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Health Reform: What's Ahead for State and Local Governments (and Journalists Who Cover Them)

Health Reform: What's Ahead for State and Local Governments (and Journalists Who Cover Them)

Picture of Barbara Feder Ostrov

Most journalists don't pay much attention to their local "medically indigent" program, which offers health care to poor people who don't qualify for Medicaid or other government programs. But that's one of the local programs that could be at risk under health reform.

That's just one of the story ideas coming out of an Association of Health Care Journalists conference panel today on how state and local reporters can cover health reform's rollout. Moderator Vicky Colliver, a 2009 Dennis A. Hunt grant recipient and San Francisco Chronicle health reporter, described health reform as "a gift" for reporters outside the Beltway. One question she raised:  With 9 million people on Medi-Cal (California's Medicaid program), when is Medicaid a safety net and when is it just part of the system?

Panelist Martha King, health program director of the National Conference of State Legislatures, told reporters that the nation's 50 states are responding in as many different ways to health reform. "A lot depends on their resources, uninsured population and political philosophy," she said. "A number of states are like deer in the headlights, saying, oh my God, what do we do now?"

Other states, however, already have implemented items called for under the law, King said. For example, Utah requires insurers to cover young adults who might otherwise "age out" of their parents' policies after college. The reason? A large number of the state's young Mormon residents go on religious missions after college and want to remain on their parents' policies.

A key factor in states' preliminary responses to rolling out health reform is budget deficits, said Marian Mulkey, senior program officer of the California HealthCare Foundation. State governments are going to have to pick and choose, she said, and "they'll let some things be lower priorities." But what things? Those are questions reporters should be asking.

Here's the best concrete story idea from the panel: How will health reform affect programs for medically indigent people in your community? If everyone's supposed to be insured after 2014, would there even be anyone left to serve? It's time to start asking those questions of your local county health officials.


National Conference of State Legislatures: State Health Reform
California HealthCare Foundation: County Programs for the Medically Indigent in California
ReportingonHealth: Localizing Health Reform


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