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What's next for covering health reform: Noam Levey

Noam LeveyNoam N. Levey covers health care policy for the Los Angeles Times/Tribune Washington bureau. Levey grew up in Boston, where his father was a doctor, and earned a degree from Princeton University in Middle Eastern history. He has written for newspapers in the Persian Gulf, Midwest and California. Since 2003, he has been a staff writer for the Los Angeles Times, covering City Hall, Capitol Hill and most recently, the 2008 presidential election. Levey was a panelist on the Talking Health webcast about insurance on May 1, 2009.

Relevant stories

Noam Levey
Health policy reporter
Los Angeles Times/Tribune Washington Bureau

Here are some stories you want to consider on a local level:

Insurance premiums aren't likely to come down any time soon. Tracking what local insurers are doing, especially before a new regulatory regime is put in place would be worthwhile. Look for the kind of gaming that drug companies are accused of doing this year to boost prices. Tracking premiums in the individual market is very difficult, but it is worth checking with your state insurance commissioner, as many at least require insurance companies to report premium increases. Kaiser Family Foundation maintains good data on what is happening in the large group market. And many larger states have consumer advocacy groups that can be helpful.

The bill would create a high-risk pool to help people before exchanges start up in 2014. But these have a checkered history in states nationwide in terms of expanding access in an affordable way. Could be interesting to look at what has happened with local plans and who will be signing up for them immediately. A good source on what has happened with these is Eliza Navarro Bangit at Georgetown. The consumer group Families USA, which maintains an excellent story bank of individuals who have struggled with the healthcare system, could be a good resource to find people who have used high risk pools or been forced to drop them because they are so expensive.

The red state rebellion against health reform in states like Idaho and Virginia has more life. Some Republican state officials are already talking about suing to challenge the insurance mandate in the bill. This will get the bulk of the attention. But it is also worth looking at the capacity and the willingness of state/local government leaders to take on the new responsibilities under the health legislation. A lot depends on what states rather than federal government will do. The Kaiser Family Foundation summary of the legislation contains good information on the responsibilities of state governments. The National Conference of State Legislatures, the National Governors Association and the National Association of Insurance Commissioners have information on what individual states are doing now to regulate healthcare, which may provide a good guide about their capacity to do more.

House reconciliation package promises aid to boost pay for primary care docs treating Medicaid patients, but will this be enough in states where doctors have already fled the Medicaid system?

Doctor shortages in Massachusetts have complicated that state's attempt to move toward universal coverage. Healthcare legislation seeks to address this with new incentives, but will that happen fast enough, especially in parts of the country that don't have nearly the number of doctors that Massachusetts had?