State Health Reform

Assist states in implementing transparent, evidence-based, free market health policy reforms through rigorous, data-driven research and best practices.

• The Tenth Amendment to the U.S. Constitution declares “the powers not delegated to the United State by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”
• Public policy is most effective when it is designed and implemented close to the people it affects, making states the optimal venue for meaningful health care reforms.
• States are uniquely positioned as nimble innovators of public policy solutions, charting a path for other states and the nation.
• Excessive government and burdensome regulations undermine market competition where providers must best meet the needs of the people in both urban and rural areas in cost efficient ways and instead lead health systems and other health industry entities to devote resources to lobbying government to obtain benefits for themselves and restrict the competition they face.
• Perverse federal financial incentives, largely within the Medicaid program, displace states’ focus from vulnerable patients to competing for additional federal funds financed with rising federal deficits and debt.
• Patients benefit most when their choices can influence providers to enhance quality, increase efficiency, and encourage innovation.

Goal 1: Bolster program integrity in state Medicaid programs.

• End self-attestation as acceptable eligibility criteria and improve verification of eligibility information.
• Reinforce proper enrollment and program value through modest premiums.
• Commission better audits of vulnerabilities in eligibility pathways.
• Identify and end pathways for waste, fraud, and abuse in state Medicaid programs.

Goal 2: Ensure Medicaid programs are focused on serving the truly vulnerable.

• Focus Medicaid on helping children, the poor, pregnant mothers, and the elderly.
• Implement the community-engagement requirements in the federal One Big Beautiful Bill to encourage work and upward mobility.
• Reverse trends where the truly needy are left vulnerable by perverse federal incentives to serve the able-bodied, working-age enrollees instead.

Goal 3: Hold accountable health insurers operating Medicaid managed care plans.

• Establish strong reporting standards on medical loss ratio, spending, and enrollment data, including enrollees with zero claims.
• Create incentives to reduce costs and get individuals off Medicaid.
• Expose and mitigate the impact of shell games to ensure appropriate rate setting.
• Strictly enforce reporting requirements with sanctions for noncompliance.

Goal 4: Remove barriers to health care access and support overall health and well-being.

• Increase health care supply by repealing certificate of need laws and by expanding scope of practice for non-physicians.
• Expand options for patients my maximizing available coverage alternatives like short-term, limited-duration plans and Farm Bureau options.
• Diversify physician-training pathways by going beyond the traditional avenue through medical residencies.
• Reduce the subsidization of poor health by removing junk food from the Supplemental Nutrition Assistance Program.