Even as Congress continues to debate health care reform, state governments are stepping in to offer leadership and oftentimes expand coverage.

Last year, when Washington state was facing a $9 billion revenue shortfall, many observers expressed concerned that lawmakers would take steps to cut back on its General Assistance for the Unemployable (GA-U) program -- which offers health coverage for those with disabilities that prevent them from holding steady employment.

Instead, the legislature protected GA-U and established a pilot program to offer coordinated health care to improve the service in two counties. The results were successful, saving the state $3.5 million in hospital and pharmaceutical costs.

This year, the GA-U program will go statewide, covering 18,000 people who cannot work.

The legislature must address another shortfall next year, but reforms like this -- which save the state significant money in the long term -- offer lawmakers plenty of incentive to find ways to keep new programs funded.