Amid Stalled Health Reform Efforts, Advocates Emerge For The State-By-State Approach

Proponents of state-based health reform are saying that the federal stall over a health overhaul is giving states a perfect opportunity to showcase what they can do to solve the health care cost and coverage crisis, The Washington Post reports. "Advocates of a state-by-state approach are invoking welfare reform, which originated in the states, and education, an area in which the federal government goads states to improve but lets them choose their own approaches. Imposing national health-care reform, they argue, ignores local variations in health-care markets and politics." The advocates come from states like Texas, Missouri and many in the South and West. "Supporters of a national approach counter that relying on states would mean accepting the status quo for years to come. A state-by-state approach makes it harder to rein in health costs with systemwide reforms. And cash-strapped states are in no position to launch new initiatives." In California, for instance, a bill to provide universal coverage for that state's residents is being met with a veto promise by Gov. Arnold Schwarzenegger and "health-related proposals in states tend to be narrow, such as requiring coverage for certain conditions. In fact, many states are reducing coverage for low-income residents" (MacGillis, 2/14).