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Healthcare is a national crisis, but we can't wait for the federal government to do something about it. States across the nation are taking action, and Washington State should be in the lead.
Almost 600,000 Washington residents lack any health insurance, including 73,000 children. Thousands more are underinsured.
A Broken System
Our healthcare system is based on employers providing coverage, but more than a third of businesses don't offer health insurance to their employees. In Washington State, 73% of the uninsured come from working families.
And the problem isn’t limited to people without insurance -- millions of Americans are underinsured and can find themselves financially devastated when faced with medical problems. Half of all bankruptcy filings in the United States are at least partly the result of medical expenses, even though nearly 70% of those people had insurance.
Even among people with employer provided healthcare, costs are rising sharply. The average employee contribution to company-provided health insurance has increased more than 143 percent since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115 percent during the same period.
This is also a major challenge for businesses, especially small businesses. Among Washington employers that have fewer than 50 employees and offer coverage, the average monthly premium for single coverage increased from $164 in 1998 to $317 in 2004. Many small businesses simply can’t afford to provide coverage to their employees.
States Taking the Lead
Despite widespread acknowledgement that the healthcare crisis is our nation’s most challenging domestic problem, the federal government has done little to address it. It’s been left to states to pioneer innovative solutions, and states are stepping up to the challenge:
- Maine
In 2003, Maine enacted an innovative plan to encourage employers to expand health coverage. Maine’s “Dirigo” plan allows enrollees—mostly individuals and smaller companies—to participate in a buying pool. By lowering and stabilizing insurance rates, participation in the pool offers the benefits of a larger group. The Dirigo plan also expands Medicaid to cover more low-income residents and provides subsidies to middle-income families, using a sliding scale based on ability to pay.
- Maryland
In January 2006, Maryland enacted Fair Share Health Care as a part of its ongoing Health Care for All campaign. The overall plan would require small employers to make a “fair share” contribution—4.5 percent of payroll—in addition to the eight percent for large employers enacted in 2006. Other pieces of the Maryland Health Care for All campaign would expand SCHIP and Medicaid eligibility to trigger federal matching funds, give individuals and families access to group purchasing power through a small group health insurance consortium, and increase the state tobacco tax by 50 cents per pack to raise Medicaid and SCHIP provider reimbursement rates. It would also create a quasi-public insurer to provide comprehensive and affordable benefits.
- Massachusets
In April 2006, Massachusetts enacted a law that requires all residents to obtain health insurance. The Massachusetts plan uses state-funded healthcare expansions, a modest tax on companies that fail to insure their employees, and a self-insurance requirement in order to cover 550,000 uninsured residents.
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