A Better Direction for Health Reform

---

Policy Focus

A Better Direction for Health Reform RECIPES FOR RATIONAL GOVERNMENT FROM THE INDEPENDENT WOMEN’S FORUM Hadley Heath, Senior Policy Analyst

1\S`

WHAT YOU NEED TO KNOW

=VS\TL5\TILY

T

OL7H[PLU[7YV[LJ[PVUHUK(ɈVYKHISL*HYL(J[HSZVRUV^UHZ 6IHTH*HYLTHZZP]LS`L_WHUKLKNV]LYUTLU[»ZYVSLPUV\YOLHS[O

JHYLZ`Z[LTTPJYVTHUHNPUN[OLWYHJ[PJLZVM[OLPUZ\YHUJLPUK\Z[Y`HUK

05;/0:0::LZOV\SKLUK[OLIPHZ[V^HYKLTWSV`LYZWVUZVYLKPUZ\YHUJLI` HSSV^PUNWLVWSL[VW\YJOHZLHU`PUZ\YHUJLWSHU^P[OWYL[H_KVSSHYZ;OLU [OLTHYRL[^V\SKYLZWVUK[V[OLWYLMLYLUJLZVMTHU`TVYLKLJPZPVUTHRLYZ

6

UV[Q\Z[LTWSV`LYZ :[H[LZZOV\SKHSZVYVSSIHJRJV]LYHNLTHUKH[LZILJH\ZL[OL`Z[PÅL JVTWL[P[PVUHUKYHPZLWYLTP\TZ0UKP]PK\HSZHUKMHTPSPLZRUV^ILZ[^OH[ JV]LYHNL[OL`ULLKUV[[OLNV]LYUTLU[ (UKÄUHSS`PTHNPULT\S[PWS`PUN`V\YOLHS[OPUZ\YHUJLVW[PVUZÄM[`[PTLZ (SSV^PUN[OLW\YJOHZLVMPUZ\YHUJLHJYVZZZ[H[LSPULZ^V\SKKVQ\Z[[OH[ SLHKPUN[VTVYLYVI\Z[JVTWL[P[PVUTVYLVW[PVUZHUKSV^LYWYPJLZ

>/@@6P[OTVYLHUKTVYLKLJPZPVUTHRLYZPU

WVW\SH[PVU[OLWLYJLU[HNLVM(TLYPJHUZ^P[O

[OLTHYRL[PUZ\YHUJLJVTWHUPLZ^V\SKVɈLY

LTWSV`LYZWVUZVYLKPUZ\YHUJLOHZKLJYLHZLK

TVYLKP]LYZLVW[PVUZHUK^V\SKJVTWL[LTVYL

;VKH`[OH[ÄN\YLPZHIV\[WLYJLU[I\[LTWSV`LY

HNNYLZZP]LS`[VJH[LY[OLPYWVSPJPLZ[V[OLKLTHUKZ

Z\Y]L`ZPUKPJH[L[OH[THU`TVYLLTWSV`LYZ^PSS

VMPUKP]PK\HSZHUKMHTPS`\UP[ZUV[VɉJL\UP[Z

KYVWJV]LYHNLZVVU

0UZ[LHKVMI\`PUN`V\YLTWSV`LY»ZWSHU¶[OH[

;OLYLHYLV[OLYWYVISLTZ^P[OLTWSV`LY ZWVUZVYLKPUZ\YHUJL,TWSV`LYZHYLVM[LU YLZWVUZPISLMVYJOVVZPUNHUPUZ\YHUJLWSHUMVYH

WV[LU[PHSS`PUJS\KLZJV]LYHNLMVYZLY]PJLZ`V\KVU»[ ^HU[VYULLK¶`V\JV\SKI\`HSLZZL_WLUZP]LWSHU ;OPZ^V\SKHSZVSHYNLS`ZVS]L[OLWYVISLTVM

