- The Washington Times - Thursday, December 28, 2006

The idea of universal health care may have hit its stride. At a time when a record 46 million Americans are without health insurance and an ineluctable rise in health care costs weakens the ability of U.S. businesses to compete, states are taking steps toward various forms of universal health insurance.

It is in the states, not the federal government, that health care coverage for all is likely to emerge.

“We are far more likely to get to something near universal coverage by an evolutionary process that starts in the states and spreads regionally and eventually to the federal level,” said Ed Haislmaier, a research fellow at the Heritage Foundation, a Washington think tank.

Next year, Maryland, the District, California, Louisiana, Minnesota, Ohio, Wisconsin, Colorado and New Mexico will dovetail the efforts of Massachusetts, Vermont and Maine, which already are attempting universal health care.

“States have been out there as leaders in health care reform,” Laura Tobler, health care policy analyst for the National Conference of State Legislatures, recently told the Associated Press. “Without a federal consensus on how to address the uninsured, states have taken on the responsibility of health care reform.”

It is not an easy gambit. Lawmakers in Maine are discussing new taxes on soda and snack products — on top of increased levies on cigarettes and beer — to fund a universal health care program that has stumbled since 2003.

The health care spotlight will be thrust on Massachusetts next year. The state will attempt to implement the innovative plan of outgoing Gov. Mitt Romney, a Republican who is considering a White House bid. Massachusetts is attempting to force people to buy health insurance. The central element in the plan requires residents who are voluntarily uninsured to buy coverage or face tax penalties.

Because Massachusetts has relatively few uninsured residents — about 10 percent compared with 18 percent nationally — the plan is more feasible there than in other states.

States are using the Massachusetts model to tailor health care reforms to their demographics. For more than a decade, states have largely focused on designing “product solutions,” such as standardized private insurance or state-subsidized benefit plans. Now, they are taking a system-focused approach by restructuring the market for private insurance.

Vermont’s Catamount Health is a state-run program enacted in May that will subsidize the purchase of private insurance. That plan goes into effect in October. In Minnesota, Gov. Tim Pawlenty, a Republican, signaled that he is open to a Massachusetts-style mandate that all residents be insured.

In Maryland, the General Assembly is expected to take on health care after a federal judge invalidated the so-called “fair share” measure, which the Democrat-controlled legislature enacted over the veto of Gov. Robert L. Ehrlich Jr., a Republican. The legislation would have required large employers — specifically Wal-Mart Stores Inc., the only employer that fit the bill’s requirements — to contribute certain amounts toward employee health care benefits.

“I expect that in Washington, D.C., and Maryland there will be legislation introduced in 2007 to provide more insurance coverage,” Mr. Haislmaier said.

Health care runs Fridays. Contact Gregory Lopes at 202/636-4892 or [email protected]washingtontimes.com.

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