Reimagining Federal and
State Roles in Health Care
Reform
AcademyHealth
National Health Policy Conference
Secretary John M. Colmers, DHMH
February 9, 2010
Immediate Focus
• States need continued ARRA support to
get through FY 2011
– Maintenance of Effort and FMAP
– Appears to enjoy bipartisan support
• Budget picture remains challenging
– Maryland budget reductions
• GF lower in FY11 than in FY07
– Health programs are significant portion of
overall budget
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One State’s View of Reform
• Although not perfect, federal legislation would
would do what most states cannot
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Expand Medicaid across the board to childless adults
Require health insurance coverage
Establish subsidies
Eliminate medical underwriting
• Offered numerous opportunities for states to
address other parts of reform
– Cost containment
– Quality and delivery system reform
– Realignment of programs funding uninsured
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States Cannot Wait
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HIT Infrastructure
Medicaid reforms
Small group and individual market reforms
Payment reforms
All payer demonstrations
Delivery system reforms
Malpractice and medical liability reform
Manpower issues
Etc., etc., etc.
What’s Next?
• Continue to press for national reforms
• Prepare for incremental change
• Status quo remains bleak
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