SHYNLNYV\WVMLTWSV`LLZ;OPZJVSSLJ[P]LKLJPZPVU

WYLL_PZ[PUNJVUKP[PVUZI`THRPUNP[LHZPLYMVY

THRPUNTLHUZ[OH[TVZ[PUKP]PK\HSZHYLU»[

WLVWSL[VTHPU[HPUJVU[PU\V\ZPUZ\YHUJLJV]LYHNL

JOVVZPUNMYVTH^PKLHYYH`VMVW[PVUZI\[HYL

;OLYLMVYLWVSPJ`THRLYZZOV\SKNP]LPUKP]PK\HS

ZPTWS`HJJLW[PUN^OH[L]LYKLJPZPVU[OLPYIVZZOHZ

THYRL[OLHS[OPUZ\YHUJL[OLZHTL[H_[YLH[TLU[

THKL6M[LUWLVWSL^OV^VYR[VNL[OLYOH]L]LY`

[OH[LTWSV`LYZWVUZVYLKPUZ\YHUJLLUQV`ZHUK IWF Policy Focus, July 2012 Q 3

W\[PUKP]PK\HSZPUJOHYNLVMJOVVZPUN[OLPYV^U

(51), New York (55), Texas (54), Virginia (55),

PUZ\YHUJLWSHU@V\YIVZZKVLZU»[JOVVZL`V\Y

and Washington (53). Another dozen states

H\[VVYOVTLV^ULY»ZPUZ\YHUJL¶^O`ZOV\SKOL

require at least 40 types of mandated coverage.

JOVVZL`V\YOLHS[OPUZ\YHUJL&

State legislatures have enacted a total of 1,961 mandated coverage laws.

9LK\JL:[H[L3L]LS*V]LYHNL4HUKH[LZ 6IHTH*HYLPUJS\KLZHTHUKH[L[OH[

:VTLVM[OLZLTHUKH[LZHYLKV^UYPNO[ZPSS` YLX\PYPUN[LL[V[HSLYZ[VI\`JV]LYHNLMVYHSJVOVSPZT

PUKP]PK\HSZW\YJOHZLHUKTHPU[HPUPUZ\YHUJL

YLOHIPSP[H[PVU[YLH[TLU[VYYLX\PYPUNJV]LYHNLMVY

JV]LYHNL[OH[TLL[ZHUH[PVUHS¸TPUPT\TLZZLU[PHS

HJ\W\UJ[\YLOHPYWPLJLZUH[\YVWH[O`L[J

JV]LYHNL¹YLX\PYLTLU[;OPZWYV]PZPVUPUJYLHZLZ

6MJV\YZLTVYLTHUKH[LKJV]LYHNLZV\UKZ

[OLWYPJLVMPUZ\YHUJLWYLTP\TZHUKZ\IQLJ[Z

OHYTSLZZ^OLU^LJVUZPKLYVUS`[OLILULÄ[I\[

OLHS[OPUZ\YHUJLJV]LYHNL[V[OLWVSP[PJHS[\NVM

LHJOUL^ILULÄ[JVTLZ^P[OHJVZ[:[H[LZ^P[O

^HYVMZWLJPHSPU[LYLZ[Z^OV^PSSÄNO[[VOH]L[OLPY

TVYLTHUKH[LKJV]LYHNLWPLJLZ¶\UZ\YWYPZPUNS`¶

[YLH[TLU[ZJVUZPKLYLK¸LZZLU[PHS¹

OH]LOPNOLYH]LYHNLWYLTP\TZ;VYLK\JLJVZ[ZHUK

0U[OLZHTL^H`HSSZ[H[LZOH]L YLX\PYLTLU[ZMVYTPUPT\TPUZ\YHUJLJV]LYHNL OPSL [OL+LWHY[TLU[VM/LHS[OHUK/\THU:LY]PJLZ OHZWYVTPZLKZVTLÅL_PIPSP[`PUYLHSP[`[OLVUS` ¸ÅL_PIPSP[`¹PZVU[OLZPKLVMTVYLHUKTVYL THUKH[LKJV]LYHNL )\[ZVTLZ[H[LZHYLHSYLHK`^H`HOLHKVM

