Big changes are afoot for the House and Senate with Democrats retaking control of both houses. At the Federal level, Democrats have pledged to make health care reform a priority when they take control of the House and Senate in the 110th Congress. Issues such as revision to the Medicare prescription drug benefit and expanded federal funding for embryonic stem cell research are likely to top the leadership’s legislative agenda. At the state level, the outcome of key gubernatorial races and ballot initiatives will play a key role in health care reform agendas, particularly as they relate to affordability and access to health care for lower income Americans.
Below is a brief summary of election results and their relevance to state health policy as adapted from the November 8th issue of the Kaiser Daily Health Policy Report.
Results of Select Gubernatorial Races
California. Incumbent Governor Arnold Schwarzenegger (R) defeated state Treasurer Phil Angelides (D) by a margin of 56 to 39 percent. In his first term, Schwarzenegger vetoed a state Senate bill that would have created a single-payer health care system for Californians. Schwarzenegger has stated, however, that every Californian including children should have access to health insurance. Last year he vetoed a bill that would have ensured universal coverage for children, saying that the legislation was too costly. Early in 2006, Schwarzenegger appointed a bipartisan group of health experts to draft a health care plan due by early 2007. Recently, he signed legislation that requires pharmaceutical companies to create discount pharmaceutical programs for uninsured residents.
Florida. State Attorney General Charlie Crist (R) defeated U.S. Representative Jim Davis (D) 52 to 45 percent. Crist has pledged to continue shifting Medicaid beneficiaries to managed care plans and to use the state’s purchasing power to negotiate discounts on prescription drugs. Crist also supports a change in state law that would enable small businesses to form purchasing pools for buying employee health care coverage.
Illinois. Incumbent Governor Rod Blagojevich (D) won by a 49 to 40 percent margin over state Treasurer Judy Baar Topinka (R). During his first term, Blagojevich expanded the state’s All-Kids and FamilyCare programs to cover as many as 475,000 previously uninsured children and adults. All-Kids is the nation’s first universal insurance plan for children.
Iowa. Iowa Secretary of State Chet Culver (D) defeated U.S. Representative Jim Nussle (R) 54 to 44 percent. Culver has pledged to expand the state’s Hawk-I health insurance program to include families with incomes up to 200 percent of the federal poverty level who lack employer-sponsored health coverage. Culver would allow residents of all income levels to purchase health insurance for their children through Hawk-I on a sliding scale basis. In addition, Culver has said he plans to invest $10 million in state funds for a new center on stem cell research, located at the University of Iowa.
Massachusetts. Former Assistant U.S. Attorney General Deval Patrick (D) defeated Lieutenant Governor Kerry Healey (R) by a 56 to 35 percent margin. Patrick supports expanded eligibility requirements for Medicaid and an assessment on employers that do not offer health coverage. He also proposes a program that would guarantee catastrophic health coverage for all residents who are not covered under Medicaid or Medicare.
New York. Attorney General Eliot Spitzer (D) defeated attorney John Faso (R) by a 69 to 29 percent margin. Spitzer pledged health coverage for all children as well as reduced prescription drug costs through more widespread use of generic drugs and by negotiating discounts using the state’s purchasing power. Spitzer has also said that he will examine ways to curb Medicaid spending increases by reducing the cost of long term care and stepping up efforts to prevent and detect Medicaid fraud.
Results of Select State Ballot Initiatives
Arizona’s Proposition 203. Voters approved this measure 53 percent to 47 percent. The measure will add an extra 80 cents per pack to the state’s cigarette tax with resulting funds slated for health and education programs for children five years and younger. The measure, which is expected to raise approximately $150 million in revenues for these programs, also establishes a new Arizona Early Childhood Development and Health Fund to be administered by a board appointed by the governor.
California’s Proposition 86. Voters rejected this measure 52 percent to 48 percent. The measure would have increased the state tobacco tax by $2.60 per pack to fund various health-related programs, including emergency room operations, expansion of the state’s health insurance program for low-income children, and smoking prevention and education programs, among others. The measure would have resulted in approximately $2.1 billion additional revenues for these programs.
Missouri’s Amendment 3. Voters rejected this proposed amendment 52 percent to 48 percent. The amendment would have increased the state’s cigarette tax by 80 cents a pack and would have tripled the tax on other tobacco products. A portion of the increased revenues would have gone to improve reimbursement rates for those health care providers serving Medicaid beneficiaries and uninsured residents. Revenues were also slated to improve the state’s health care programs for low income residents and for programs to prevent and reduce tobacco use.
Oregon’s Measure 44. This measure passed with 77 percent of the vote. The measure will expand the Oregon Prescription Drug Program by removing eligibility requirements so that all Oregonians—regardless of age or income—who lack coverage may participate. Participants in the program receive a card that makes them eligible to purchase prescription drugs at a discounted price from participating pharmacies.
South Dakota’s Measure 2. This measure failed with 61 percent of voters casting a ‘no’ vote. The measure would have increased the state’s tobacco tax by $1.00 a pack and would have also increased the tax on other tobacco products. The proposed law would have deposited $30 million in tobacco tax revenues into the state’s general fund. Tobacco tax revenues in excess of this amount, up to $5 million, would have been deposited in a tobacco prevention and reduction trust fund. Any additional tobacco tax revenues above and beyond $35 million would have been divided between a property tax reduction fund, and education and health care trust funds.
Florida’s Amendment 4. Voters approved amendment 4 with 61 percent voting to adopt the measure. The amendment requires that 15 percent, or $57 million, of the 2005 tobacco settlement to Florida be used toward a comprehensive statewide tobacco education and prevention program using Centers for Disease Control and Prevention best practices.
Taxpayer Bill of Rights (TABOR) Ballot Initiatives. TABOR-style measures that would have restricted state spending growth to inflation plus the population growth rate were on the ballot in Maine (Question 1), Nebraska (Measure 423), and Oregon (Measure 48). None of these initiatives was approved by the voters.
