Thanks to the 2/3 Democratic majority in the Connecticut Legislature, Democrats in 2009 overrode the governor’s veto of a bill to create “SustiNet,” designed to be the nation’s first true public option health insurance plan. But with the Connecticut Legislature and governorship up for election in 2010, many analysts believe that this year’s voters hold the fate of SustiNet in their hands.

And the choice couldn’t be clearer – if you live in Connecticut and believe in building a public option, you need to get out and vote for Democrats. The American Prospect’s Joanne Kenen explained the situation:

Though approved in concept by the state Legislature, SustiNet at this point is only a concept. It has a board, a cadre of volunteer analysts, and task forces as well as support from foundations, advocates, and Democratic legislators. But the commission must go back to the Legislature next year for final approval -- and funding -- in an environment that is fiscally challenging and politically uncertain. The race to succeed Gov. Jodi Rell, a moderate Republican who is not seeking re-election, is competitive, and the Legislature, which passed the SustiNet bill and then overrode Rell's veto, could have a different composition post-November. For political or economic reasons, SustiNet could be delayed or scaled down. But state Rep. Chris Donovan, the speaker of the Connecticut House, says the idea has broad public support. The message he has been relaying around the state, he says, is, "Better plan, costs less. Like that beer commercial: tastes great, less filling."

We hope you caught that – even a self-proclaimed “moderate” Republican vetoed the plan last year, despite broad public support (that seems to be happening a lot lately). Which means the best way to guarantee that SustiNet stays on track is to maintain the Democrats’ veto-proof majority in the legislature.

It would take a disastrous election cycle to break State House Democrats’ 114-37 advantage, but State Senate Democrats currently sit right at the 2/3 mark with a 24-12 edge. Just like the federal health care reform bill, not a single Republican State Senator voted to pass SustiNet.

And make no mistake, if SustiNet goes online in 2012 as planned, it will be a groundbreaking achievement for health care reform:

[SustiNet Board Co-Chair Kevin] Lembo and other advocates note that SustiNet is not just a coverage mechanism. It was conceived, too, as a catalyst for delivery-system reform, aiming to improve quality while restraining costs. Various task forces are working on creating or expanding medical homes and chronic -- disease management, electronic medical records, incentives for evidence-based medicine, and public-health initiatives on obesity and tobacco. Addressing racial and socioeconomic health disparities is also an explicit goal. Lembo said the public option could end up covering about 1 million people out of Connecticut's 3.5 million, meaning it could have a big ripple effect on health-care delivery and public health throughout the state.

If the experience of Massachusetts, Hawaii, and Oregon are any guide, it could also become a model for other states to follow – and possibly the federal government as well.

The non-partisan Annie E. Casey Foundation has released the 2010 edition of its annual Kids Count ranking, which measures each state on 10 key indicators of children’s welfare and educational opportunities. Unsurprisingly, states with Democratic legislatures dominate the 2010 rankings.

Eight of the top-ten overall states have Democratic legislatures – New Hampshire, Minnesota, Vermont, Massachusetts, Iowa, New Jersey, Connecticut, and Wisconsin. Only one Republican-controlled state and one state with a nominally non-partisan legislature made the top ten.

More impressively, states with Democratically-controlled legislatures outnumber Republican-controlled states in the top-ten* of every single subcategory. The breakdown of each subcategory is:

• Fewest Low-Birthweight Babies: 6D-3R-1Split

• Lowest Infant Mortality: 9D-1R-0Split
• Fewest Child Deaths: 10D-0R-0Split
• Fewest Teen Deaths from All Causes: 10D-0R-0Split
• Fewest Teen Births by Age Group: 9D-1R-0Split
• Fewest Teens Ages 16-19 Not in School and Not H.S. Graduates: 9D-1R-4Split*^
• Fewest Teens Ages 16-19 Not in School and Not Working: 7D-4R-2Split*^
• Fewest Children Living in Families where No Parent has Full-Time, Year-Round Employment: 6D-5R-2Split*^
• Fewest Children in Poverty: 9D-2R-2Split*^
• Fewest Children in Single-Parent Families: 6D-4R-1Split*^

*Because of ties in the subcategories, some top-ten lists contain more than ten states.
^We counted Nebraska’s non-partisan legislature as being under split-control.

The release of the Kids Count ranking comes on the heels of CNBC’s “Top States for Business” ranking, in which not a single state in the top ten of the education subcategory had a Republican-controlled legislature.

Both rankings reinforce the larger argument we make each and every day: that the states that are moving forward and working to provide opportunity for future generations, by and large, are states with Democratic leadership.

