Maine studies prospects for state reform efforts while N.Y. experience shows impact of guaranteeing access to coverage

In Maine, insurance regulators say measures aimed at expanding health coverage to more people in that state should wait for final action in Congress, The Associated Press/WBZ reports. A Maine report "released last week, stems from a 2009 law that asks the superintendent to review ways to improve the availability and affordability of Maine's individual health insurance market." In the report, the authors write that Maine's options to expand access and make coverage more affordable will depend on what Congress does. "Citing census data, the report says Maine has an uninsured rate of 9.6 percent, the sixth lowest in the nation and well below the national average of 15.4 percent. A recent public opinion survey by a Portland firm puts the state rate at 11 percent" (Adams, 2/20). 

Los Angeles Times: New York's experience in trying to help the uninsured "offers a cautionary tale: Making isolated changes to the complex medical insurance system can have unwelcome consequences." After New York passed a law requiring health insurers to cover all applicants regardless of pre-existing condition, premiums went up significantly and "are now the highest in the nation by some measures, with individual health coverage costing about $9,000 a year on average. And nearly one in seven New Yorkers still lacks health coverage, a greater proportion than before the law was passed." So-called guaranteed issue provisions "became popular in the early 1990s, as states including New Jersey and Washington contended with insurance companies that were denying coverage to people with preexisting health problems. New York went further, becoming the first state to also include a 'pure community rating' requirement that prohibited insurers from varying premiums based on customers' age or health, another common industry practice." Individual market premiums have nearly tripled since 2001 in New York (Levey, 2/21). 

Los Angeles Times, in a separate story: Beverage lobbyists who fought against inclusion of a soda tax to help pay for health reform are now facing a similar fight on the state level as states individually consider their own taxes on sugary, high-calories beverages to make up for shrinking budgets. "The next showdown could be in California, where legislators last week pledged to pass such a tax in light of new studies linking soft drink consumption to obesity in children and adults. One study suggests that obesity and related problems cost California alone $41 billion a year in medical expenses and reduced productivity." Twelve states in the past year have altered the tax treatment of soft drinks. "Nonetheless, Kevin Keane, a senior vice president for the American Beverage Assn., called the tax idea a 'money grab' that would hurt working families." (Geiger and Hamburger, 2/22).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.