http://www.iht.com/articles/2007/12/25/america/25health.php
A year that began with great ambition for major expansions of health insurance here and in other state capitals is ending with considerable uncertainty, as a second wave of change runs headlong into a darkening economy and political divisions over how to apportion the cost.
Though the governors of three big states — California, Illinois and Pennsylvania — proposed sweeping plans to restructure health care this year, none will finish 2007 with bills passed and signed. In each state, the initiatives confronted entrenched opposition from insurance and other business lobbies that made it far more difficult to build a consensus for change than in the smaller New England states that acted in recent years.
The Schwarzenegger-Núñez plan, which passed the Democratic-controlled Assembly last week, expands on the universal coverage law that Massachusetts passed in 2006. That state now requires insurance companies to offer coverage regardless of an applicant's health status and mandates that most residents have insurance by Dec. 31, or face a tax penalty of $219.
State officials project that more than 300,000 previously uninsured people will sign up in time, a third of them in a surge over the last month. That has put Massachusetts more than halfway to its goal of insuring everyone.
The downside, and one noted by states with widening budget gaps, is that the program is expected to exceed its first-year budget by at least $150 million. And state officials are struggling to prevent double-digit premium increases next year.
Whether the momentum that began with State of the State addresses last January will continue into 2008 is not clear. It had been widely felt by health reform advocates that this nonelection year provided the best political climate for change.
Now the focus may shift to the presidential campaign, where the leading candidates for the Democratic nomination have each proposed major overhauls. Some state leaders may be tempted to wait out the year to gauge whether the next president will push for a national health plan that might subsume state efforts.
The essential problem, meanwhile, continues to worsen. The Census Bureau reported that the number of uninsured grew to 47 million in 2006, a one-year increase of 2.2 million. The share of United States residents who had employer-based coverage dropped to 60 percent from 64 percent in 2000, according to the Economic Policy Institute, a liberal research group. And though the rate of growth has slowed, the cost of employer-sponsored premiums still rose by 6.1 percent in 2007, more than double the inflation rate, according to the Kaiser Family Foundation.