Yesterday was the first day that the health care reform law’s “high-risk pools,” set up by the federal government to cover people with pre-existing conditions, began accepting applications. But because states have the option of using the federal plan or setting up their own, only 21 states can take applications so far:

These 21 states have asked the federal government to run the high-risk pool rather than administer it themselves: Alabama, Arizona, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia, Wyoming.

Residents of these states can apply starting Thursday. Administration officials said people who apply by July 15 will begin receiving coverage by Aug. 1.

The remaining 29 states and the District of Columbia will run their own programs and begin accepting applications over the next several months.

“Asked,” of course, is a charitable description by the Los Angeles Times. No doubt some of these states – particularly those with Democratic-controlled legislatures and whose leadership actually care about the uninsured – weighed the options and decided that a federally-run high-risk pool is the better option for them. The federal pools are coming online quicker, most likely, because Federal officials have had the better part of two years to think about how to implement high-risk pools, and some states obviously saw value in having a plan that’s part of a national standard.

But other states didn’t “ask” the federal government to set up their high-risk pools any more than an infant throwing a dinner-time temper tantrum “asks” mommy or daddy to handle the spoon and sippy-cup. For Republican officials in those states, local control was far less important than throwing their tantrum and making a big show out of refusing to lift a finger for reform.

Mother Jones described the situation with a little bit more context at the beginning of May:

At least 15 states—all but three led by Republicans—have decided against creating insurance pools for Americans with pre-existing conditions, forcing the federal government to step in and establish the high-risk pools itself. By contrast, at least 28 states—all but seven led by Democrats—will help the federal government by creating the pools themselves. It’s the first major decision for states to make under the new law. And the Republican-led refusals are the latest sign that red states will be far less willing to play nice as health reform gets underway.

Ultimately, though, the L.A. Times got it right. Republicans may have thought they were making some grand statement against President Obama and against health care reform by refusing to cooperate in the high-risk pools, but all they were really doing is asking the federal government to make the decisions for them.

And they didn’t even succeed in slowing down reform in their states. If anything, they sped it up – which makes this Republican failure a WIN for those with preexisting conditions.

The debate still rages in America over when life begins. But what is beyond debate is that an infant born into this world is indisputably a living, breathing, feeling human being.

And Republicans in Tennessee just voted to let some of them die.

Since 2004, Tennessee’s Office of Children's Care Coordination has given millions of dollars in grants across the state in an effort to teach expectant parents how to prevent premature births and have otherwise healthy newborns, all as part of a broader effort to drive down third-world-level infant mortality rates in some parts of Tennessee.

The program has been so successful that its administrator said outright that canceling funding for the program would cause Tennessee babies to die.

Naturally, a State Senate committee's Republicans voted unanimously to do just that:

The committee voted 7-4, on straight party lines Thursday night to reject an effort by Senate Democratic Leader Jim Kyle of Memphis and others to restore the state budget funding for the governor's Office of Children's Care Coordination and the grants it administers across Tennessee.

Republicans hold a 19-14 Senate majority, and the budget alternative they first unveiled May 11 has called for cutting the program's $4.6 million budget in half for the fiscal year that starts July 1, then eliminating it entirely the following year.

But Bob Duncan, director of both the Office of Children's Care Coordination and the Cover Kids health insurance program, said that effectively eliminates the program and its grants for local services in Shelby County and across Tennessee on Dec. 31. Asked what would happen if that occurs, he said, "You will see an increase in babies dying." [emphasis added]

Newspapers across Tennessee blasted this vote, and rightly so. The Nashville Tennessean called the Republican budget plan that ended funding for the program “heartbreaking hypocrisy.” And that, in a nutshell, is why this vote and this budget are so dangerous for Tennessee Republicans. It exposes their years of masquerading as “pro-life” legislators for what it really was: lies.

"If you are going to have a baby, let's give that baby a fighting chance," said Bob Duncan, head of the Governor's Office of Children's Care Coordination, which is on the chopping block. "This is real stuff. This is lives that are being saved and babies getting a chance to live. It just breaks my heart to know what is going to happen." If the Senate's budget passes, this office will close.

What is going to happen? Newborns are going to die. It's that simple. Politicians cannot hide the chilling statistics: In 2006, nine out of every 1,000 babies born in Nashville died before their first birthday. Today, thanks to this program that rate is down to six out of 1,000 births.

Democrats only need to pick up three seats to win back control the State Senate and two seats for control of the State House. That’s all it would take to make sure a budget like this never sees the light of day.

