States take problem health care own hands in

19 consider insurance B xes

Rising health care costs and increased concern among the middle class about paying for medical care have prompted a growing number of states to consider ways to extend health insurance to everyone.

Lawmakers in at least 19 states have considered proposals to expand health coverage this year, according to the National Conference of

State Legislatures. That’s up from

12 in 2003. “ It re @ ects frustration with the growing problem of the uninsured and rising health care costs at the state level,” says Drew Altman, head of the Kaiser Family Foundation, a non- partisan research group based in Menlo Park, Calif.

In Congress, Rep. Jim Langevin, D- R. I., says he will introduce a bill today that would create a nationwide insurance program similar to one that now covers federal workers. But policy experts don’t expect Washington to pass major health reforms soon. New programs are more likely to come from the states.

“ I cannot imagine anything signiBcant going through Congress anytime soon,” says Stuart Butler of the Heritage Foundation. “Another approach, the preferable one, is to let people try what they want to do in their state, providing it meets certain standards.”

State proposals vary widely. Some propose governmentinsurance. Otherswould require either employers or individuals or both to buy insurance. Some simplywould create commissions to studyways to cover all residents.

Among the more active states:

uMassachusetts. A plan initiated by Gov. Mitt Romney would require all individuals to buy insurance and would establish two different programs through which they could purchase coverage. A House version of the bill passed Thursday, with a provision that employers provide health coverage or pay a payroll tax. A Senate version, without the tax, has been B led and is likely to be debated in the next fewweeks.

uCalifornia. Lawmakers introduced a bill to create a statewide insurance program, funded by taxes.

uMinnesota. Lawmakers have introduced a measure calling for a state universal health care program. New York has two similar bills.

At least two states have approved measures:

uMaine has 8,000 people enrolled in a program begun two years ago to help cover the uninsured.

uIllinois in October approved a plan that starts July 1, 2006, to offer low-cost health insurance to all the state’s children.

Some measures have failed. Vermont lawmakers passed a measure calling for government- funded universal coverage, but the governor vetoed it in June. Health care uDetails of all

the state

measures, 7A