(SSV^[OL7\YJOHZLVM0UZ\YHUJL (JYVZZ:[H[L3PULZ *\YYLU[S`OLHS[OPUZ\YHUJLSH^ZYLX\PYL[OH[ (TLYPJHUZI\`OLHS[OPUZ\YHUJLPU[OLZ[H[L^OLYL [OL`SP]L:[H[LZHSSZLWHYH[LS`YLN\SH[LOLHS[O

6IHTH*HYLPUTHUKH[PUN^OH[[`WLVMPUZ\YHUJL

PUZ\YHUJLWYV]PKLYZHUKOH]LZLWHYH[LPUZ\YHUJL

WLVWSLT\Z[I\`;OL*H[V0UZ[P[\[LWVPU[ZV\[PU

SPJLUZPUNSH^Z[OH[WYL]LU[WLVWSLMYVTILPUNPU[OL

P[Z.\PKLMVY:[H[L3LNPZSH[VYZ:

ZHTLPUZ\YHUJLWVVS^P[OYLZPKLU[ZVMV[OLYZ[H[LZ

Eleven states require consumers to purchase 50

)\[ZVSVUNHZPUZ\YHUJLJVTWHUPLZHYL

or more types of mandated coverage: California

TVUP[VYLKHUKW\UPZOLKMVYJYPTPUHSHJ[P]P[`IYLHRPUN

(50), Connecticut (51), Maine (53), Maryland

JVU[YHJ[SH^ZMVYL_HTWSL[OLYL»ZUVYLHZVU^O`

(63), Minnesota (64), Nevada (52), New Mexico

WLVWSLZOV\SKU»[ILHSSV^LK[VI\`PUZ\YHUJLHJYVZZ

4 Q To learn more about the Independent Women’s Forum, visit www.iwf.org.

Z[H[LSPULZ0UMHJ[ZVTLZ[H[LZOH]LH[[LTW[LK[V

L_PZ[PUNJVUKP[PVUZ^V\SKILYLZVS]LK9LK\JPUN

HSSV^[OPZI`ZPNUPUNJVTWHJ[Z^P[OLHJOV[OLY^OPJO

THUKH[LZHUKTHYRL[YLZ[YPJ[PVUZ^V\SKHSZVTHRL

OH]LUV[ILLUHWWYV]LKI`*VUNYLZZ

PUZ\YHUJLTVYLHɈVYKHISLHUKNP]LJVUZ\TLYZ

0MPUKP]PK\HSZ^LYLHSSV^LK[VI\`PUZ\YHUJL MYVTV[OLYZ[H[LZ[OL`^V\SKILHISL[VÄUK[OL

TVYLVW[PVUZ >LZOV\SK^VYR[VNL[NV]LYUTLU[V\[VMOLHS[O

SV^LZ[WYPJLZMVY[OLWSHU[OL`^HU[HUK[OL`

JHYLHUKW\[PUKP]PK\HSZPUJOHYNL;OPZÄYZ[TLHUZ

^V\SKWYVIHIS`ÄUK[OPZWSHUPUHZ[H[L^P[OML^LY

YLWLHSPUN6IHTH*HYLHUK[OLUW\YZ\PUNHKPɈLYLU[

THUKH[LKJV]LYHNLSH^Z;OPZ^V\SKTHRL[OL

IL[[LYKPYLJ[PVU[VYLMVYT[OLOLHS[OZ`Z[LT

OLHS[OPUZ\YHUJLTHYRL[TVYLJVTWL[P[P]LHUK ^V\SKM\Y[OLYLUJV\YHNLWVSPJ`THRLYZPUZ[H[LZ ^P[OOLH]`YLN\SH[PVUZ[VYVSSIHJRNV]LYUTLU[ YLX\PYLTLU[ZVUPUZ\YHUJLWVSPJPLZ

Reforming Medicare and Medicaid 4LKPJHYLHUK4LKPJHPKHYLIV[OPUULLKVM ZLYPV\ZYLMVYT;OL`HYLIPNKYP]LYZVMV\YSVUN [LYTUH[PVUHSKLI[WYVISLTZHUKTPSSPVUZVM (TLYPJHUZYLS`VU[OLZLWYVNYHTZMVYOLHS[O

