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Q&A: What Federal Health Reform Means for the States
[PDF]The effort to reform health care at the national level is a complex one. If federal legislation ultimately passes, the states will need to implement mandated changes and pay for them. The Institute's director of health policy research offers a primer of the challenges that states may face.
Courtney Burke, January 2010
Health Care Reform: What You Need to Know and
How it Will Affect New York State
[PDF]Courtney Burke, who directs the Institute's Health Policy Research Center, discussed federal health reform and its effect on New York State in presentations to the State Academy of Public Administration and the Schenectady Business and Women's Association. The presentation includes a look at similarities and differences in House and Senate bills, the effective dates of various provisions and their potential impacts on the state.
Courtney Burke, January 2010
The Weakening of the States
[PDF]The role of the states in American government is weakening, according to this report released at the Institute's first national conference on states' long-term budget gaps. There are three main causes: The Great Recession has strained state government finances to near the breaking point, while increasing the need for services. Medicaid continues to put heavy pressure on the finances of every state. And the information revolution has produced a de-emphasis on states generally by creating the false impression that more and more of domestic government can be micromanaged from Washington.
Richard P. Nathan, November 30, 2009
Gold, Silver, and Bronze: The Important Role of Product Standardization in Health Insurance Reform
[PDF]National health reform will rely on consumer choice and competition to control costs whether or not there is a public insurance option, according to this Institute report. Rational consumer choice, however, is difficult without standardizing health insurance plans, so that value can be easily compared. States may have to play a key role in such standardization.
Courtney Burke with Dina Belloff, November 10, 2009
Companion piece: State Case Studies: Product Standardization in Small Group and Individual Insurance Markets
The Role of States in National Health Reform
[PDF]Health insurance was the topic of the Tenth Binghamton Symposium on Health Care Management and Policy at Binghamton University's School of Management. Courtney Burke, director of the Rockefeller Institute's Health Policy Research Center, spoke about the role of the states in implementing national health reform efforts. Burke covered such topics as financing, administration, implementation and the need to address issues not covered in federal legislation, like cost and quality considerations.
Courtney Burke, October 10, 2009
The More Things Change:
The New NIH Guidelines on Human Stem Cell Research
Many assumed that the Obama administration would usher in a sea change from the previous administration by expanding support from the National Insitutes of Health for human embryonic stem cell research and reducing the patchwork of state and federal regulations that currently governs it. In this article, Michelle N. Meyer and James W. Fossett of the Rockefeller Institute's Health Policy Research Center conclude that changes in stem cell research from the Bush era are actually likely to be limited in scope.
Michelle N. Meyer and James W. Fossett, Kennedy Institute of Ethics Journal, Fall 2009
Managing Risk in Health Insurance Markets:
A Challenge for States in the Midst of Health Care Reform
[PDF]States seeking to manage health-insurance risk while providing coverage to more residents should apply several strategies at once, say the Institute's Courtney Burke and Harvard University's Katherine Swartz in this report. Strategies include a requirement that individuals purchase insurance, creation of an insurance exchange, and merger of small group and individual markets.
Courtney Burke and Katherine Swartz, September 10, 2009
Chickens, Eggs, and Institutions:
Minnesota Launches Health Care Homes
[PDF]Can universal coverage and containment of the rate of growth of health care costs be achieved simultaneously? If not, which comes first, the chicken or the egg? This report, from Institute Co-Director Richard P. Nathan and Columbia University's Lawrence D. Brown, looks at Minnesota's experiment with health care homes as one instructive effort.
Lawrence D. Brown and Richard P. Nathan, August 2009
States' Regulation of Assisted Reproductive Technologies
[PDF]This paper addresses the extent to which the rights of privacy and reproductive liberty protected by the United States Constitution prevent states from regulating assisted reproductive technologies (ARTs). It concludes that under the best interpretation of the Supreme Court's existing case law, states have ample room to regulate individuals' decision to procreate, including decisions to use ARTs. States, pursuant to their police powers, may regulate ARTs in order to protect the health, safety and welfare of their citizens. However, courts will strictly scrutinize any regulation of procreation that distinguishes socially disfavored groups for different treatment. Similarly, even where a regulation would apply equally to all citizens, it must serve a legitimate governmental interest, rather than merely reflect “outmoded taboos.”
Michelle N. Meyer, July 2009
How States Are Financing Health Coverage Initiatives
[PDF]Courtney Burke, director of the Institute's Health Policy Research Center, gave a presentation on states' efforts to provide health insurance coverage at the 2009 annual research meeting of AcademyHealth, a professional society for health researchers and policy analysts. In addition to a talk and slide presentation, Burke presented posters on state financing of such coverage efforts and on risk management strategies.
State Financing for Coverage Initiatives: Poster Abstract
Managing Risk: Poster Abstract
Courtney Burke, June 27, 2009
State Financing for Health Coverage Initiatives:
Observations and Options
[PDF]New York faces steep financial challenges as it works toward universal health care coverage, according to a new report by the Institute's Health Policy Research Center. The report, funded by the New York State Health Foundation, analyzes potential sources of revenue and savings that the state could tap.
Courtney Burke and Kimberley Fox, June 3, 2009
Mitigating the Effects of High-Risk, High-Cost Populations in the Private Health Insurance Market
[PDF]At this Institute Public Policy Forum, Katherine Swartz, professor of health policy and economics at the Harvard School of Public Health, provided an overview of the "Massachusetts experience" with ensuring universal health coverage, with a focus on the need to manage — and contain costs — for people with high medical expenses. In response, New York officials representing the departments of Health and Insurance — Troy Oechsner, Jay Laudato and Eileen Hayes — shared perspectives on New York's challenges in expanding care to more high-risk patients.
May 21, 2009
What the Berger Commission Has Meant for Acute Care in New York's
Capital Region
[PDF]The New York State Commission on Health Care Facilities in the 21st Century — more commonly known as the Berger Commission — recommended a series of hospital and nursing home restructurings three years ago to reduce excess capacity, and ultimately costs, in the medical industry. At this Institute Publicy Policy Forum, James W. Connolly, president and chief executive of Ellis Hospital in Schenectady — a community he dubbed the commission's "Ground Zero" — discussed his oversight of a successful three-hospital consolidation there. James K. Reed, president and CEO of Northeast Health in Troy, where the commission made no such restructuring recommendations, talked about the voluntary consolidations that his organization is undergoing with two other area health systems. Both men said the industry needs to move forward itself with further restructuring.
May 1, 2009
Assessing Asset Transfer for Medicaid Eligibility in New York State
[PDF]New Rockefeller Institute research examines the transfer of personal financial assets by New Yorkers seeking to have Medicaid pay for nursing home care. About 7 percent of such applications were rejected from 1998 to 2008 because applicants had transferred assets to family members or others within a few years of requesting Medicaid coverage, the study finds. Counties throughout the state varied widely in the percentage of applicants they rejected because of such asset transfers.
Rockefeller Institute of Government, March 2009
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Medicaid and Long-Term Care: New York Compared to 18 Other States
[PDF]New York’s Medicaid program spends more on long-term health care than any other state, but indicators of quality are only about average or slightly above average. This study compares New York to 18 other large or Northeastern states.
Rockefeller Institute of Government, February 2009
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