Although the health care debate has slowed on a national level, many states are discussing universal coverage plans for their residents. To date, three states have passed some form of universal coverage plans, while many others have plans in the works. Below is a summary of the states that are working toward reform, along with a brief description of their efforts.
| State | Action to date |
| California | Despite being vetoed twice in the past (in 2006 and 2008) by Gov. Arnold Schwarzenegger, the California Senate has once again passed a single-payer health plan. The plan includes provisions for everyone to be covered, to have their choice of providers; comprehensive benefits; promises of quality care, fair cost sharing, and efficient administration; and protections for cost control. |
| Colorado | For the past several years, improvements to the Medicaid and CHIP program have been ongoing, and the Colorado Blue Ribbon Commission for Health Care Reform studied and established models to expand coverage and decrease costs. Thanks to the commission's efforts, the "Building Blocks for Health Care Reform" package was announced. Health-related items on the 2010 agenda include gender rating, wellness initiatives, and pharmaceutical reform. |
| Connecticut | The legislature passed Governor Rell's Charter Oak Health Plan to provide health care coverage for uninsured adults. The plan offers a state-defined benefit package and premium subsidies based on a sliding scale for any adult between 19 and 64 who does not have health coverage through their employer. Legislation was also passed to create a Health First Authority that is charged with developing a comprehensive health reform plan, which was completed by December 1, 2008. |
| Illinois | In March 2007, Governor Rod Blagojevich proposed "Illinois Covered" to provide affordable and quality health care coverage to all residents. The proposal built on the Illinois All Kids program. However, The General Assembly failed to approve comprehensive health reform. Now, grassroots campaigns in the state are seeking to refocus on reform. |
| Iowa | In 2008, a legislative report was issued on how to cost-effectively achieve universal health coverage. Reform efforts so far have focused on children, families in poverty, and pregnant women, but there are more plans for further reform in the coming years. |
| Kansas | The former home of Health and Human Services secretary Kathleen Sebelius, Kansas has focused most of its reform efforts on Medicaid, increasing clinic funding, and requiring employers to establish Section 125 cafeteria plans that permit workers to use pre-tax dollars for premiums. |
| Maine | In June 2003 Maine became one of the first states to pass comprehensive health care legislation. The Dirigo Health Reform Act aims to provide every citizen with access to quality health care. The Act includes a number of cost-containment initiatives, including system-wide health planning, public price disclosure, simplification of administrative functions, reductions in paperwork, and voluntary limits on the growth of health insurance premiums and health care costs. The Act creates the Dirigo Health Agency, which administers the Dirigo Health plan and establishes the Maine Quality Forum. The Forum promotes quality of care initiatives. A new insurance plan, called DirigoChoice, serves as an affordable health insurance option for small businesses, the self-employed, and eligible individuals without access to employer-sponsored insurance. People earning less than 300 percent of the federal poverty level will be eligible for a sliding scale subsidy for DirigoChoice. |
| Massachusetts | The Massachusetts legislature enacted its comprehensive health care reform package on April 12, 2006 and sent it to Governor Mitt Romney for his signature. The law reflects a 16-month debate and series of compromises between Democrats and Republicans aimed at ensuring that all citizens have access to health care; the final bill passed with four "nay" votes out of 200 Senate and House members. The law pulls together a number of strategies targeting various uninsured populations, including an "individual mandate" requiring that almost all residents have health insurance. It also creates the Commonwealth Health Insurance Connector, which assists small businesses and individuals in navigating the insurance world. |
| Minnesota | The state's comprehensive reform legislation: Expands MinnesotaCare eligibility for childless adults to 250 percent of the federal poverty level; Reduces the sliding scale premiums for MinnesotaCare; Requires employers with 11 or more full-time employees who do not offer insurance to establish a Section 125 plan, and provides funding to help them do so; Promotes the use of health care homes to coordinate care for people with chronic conditions; Increases transparency of the price and quality of health care services; Improves health information technology, including electronic medical records and e-prescriptions. On July 29, 2008, Governor Pawlenty unveiled a plan to allow all state residents to access their personal health records and compare prescription and procedure costs online. |
| New Jersey | The state took the first steps toward universal mandates last year with the passage of S-1557. The new law will expand eligibility for New Jersey FamilyCare to more low-income parents, as well as expand efforts to enroll uninsured dependents up to age 31 who meet current income standards into the program. The program has recently been facing proposed cutbacks, however. Senator Vitale, who introduced S-1557, plans to continue his reform efforts until all state residents are required to have coverage. |
| New Mexico | In 2008, a plan called Health Solutions New Mexico which would achieve universal health coverage, improve access and quality of health care, and contain costs while preserving roles for government, employers, private vendors, providers and individuals/families was unveiled. However it didn't pass, mostly thanks to cost concerns. |
| New York | The Partnership for Coverage contracted with the Urban Institute to model four health reform proposals that are expected to be presented during the Spring of 2009. On May 15, 2009, Governor Paterson announced health reform legislation that builds on health care provisions in the 2009-2010 budget. |
| Oregon | In June 2009, legislation was passed that expands coverage to children and some low-income adults. The legislation also creates the Oregon Health Authority Board, a health insurance exchange, and a quality care institute. |
| Pennsylvania | In 2007, Governor Rendell's proposed health care reform plan, Prescription for Pennsylvania, was introduced into the state legislature, but not acted on. However, several bills aimed at achieving smaller elements of the health care reform plan were enacted. By the end of the two-year legislative session, the legislature failed to reach a compromise over expanding coverage to some uninsured adults. |
| Vermont | Vermont passed the Health Care Affordability Act (H861) in 2006. An integral piece of this reform is a new health insurance program called Catamount Health. This program, a comprehensive model of healthcare, provides affordable coverage for the uninsured by focusing on two major components: better management of chronic care and making health care affordable and accessible. Through Catamount Health, everyone who is uninsured for 12 months or more has access to, as well as help paying for, a comprehensive health insurance package, following a guiding principle that everybody is covered and everybody pays. The plan is offered by the private sector and subsidized with public funds through a sliding scale for anyone under 300 percent of poverty. The program is financed with sliding-scale co-pays, tobacco taxes, Medicaid dollars, and an employer assessment. State fiscal obligations are controlled through enrollment caps. |
| Washington | Washington has proceeded with coverage expansions for children; however, the economic crisis has forced the state to stop implementation of other health reform-related coverage expansions and to cut enrollment in Basic Health, the state's coverage program for low-income adults by 40,000. |
| Wisconsin | BadgerCare Plus, the state's newly simplified Medicaid program, was launched on February 1, 2008 and 129,000 have enrolled as of March 2009. |
