Since the Innovations in American Government Awards were created in 1986, states have won 71 prizes, and many award-winning programs have been widely adopted in other places.
Three states have already emulated the Commonwealth Connector, which allows Mass. residents to choose from a wide range of public and private health care options, in developing their own universal health care plans.
California, Utah and, most recently, Oregon have sought guidance from the Connector, its chief executive Jon Kinsdale told Stateline.org. Oregon is one of 13 states recently announced as winners of a new $71 million federal grant for health reform from the U.S. Department of Health and Human Services. “I wouldn’t be surprised if other selected states reach out to us for advice,” Kinsdale said.
Launched in 2006 when Massachusetts began requiring all adults to purchase health insurance, the Connector combines funding from Medicaid, the federal-state health insurance program for the poor, with private insurance support to offer a full range of options to meet the needs of Massachusetts residents at every income level.
“There’s no cliff like you have with Medicaid,” Bovbjerg said. Instead, the Connector provides a smooth transition from fully-subsidized health coverage to partially covered options and programs that are fully funded by individuals or businesses.
The Connector is similar to the so-called Exchange under the Obama administration’s proposal, designed to allow uninsured individuals and small businesses to compare plans and buy coverage at competitive prices, in some cases with federal tax credits.
Like elsewhere in the country and currently in Congress, it would have been difficult, if not impossible, for Massachusetts politicians to hammer out the complex details of what constitutes universal coverage and how it should be priced. But because the Connector’s 10-member board is made up of public and private practitioners who buy health insurance for a living, politics was set aside and the interest of purchasers was in the forefront.
Massachusetts law calls for board members to be appointed by the governor and attorney general and to include an actuarial economist, an employee benefits specialist, a health economist, and representatives from a small business, a health consumer organization and a labor union. Four members serve ex-officio: the secretary of administration, insurance commissioner, state Medicaid director and group insurance commission director.
Since the Connector’s inception, the state’s uninsured rate has dropped from 10.4 percent in 2006 to 2.6 percent in 2008, while the national average remains at 15.3 percent. In addition, use of free care at clinics and emergency rooms decreased by 37 percent between 2006 and 2007.
Last year, the Connector estimated that more than 200,000 adults could not afford health coverage and were not eligible for either job-related insurance or Medicaid; to date 160,000 of those individuals have enrolled.
Going forward, the Connector’s Kinsdale said the biggest challenge will be holding down health care costs, which are rising faster in Massachusetts than elsewhere in the country. In addition, he said national reform — if enacted — could require changes in the commonwealth’s plan.
But he said he was confident the staff and board would make the needed adjustments. “We have recruited staff who combine a devotion to public service with a passion for innovation. This team was energized by doing a start-up, and will meet the next set of challenges with the gusto equal to what we have already demonstrated,” Kinsdale said.
Five other awards were presented for the following innovations:
- Idaho improved water use throughout the state by providing satellite-produced images of evaporation from all sources and transpiration from farm crops and other vegetation.
- The Chicago Public School District, through a partnership with a non-profit organization, created an organization New Leaders for New Schools that nurtures school principals in an effort to improve performance in the city’s public schools.
- Kingsport, Tenn., revitalized its ailing economy by improving access to higher education for its labor force.
- Milwaukee County, Wis., created a program called Wraparound Milwaukee that provided home-based mental health care for troubled youth and their families.
- The District of Columbia, under a program called Democratization of Government Data, delivered real-time information such as crime reports, school data and real estate developments, to a central location that anyone can access to provide customized reports for citizens.