great deal on
its plate in terms of implementing health reform (we at CCF are eagerly
awaiting every bit of guidance and regulation CMS can throw at us!), many key
tasks now move to the states.
Should we set up a new high-risk pool? What should our
exchange look like? Who should run it? How do the new insurance reforms
interact with our current protections? To help sort through all these
complicated and intertwined issues, seven states have set up commissions,
advisory councils, or offices of health reform to take a look at their options
and help guide implementation.
Connecticut was first out of the box, with the Governor
establishing a 15-member board (the Connecticut Health Care Reform Advisory
Board) way back in July. Since then, Colorado, Maryland, Michigan, Washington,
and Wisconsin have stepped forward. And, just last week, the Governor of Maine
signed an executive order establishing the Health Reform Implementation
These commissions/offices are comprised of agency heads
(like the Secretary of Health and Human Services and the Insurance
Commissioner) and sometimes include other interested parties (such as representatives
of the hospital industry). While none include a consumer or advocate voice on
the panel itself, most provide some sort of mechanism for public comment. Take
Colorado as an example – where the board can establish task forces that include
outside groups, including consumer advocates.
As health reform moves toward implementation, it’s
important to keep tabs on what your state is doing. Have they established a
commission? Are consumers and advocates represented on these boards? If not, is
there a way to expand representation or does the public have another outlet to
Depending on the state, these commissions may yield a
great deal of power in influencing what reform looks like. It’s important that
all voices are heard in the process.
If you want more details on the various commissions and
links to the executive orders, check out RWJF’s State Coverage Initiatives’
States Take Different Approaches to Respond to Federal Health Reform.)