Health Reform Coverage Is Up to the States

Concerned about the impact of health reform on your health care?  To a large extent, insurance coverage under the new law will depend on actions taken by state governments.  Here’s a quick rundown—and a suggestion.

The reform law passed by Congress in March 2010—known as the Patient Protection and Affordable Care Act—gives a huge role to states.  State governments are empowered to create health insurance “exchanges,” which will cover those individuals and small businesses not covered through the private insurance market, Medicare, or Medicaid.  The law lets states shape most aspects of this exchange-based coverage.

photo of legislator

Under the new law, states also can:

  • run “high-risk pools” for people who now can’t get coverage
  • expand Medicaid to include people with incomes substantially above the poverty level
  • regulate private insurance plans, including premium rates
  • develop strategic plans to focus on key issues, such as obesity or disease prevention.

If you have a major concern—such as getting coverage quickly, getting coverage for a treatment you need or use, or making sure everyone in your family will be covered—you might present your concern to your state health department or state legislator.

Every state has a health department, though they go by various names, and each department is headed by a commissioner, director, or other top official.  If you do a little Web research, you can find the name and contact information of that official, and someone in the department almost surely will get back to you, eventually.  The same goes for the members of your state Assembly or Senate who represent you.

To find your state health agency, visit and go to “Find Your State Health Agency” on the homepage.  To find your state legislators, go to and enter your 9-digit ZIP code.  Then click on the legislator’s name—use email or regular mail to contact them.

Make sure your letter or email clearly presents your question or concern.  Short is better than long.  Don’t include any threats or insults.  Keep a copy (and send us one, if you would).  If you don’t hear back within a month, write again, including a copy of your earlier letter.

When it comes to health reform, state officials need to hear what’s on our minds!

Take care.

Photo credit:  Marty Luster. Attribution.


4 Responses to Health Reform Coverage Is Up to the States

  1. Tom Ervin says:

    It’s early yet, but my hunch is that leaving much of health reform up to the state governments is/was a poor idea. I’d prefer to see more uniformity.

    Me in Arizona, but perhaps not much longer.

  2. New Associates says:

    Thanks for your thoughtful comment,Tom. It’s true that the states have such a huge role to play in implementing the bill that Republican claims of a federal takeover appear misplaced.

    The House of Representatives originally passed a version of the health reform bill that gave more authority to the federal government and less to the states. After Republican Scott Brown won Ted Kennedy’s old Senate seat, though, the House had to accept the Senate’s version of the bill in order to avoid a Senate filibuster.

  3. health insurance should only be taken from reputable companies, you really don’t want to get it from fly-by-night companies .;-

  4. Kian Gray says:

    *;” I am really thankful to this topic because it really gives useful information :**

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