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With the collapse of national health care reform efforts in the early 1990s, states emerged as a focal point for new policy and administrative developments in U.S. health care. This book provides a timely overview of the key issues facing states as they have responded to this challenge. It tells how states are making decisions about health policies and then putting them into action -- and how legislatures, executives, courts, and bureaucracies all participate in this process. The New Politics of State Health Policy describes many of the major trends in states' responses to health care problems of the 1990s, and it identifies the forces that will influence state policy actions in the new century. It examines reforms now under way, from Medicaid to tobacco control to mental health, and addresses today's most pressing issues surrounding managed care, health insurance, and public health administration. Editors Hackey and Rochefort have brought together a distinguished group of scholars and practitioners in the field of health policy analysis. Frank Thompson, Theodore Marmor, Michael Dukakis, and others map out the different institutional frames shaping how each state approaches the health care domain. While some states deliberate over universal coverage, others have shifted to the county level decisions once made in Washington, D.C. But all face the difficulty of taking on unprecedented responsibilities with limited resources amid the often-conflicting concerns of public management and "moral politics". Each contribution in the volume explores the interplay between state governance and health care policy by addressing four themes: the capacity of states to fulfill their new healthcare roles, the significance of recent policy changes, patterns in the politics of state health policy making, and the relationship of state-level changes to failed national health care reform.

Perhaps the most glaring failure of the American mixed public/private health care system is that millions, including many of the most vulnerable, go without health insurance. In Running in Place, Eliot Fishman analyzes the various means-tested health insurance initiatives instituted at the state level since the 1960s and finds that, while there have been successes, on the whole these programs have never come close to fulfilling expectations regarding increasing the numbers of low-income people enrolled or their access to mainstream health providers.Fishman argues that such state-administered measures, modeled on Medicaid, the oldest and largest of the programs, will not bring the nation close to the goal of universal coverage. At the same time, sweeping reforms that have been proposed, such as a federally administered single-payer plan, are not feasible given the current political atmosphere in Washington. Steering between these two poles -- retaining the decentralizing features of the Medicaid model that make it popular while increasing its effectiveness -- will require that the federal government assume more of the fiscal burden even as states continue to run their own programs. More people will be covered if enrollment becomes automatic, with eligibility verified retrospectively, and the appeal of such programs will increase if they are broadened to include working families who are having trouble finding affordable insurance.

Comprehensive health insurance (Maine) - In June of 2003, the Maine, USA Legislature passed a comprehensive health insurance plan, granting low-cost coverage available to all state residents by 2009. Through a semi-private agency, the state will provide coverage to uninsured residents, small businesses and municipalities and the self-employed.

Ontario Health Insurance Plan - The Ontario Hospital Insurance Plan (OHIP) is the government-run health plan for the Canadian province of Ontario. More recently it has been referred to as the Ontario Health Insurance Plan, but the official name uses the term Hospital rather than Health due to legal questions related to the coverage of prescription drugs.

Group Health Cooperative - Group Health Cooperative, based in Seattle, Washington, is a consumer-governed nonprofit healthcare system. Established in 1947, it today provides coverage and care for about 540,000 people in Washington and Idaho and is one of the largest private employers in Washington.

Health maintenance organization - A Health Maintenance Organization (HMO) is a type of Managed Care Organization (MCO) that provides a form of health insurance coverage in the United States that is fulfilled through hospitals, doctors, and other providers with which the HMO has a contract. Unlike traditional indemnity insurance, care provided in an HMO generally follows a set of care guidelines provided through the HMO's network of providers.

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