If the experiences of other states are any indication, Colorado could have a tough road ahead in its quest for statewide health care reform. With a few exceptions such as Massachusetts and Maine, other states working to implement reforms have been stymied by legislative roadblocks, unfeasible price tags and impotent committees.
In Illinois, lawmakers are in a nearly six-week budget standoff with Democratic Gov. Rod Blagojevich over his insistence on passing major health care reform legislation this year. The state is over a month into the new fiscal year without a budget, primarily because Blagojevich has been fighting with lawmakers over his proposal, Illinois Covered, which would provide near-universal health coverage to uninsured residents. Illinois lawmakers, including many Democrats, have rejected Blagojevich’s proposal as too expensive, but the Governor isn’t backing down. Wisconsin is also without a budget well past the July 1 deadline because of a legislative impasse over health care reform. The state Senate, controlled by Democrats, passed a proposal called Healthy Wisconsin that would provide universal coverage to residents. The Republican-led state Assembly refuses to agree to the $15.2 billion dollar-a-year plan, saying it would require imposing the biggest tax in state history.
In Maryland, another state where covering more of the uninsured is a top priority, health care reform efforts are being held up by a projected budget shortfall. The Maryland Health Care Commission proposed a plan last fall that aimed to provide nearly universal coverage at low cost to the uninsured, but when its $2.5 billion-a-year price tag was announced, lawmakers scoffed. During the ensuing legislative session, Maryland lawmakers tried to implement smaller reforms. But now the state is trying to reconcile a $1.5 billion budget shortfall, which means comprehensive reform is impossible for the time being and health safety net programs could be cut.
In Colorado, health care reform advocates have all eyes on the state’s 208 Commission, which was created by the Legislature last year with the charge of finding ways to reduce health costs and cover more of the uninsured. While the commission is the most serious step Colorado has taken towards health care reform in recent years and watchers remain hopeful, similar study groups in other states have been duds.
Louisiana Gov. Kathleen Blanco initiated a Governor’s Health Care Reform Panel in 2004 with the goal of studying Louisiana’s health care system and making recommendations for change. When the panel disbanded two years later, many reform advocates were disappointed. While small changes had been made, Louisiana’s major health care problems remained.
But unlike the Louisiana panel, Colorado’s 208 Commission has a prescribed timetable. The group is now studying four proposals for comprehensive health care reform and will likely develop a fifth composite proposal that will be presented to the Legislature in January. It remains to be seen whether Commissioners will back comprehensive reform or patchwork solutions. But if lawmakers are presented with a sweeping reform proposal, they have the challenge of getting it passed. And as seen in other states, that’s not always easy.