()L[[LY+PYLJ[PVUMVY/LHS[O9LMVYT 6IHTH*HYLOHZUVISLNVHSZ!L_WHUKOLHS[O PUZ\YHUJLJV]LYHNLPTWYV]LHJJLZZ[VJHYL

PUZ\YHUJL;OL`OH]LHWYVMV\UKLɈLJ[VUOV^ V\YOLHS[OJHYLZ`Z[LT^VYRZMVYHSS(TLYPJHUZ PUJS\KPUN[OVZLV\[ZPKLVM[OLWYVNYHTZ *\YYLU[S`WVSPJ`THRLYZ[Y`[VJVU[YVS[OLZL

HUKYLK\JLJVZ[Z/(;@6VTLU»Z-VY\T

Q

5H[PVUHS*LU[LYMVY7VSPJ`(UHS`ZPZ

Q

;OL.HSLU0UZ[P[\[L

HIV\[HWVSP[PJHSWVSPJ`PZZ\LP[^PSSILM\U >YP[LHSL[[LY[V[OLLKP[VY:OV^\WH[SVJHS NV]LYUTLU[TLL[PUNZHUKTHRL`V\YVWPUPVUZ RUV^U.V[VYHSSPLZ)L[[LY`L[VYNHUPaL YHSSPLZ(ML^TV[P]H[LKWLVWSLJHUJOHUNL[OL ^VYSK O Remain Engaged:;VVTHU`NVVKJP[PaLUZ ZLLLSLJ[PVU[PTLHZ[OLVUS`[PTL[OL`ULLK

Talk to Your Friends: /LSW`V\YMYPLUKZHUK

[VWH`H[[LU[PVU[VWVSP[PJZ>LULLKL]LY`

MHTPS`\UKLYZ[HUK[OLZLPTWVY[HU[PZZ\LZ;LSS

VUL[VWH`H[[LU[PVUHUKOVSKLSLJ[LKVɉJPHSZ

[OLTHIV\[^OH[»ZNVPUNVUHUKLUJV\YHNL

HJJV\U[HISL3L[`V\Y9LWYLZLU[H[P]LZRUV^

[OLT[VQVPU`V\PUNL[[PUNPU]VS]LK

`V\YVWPUPVUZ(M[LYHSS[OL`HYLZ\WWVZLK[V

Become a Leader in the Community:

^VYRMVY`V\

.L[HNYV\W[VNL[OLYLHJOTVU[O[V[HSR

()664,5»:-69VTLU»Z-VY\T0>-PZ KLKPJH[LK[VI\PSKPUNZ\WWVY[MVYMYLLTHYRL[ZSPTP[LK NV]LYUTLU[HUKPUKP]PK\HSYLZWVUZPIPSP[` 0>-HUVUWHY[PZHUJYLZLHYJOHUKLK\JH[PVUHS PUZ[P[\[PVUZLLRZ[VJVTIH[[OL[VVJVTTVUWYLZ\TW[PVU [OH[^VTLU^HU[HUKILULÄ[MYVTIPNNV]LYUTLU[HUK I\PSKH^HYLULZZVM[OL^H`Z[OH[^VTLUHYLIL[[LYZLY]LK I`NYLH[LYLJVUVTPJMYLLKVT)`HNNYLZZP]LS`ZLLRPUN LHYULKTLKPHWYV]PKPUNLHZ`[VYLHK[PTLS`W\ISPJH[PVUZ HUKJVTTLU[HY`HUKYLHJOPUNV\[[V[OLW\ISPJ^L ZLLR[VJ\S[P]H[LZ\WWVY[MVY[OLZLPTWVY[HU[WYPUJPWSLZ HUKLUJV\YHNL^VTLU[VQVPU\ZPU^VYRPUN[VYL[\YU[OL JV\U[Y`[VSPTP[LK*VUZ[P[\[PVUHSNV]LYUTLU[ >LYLS`VU[OLZ\WWVY[VMWLVWSLSPRL`V\7SLHZL]PZP[ \ZVUV\Y^LIZP[L^^^P^MVYN[VNL[TVYLPUMVYTH[PVU HUKJVUZPKLYTHRPUNHKVUH[PVU[V0>-

60;/0>- -6336>