In the States

IN THE STATES: Sun, Sand and Employer Mandates in Hawaii

October 19, 2009

Hawaii is a popular destination for anyone seeking sun, sand, surf, or even volcanoes. It's also a top spot for affordable health care coverage.

As The New York Times reported this weekend, Hawaii has the lowest Medicare costs per beneficiary and is tied with North Dakota for the nation's lowest health care premiums. People in Hawaii also tend to live longer than those elsewhere in the United States. As we've mentioned before, Hawaii ranks as one of the top states when looking at health indicators that represent health care access, quality, costs, prevention and treatment, equity and health outcomes.

There are many different theories as to what causes relative health and longevity in Hawaii's population. April Donahue, executive director of the Hawaii Medical Association, told American Medical News Hawaii's population typically has a healthy diet. The Times interviewed a number of doctors and hospitals, and found answers ranging from an active population to a significant military presence to dominance by just a few non-profit insurers in the market.

IN THE STATES: Big Variations In Quality and Access

October 9, 2009

Earlier this week, we looked at insurance coverage on a state by state (or more precisely -- district by district) level.

IN THE STATES: Pay for Performance in Medicaid

October 1, 2009

We've written often about misaligned incentives in the US health care system -- we pay for quantity of care instead of paying for quality.

IN THE STATES: North Star State Shines Bright for Health Reform

September 18, 2009

We're always looking for real-life examples of low-cost, high-quality care. Minnesota is a good place to look, and the state's largest health plan is a good place to start.

IN THE STATES: Indiana Leads the Way on Prevention

September 11, 2009

We all know you can earn rewards for frequent flying. But what about for routine trips to your doctor?

Emphasizing primary care and preventive services is a key goal of health reform and many contend the savings from such programs can help finance a health care overhaul (and make us a healthier country). Yet, the details of how these savings might be realized are less clear.

IN THE STATES: Massachusetts Health Reforms Are Bold, But Will They Succeed?

August 10, 2009

With Congress on its summer break, it seems like a good time to take a look at what's going on in Massachusetts. The state is covering 97 percent of its people. Costs remain a challenge -- but Massachusetts is moving diligently and creatively toward solutions.

The New York Times noted in an editorial this Sunday:

IN THE STATES: Deep Health Care Cuts On California Horizon

May 28, 2009

The California Healthline gives us a disturbing wrap up of how the state's fiscal crisis is going to affect how Californians access health care.

IN THE STATES: Update: PA Extends Health Coverage for Young Adults

May 13, 2009

Big news for college grads from Pennsylvania—the PA State House and Senate have both passed a bill that would allow young adults to stay on their parents' insurance all the way up until age 30. To qualify for coverage under the proposed law, the individual must be a resident of Pennsylvania or a full-time student with no spouse and no dependents. A spokesperson for Pennsylvania Gov. Ed Rendell told the Philadelphia Inquirer that he supports the bill and plans to sign it into law soon.

As I mentioned yesterday, I too am a freshly-minted college graduate... from Pennsylvania. My internship at the New America Foundation has been an awesome experience, but I'm still looking for a job that will provide me with that mythical goal of all graduates: a salary and benefits. I've spent a lot of my time thinking, talking and writing about health reform during this past semester, so it's pretty cool to have it work in my favor.

IN THE STATES: Maine’s Cost Drivers: The Same, Only More So

May 1, 2009

For years, Maine has been unwilling to wait for the federal government to tackle the crisis of health care. And with good reason: though Maine has one of the lowest rates of uninsurance, it has some of the most expensive health care in the country. One-third of the state budget goes to SCHIP/Medicaid (the highest rate in the country, the state has the highest employer contribution to the cost of employer-based insurance, and the third-highest per capita health care costs. Not surprisingly, the cost drivers that make Maine's health care so expensive are the same as those that afflict the national as a whole, according to a new report by a state advisory group.

In 2003, the Maine Legislature passed far-reaching legislation to tackle coverage and costs—including the creation of the Dirigo Health insurance program—that included aggressive collection of data that had not previously been available. Maine's Advisory Council on Health Systems Development outlined problems and proposed solutions that will look familiar to those who've followed the health reform debate at the national level.

IN THE STATES: Colorado Expands Coverage and Hospital Care

April 23, 2009

In what's been hailed as the most significant health legislation in Colorado in some 40 years, Colorado has a new law that will help cover up to 100,000 uninsured people and reduce some of the uncompensated care and cost-shifting that hurts the state's health care system and raises costs for people who are insured. It's an impressive achievement in a time of great economic pressure—one that we hope the folks here in Washington notice.

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