Expanding coverage to more than 720,000 people who otherwise would not have coverage — this and other achievements were made possible because Illinois Gov. Rod R. Blagojevich made health care a top priority since he took office in 2003, according to Theresa Eagleson, the state's Medicaid director.
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A just-published report on state efforts to cover low-income adults without children found something encouraging. Researchers looked at all 50 states to see whether policies were in place to subsidize coverage for childless adults. They found that almost half of states had some type of program in place.
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There are two strategies that states can use to address the problem of low-income adults who can't afford health care, according to Jonathan Seib, a policy advisor to Washington Gov. Chris Gregoire in Olympia.
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"Medical debt has been increasing over the past 15 years. In our state, that number has increased dramatically over this time," says Robert A. Crittenden, MD, MPH, a professor at the University of Washington School of Medicine and chief of the family medicine service at Harborview Medical Center, both in Seattle. "With the economic downturn, this is an even bigger issue. More families are facing unaffordable debt."
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The Access Project's Medical Debt Resolution Program worked with 187 people in the state of Massachusetts between September 2006 and April 2008 with a combined medical debt of over $2 million. Medical debt was resolved in a variety of ways—by informing people about their insurance appeal rights, and eligibility standards for public programs, and also by negotiating payment arrangements with medical providers. While some of these cases are ongoing, over $1 million of the debt was retired.
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The post-employment benefits of retired workers are in the spotlight, as a result of a law requiring government employers to measure and report the liabilities associated with post-employment.
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The outcome of the presidential election could determine how states approach health care reform, and to what extent state disparities in uninsured rates and income eligibility for public programs narrow or widen, according to Lisa M. Duchon, PhD, a senior consultant at Health Management Associates in Washington, DC.
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Little changes can make a big difference. Although that message still is seen as counterintuitive by some health care experts, Trust for America's Health (TFAH) has concluded that an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion a year within five years, or a return of $5.60 for every $1 invested.
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