“Creative Federalism” Could Break Gridlock & Cover the Uninsured
Seeking to break the gridlock in Congress, Congresswoman Tammy Baldwin, joined by three other Members of the House of Representatives, has introduced The Health Partnership through Creative Federalism Act, (H.R. 5864), a bipartisan health care reform bill that will empower states, with federal support, to develop creative methods to cover their uninsured residents, which now number more than 45 million Americans.
The Health Partnership Through Creative Federalism Act introduced Monday by Rep. Baldwin and co-sponsored by Reps. Tom Price (R-GA), John Tierney (D-MA), and Bob Beauprez (R-CO) will allow states to submit proposals to a bipartisan commission to garner federal grants to expand healthcare coverage and access in their state. The Commission, which is made up of local, state and federal appointees, then approves a group of proposals and submits them to Congress for approval. The bill contains a budget neutrality provision that requires the funded programs to have no combined net cost during their five-year operation.
Recognizing that one size does not fit all, Reps. Baldwin, Price, Tierney, and Beauprez, hope their "creative federalism" and their bipartisan approach will break the gridlock that impedes progress in solving this critical national problem.
Baldwin produced the legislation after working over a period of several years with her colleagues and others from across the political spectrum, including policy advisors from the Heritage Foundation, the Brookings Institution, the National Governors Association, and the Economic and Social Research Institute (ESRI) in their effort to engage in fruitful, honest, bipartisan dialogue.
"Health care reform should be one of our highest national priorities," said Baldwin who has made health care for all her paramount concern. "I'm proud of the progress my colleagues and I have made and, working together, I'm hopeful that our goals can be achieved," she said.
"Congress should actively work to solve big challenges - those without health insurance is one such challenge. However, one-size-fits-all doesn't work for healthcare. Our bipartisan working group respects greatly the principle of federalism and, together, we look forward to tackling this issue in a way that will empower states to develop methods that best suit their unique populations," said Congressman Price who is also a physician.
"As the reported number of uninsured Americans rises to staggering levels, we must find ways to work together and find a comprehensive solution so that we can turn around this healthcare crisis by implementing innovative solutions to this problem," said Congressman Tierney.
"I am extremely pleased that we were able to come together in bipartisan spirit and work together to address this critical problem," said Beauprez. "By allowing the states flexibility to create better access to much needed health care services, we will be taking the first step in solving the current crisis in health care," he said.
Frequently Asked Questions
The Health Partnership through Creative Federalism Act (H.R. 5864), is a bill designed to break the Congressional logjam regarding health care reform and provide for innovation in health care through state initiatives that expand health care coverage. States will submit proposals to expand health care coverage and access that employ a variety of approaches. A bipartisan Commission made up of state, local, and federal appointees will approve a slate composed of a variety of approaches, which will be submitted to Congress for approval.
- How is the Health Partnership through Creative Federalism Act different from other proposals to expand health coverage?
Other proposals to expand health care coverage and access favor one approach over others. The Health Partnership through Creative Federalism Act creates a process that allows for a variety of solutions to be implemented across the nation and then be evaluated.
- What are State Health Expansion and Improvement Grants?
States become eligible for federal dollars in the form of five-year State Health Expansion and Improvement Grants. To obtain grants, states commit to specific reductions in the number and percentage of the uninsured to a bipartisan Commission made up of state, local, and federal appointees. States are required to report their progress on a yearly basis.
- Who can apply for these grants?
States, regions within states, or regions that cross state borders can apply for grants.
- What reform options might be included in state applications?
States are encouraged to consider a variety of reform options, such as tax credit approaches, expansions of public programs such as Medicaid and the State Children's Health Insurance Program, the creation of purchasing pooling agreements like the FEHBP, individual market purchasing options, single risk pool or single payer systems, health savings accounts, other options, or a combination of options.
The Congressional Budget Office has not provided an official "score" for this bill, but the slate of funded state programs will have a net cost of zero. The bill contains a budget neutrality provision that requires the slate of state programs to have no combined net cost during their five-year operation. This means that some state programs may have a net cost for the federal government while others save the federal government money. Likewise, some state programs might require a federal investment up-front but will save money over their five-year lifespan.
- Is this bill like S. 2772, the Voinovich/Bingaman "Health Partnership Act"?
Yes, both bipartisan bills are based on the same approach of advancing health care reform options by empowering the states to develop innovative ways to provide health care coverage and access.
FACT SHEET
THE HEALTH PARTNERSHIP THROUGH CREATIVE FEDERALISM ACT (H.R. 5864),
A BIPARTISAN, FEDERAL-STATE PARTNERSHIP APPROACH TO BREAKING THE POLITICAL LOGJAM ON COVERING THE UNINSURED
Rep. Tammy Baldwin (D-WI)
Rep. Tom Price (R-GA)
Rep. John Tierney (D-MA)
Rep. Bob Beauprez (R-CO)
Summary: The conventional wisdom is that it is impossible to make any significant progress to help the uninsured in a polarized Congress. Meanwhile, the Census Bureau reports that the number of uninsured Americans has grown to over 45 million Americans.
The Health Partnership through Creative Federalism Act provides a path to move forward. This bill would:
- Break the Congressional logjam by allowing a diverse array of ideas to be tried in specific states.
- Test rival progressive and conservative strategies to see which are most effective, while protecting Americans already enrolled in programs.
- Expand health care coverage to Americans in need of health care.
Details: Congress would authorize grants to individual states, groups of states, or portions of states to carry out any of a broad range of strategies to increase health care coverage. States desiring to participate in a health care expansion and improvement program would submit an application to a bipartisan "State Health Innovation Commission."
The Commission would consider applications that include a variety of approaches, such as tax credits, expansion of Medicaid or SCHIP, creation of pooling arrangements like the FEHBP, single payer systems, health savings accounts, or a combination of these or other options.
After reviewing the state proposals, the Commission would submit to Congress a slate of recommended state applications that represents a variety of approaches.
States receiving grants would be required to report on their progress. At the end of a five-year period, the Commission would be required to report to Congress whether the states are meeting the goals of the Act and recommend future action Congress should take regarding overall reform.
