Affiliates get ready! States will be implementing health-care reform

Health reform efforts in Congress are ongoing, and everyday it seems less likely comprehensive legislation will be signed into law by the New Year. Yet there is a lot of confidence on Capitol Hill that a bill will get signed into law as early as January. 

Therefore, most states are gearing up for the implementation of federal health-care reform. Other states have already begun working on their own reform efforts with an eye on lowering health-care costs and finding ways to cover more people with health insurance.

Federal mandates: their impact on states and how you can get involved

When the federal government passes a law, it has to go through a rulemaking process before implementation of the law can occur. The rulemaking process begins in those federal agencies with oversight for the programs impacted by the law.

Then, if the program is to be administered by the states, the state can strengthen the federal rules (but not weaken them).  This strengthening is often done by state rulemaking.

This means once a law is passed, the work must continue.  The rulemaking process (both federal and state) can be critically important as it often determines who is the qualified provider of nutrition and health services, how those services are delivered and how much the providers will be reimbursed.

Health reform at the federal level is broad, but at the same time will have significant impact on the states. The details are often hammered out at the state level.

One health reform proposal in Congress is an appropriation for $23.5 billion in short-term aid to states to help pay for Medicaid costs that have increased resulting from significant rises in unemployment. In addition, both the Senate and the House have proposed allowing insurers to sell health policies across state lines. This is worrisome to some lawmakers who fear some health plans would take advantage of lenient rules in a number of states. This measure could affect you as a health-care professional, because of differing licensure and scope of practice laws in each state.

Another proposal before Congress would give state insurance directors unprecedented powers in deciding which benefits to cover and the cost of health plans that participate the government-run health insurance exchange (a Website that would allow individuals to research and purchase health insurance). If this becomes law ADA members will need to reach out to their state insurance directors and educate them on the benefits of medical nutrition therapy and the services of a registered dietitian.

Taking matters into their own hands

Years ago, recognizing that national health reform was improbable and many years down the line, some states began trying to address health disparities facing their citizens.  As of July, Maine, Massachusetts and Vermont had enacted comprehensive health-care reform providing to what amounts to be universal coverage. Now an additional14 states are moving towards full reform: California, Colorado, Connecticut, Illinois, Iowa, Kansas, Minnesota, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Washington and Wisconsin.

If you live in one of these states, you should be getting involved in the process to ensure nutrition services are included. To learn more about the programs in these states, please visit the Kaiser Family Foundation http://www.kff.org/uninsured/kcmu_statehealthreform.cfm and click on the state you are interested in learning more about.

What you can do to help

The main point is: Health reform is happening at all levels of government.  Reform efforts began in the states and it will end in the states. Your participation as a citizen of your state is key to ensuring RDs and DTRs are properly represented. Regardless of what happens in Congress, the states still retain considerable authority over details of insurance programs.

To learn more about your affiliate’s work in the states please contact your State Policy Representative using ADA’s Leadership Directory or contacting your affiliate office.
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