Raymond Scheppach, longtime director of the National Governors
Association (1983-2011) and a former deputy CBO director, is an expert
on the role of the states in the formulation and
implementation of public policy. Currently a professor at the
University of Virginia, he recently served as project director for a
report, Cracking the Code on Health Care Costs,
produced under the auspices of UVA's Miller Center by a State Health
Care Cost Containment Commission co-chaired
by Michael Leavitt, former Republican Governor of Utah and HHS Secretary
under George W. Bush (interviewed here), and Bill Ritter, former Democratic governor of Colorado.
The report highlights the power of state governments to shape healthcare policy, given their roles administering Medicaid, state employee benefits, and now the health insurance marketplaces established by the Affordable Care Act. It calls on states to set targets for health care spending; promote various forms of managed care, ACOs and alternatives to fee-for-service medicine in the programs it administers; and help consumers generate competition by reporting cost and quality information about health care providers and insurers.
I spoke to Dr. Scheppach, now a professor of public policy at UVA, about current and likely future state-level healthcare reform efforts.
Scheppach noted at the outset that state governments administer or oversee health insurance for a large swath of the U.S. population -- with more to come as the ACA exchanges and Medicaid expansion matures. "If you add it all together, in another year or two, there will be about 75 million people in Medicaid, another 3-5 million in state and local government employees' health plans, and then there's the exchanges." (CBO projections envision 25 million ACA exchange customers by 2018.)
The report highlights the power of state governments to shape healthcare policy, given their roles administering Medicaid, state employee benefits, and now the health insurance marketplaces established by the Affordable Care Act. It calls on states to set targets for health care spending; promote various forms of managed care, ACOs and alternatives to fee-for-service medicine in the programs it administers; and help consumers generate competition by reporting cost and quality information about health care providers and insurers.
I spoke to Dr. Scheppach, now a professor of public policy at UVA, about current and likely future state-level healthcare reform efforts.
Scheppach noted at the outset that state governments administer or oversee health insurance for a large swath of the U.S. population -- with more to come as the ACA exchanges and Medicaid expansion matures. "If you add it all together, in another year or two, there will be about 75 million people in Medicaid, another 3-5 million in state and local government employees' health plans, and then there's the exchanges." (CBO projections envision 25 million ACA exchange customers by 2018.)
