From Issue
7, May 2007
Following only the war in Iraq, health care issues have become the dominant
public policy concern, (3) according to a recent Gallup poll which shows
that 27 percent––the highest level in more than a year––say health care should be the top priority for the
president and Congress. A majority of Americans say the federal government should guarantee health insurance
to every American, especially children, and are willing to pay higher taxes to do it.(4)
According to a February poll, 60 percent of U.S. adults said they would be willing to pay higher taxes with half saying
they would pay as much as $500 more a year in higher taxes to expand health insurance
access.(5)
The State Children’s Health Insurance Program, SCHIP, created in 1997 as a 10-year,
$40 billion partnership between states and the federal government, has been touted as both a model for what broader health
care initiatives might look like(6) and criticized as an example of a “band-aid” health care
solution.(7) Under SCHIP, the states and the federal government share the cost of coverage,
but states have considerable flexibility in creating their own plans, allowing all 50 states and the District of Columbia to
be largely free to experiment with ways to extend care to children and improve their health, while attempting to contain costs.
The health consequences of a lack of health insurance are prodding a few states to move
toward universal coverage.(8)(9) While some states have adopted
plans for universal health coverage, others are focusing mainly on cost control. California, Massachusetts, and Pennsylvania
are each advancing initiatives to cover the uninsured. In general, the states are working within the health system, tapping
businesses, hospitals, insurers, and workers to pay for expanded health care. Popular proposals include guaranteeing medical
coverage to all children, subsidizing medical insurance at small businesses, and providing tax incentives for businesses and
individuals to make coverage more affordable.
Possible Implications for Kentucky: Affordable,
universally accessible, high-quality health care with an emphasis on prevention has long been one of the most important issues
for Kentuckians, based on a biennial survey conducted by the Kentucky Long-Term Policy Research Center. Yet, the experience of
Maine, a state similar to Kentucky in many respects, reveals the challenges in covering the uninsured. Maine aspired to insure
31,000 of the uninsured by 2005 and all 130,000 of the uninsured by 2009. However, only 18,800 have signed up
for the state coverage to date, partly due to its cost.(10) Clearly, no answer to the
access issue will likely come without long-overdue attention to how much health care costs in the United States.
Contributing Writers Billie S. Dunavent, Michael T. Childress, and Michal Smith-Mello
Sources:
3
Joseph Carroll, galluppoll.com, February 28, 2007.
4
Robin Toner and Janet Elder, The New York Times, March 2, 2007.
5
Kaiser Daily Health Policy Report, kaisernetwork.org, March 2, 2007.
6
Jonathan Walters, Governing, March 2007.
7
Ezekiel J. Emanuel and Victor R. Fuchs, washingtonpost.com, February 7, 2007.
8
Lisa Rein, washingtonpost.com, January 31, 2007.
9
Dennis Cauchon, usatoday.com, January 8, 2007.
10
Pam Belluck, The New York Times, April 30, 2007.