If the full Republican Senate approves this budget, they’ll take life issues off the table for their campaigns. From then on, if they even think about using abortion to smear their opponents, Democrats will have a powerful weapon to hit back with: the Republicans' own indifference to human life.

Hypocrisy is always a tougher sell than fear. Win or lose, Tennessee Republicans are going to remember that after November.

Last year, the Democratic-controlled Colorado Legislature passed the Health Care Affordability Act, seeking to extend Medicaid coverage to tens of thousands of Coloradans who would otherwise go uninsured. The law went into effect in April, with impressive results:

The point of the Health Care Affordability Act, considered Gov. Bill Ritter's most significant health care reform, is to create a pot of money through hospital fees that would draw matching federal money. The state is using the additional money — expected to reach $1.2 billion annually — to provide more Coloradans with health insurance, as well as pay back hospitals for treating patients who are either uninsured or on Medicaid.

Many hospitals, especially those that treat a large number of indigent patients or those on Medicaid, actually end up with a net gain of millions of dollars through the program, even when accounting for the new fees. But the plan also does a good job of minimizing any overall losses absorbed by hospitals that see a net loss:

Centura Health's Adventist hospitals — Porter, Avista, Littleton and Parker — will lose a combined $6.3 million through the hospital fee. Still, the 12-hospital Centura system comes out winning, with a net gain of about $4.4 million.

"The state did a very nice job of trying to limit the losers," said Randy Safady, Centura's chief financial officer. "We have a number of losing hospitals and we have a number of winning hospitals."

Overall, the new law is expected to help about 67,500 more Coloradans receive health insurance, filling a key need for many of those individuals until the federal reform law is fully implemented in 2014.

Republican Tennessee State Representative Mike Bell recently suggested that plenty of people get along just fine in America without health insurance. While discussing legislation that would attempt to nullify the federal health care insurance mandate within the state of Tennessee, Bell embraced the Mennonite practice of exchanging vegetables and other goods for health care as a feasible alternative to health insurance for Americans.

The Nashville Scene reported on a dialogue between Bell and Democratic State Representative Joe Towns in committee:

Bell: They're some of the healthiest people you have ever seen. They pay cash when they go to the doctor. They work out arrangements with the hospitals if their children have to be hospitalized. This is an individual choice that we're talking about.

Towns: You're saying they pay cash? For organ transplants and cancer and heart cases, they pay cash?

Bell: I said they pay cash or work out other arrangements. I know for a fact. I know someone in the medical field who has been paid with vegetables from the Mennonite community.

Towns: That's an anomaly. That's not how the system works. I can't take a sack of vegetables down to the utility company and pay my utility bill on my house. Nobody's going to take vegetables for payment. We can't run the country on vegetables and horse trading.

Mike Bell is not the only Republican politician advocating a return to 18th and 19th century health care practices; even candidates for the U.S. Congress and Senate have made similar arguments. While Democrats are fighting to make affordable, universal health insurance a reality, Republican state legislators like Mike Bell would have middle class Americans facing cancer and other serious diseases bringing vegetables and chickens to their doctors to plead for medical treatment.

The idea that Americans should return to the bartering system in health care shows how out of touch the Republican Party is with the real concerns of modern American families struggling to make ends meet.

John D’Elia is a Klindt/Dye Intern for the 2010 Spring Semester

The President’s health reform law is going to save thousands of lives and make coverage more affordable for millions of Americans. It also left some good, progressive ideas on the table. But with the reform bill now law, Democratic state legislators are already stepping up to put those ideas into action.

Colorado, Maine, and Maryland have all passed bills to reinforce or speed up key planks of the federal reform plan, like the prohibition on charging higher premiums for women or the ban on lifetime caps on benefits. Meanwhile Oregon, which created the Oregon Health Authority last year to study ways to improve the affordability of health care, is uniquely positioned to take advantage of the federal reform plan.

But states like Connecticut and Vermont are preparing to go even further. Connecticut will be continuing its SustiNet project, a state-administrated health plan overseen by a board of experts reporting directly to the Legislature. The Vermont Senate has given preliminary approval for a bill requiring the Legislature’s Health Care Reform Commission to develop three separate plans for implementing universal health care, including one plan that creates a state-run public insurance option.

Even before the President’s plan passed, Democratic state legislators were at the forefront of health care reform in America. But now that we have health care reform on a national scale, expect states to continue pushing the envelope – finding new ideas and offering bold solutions.

And expect Democrats to continue leading the way.

Of all the states where conservative lawmakers are trying to block the new health reform law, Georgia stands out. The Republican sponsor of a state constitutional amendment blocking the individual mandate proposed his own health reform bill three years ago, and it included an individual mandate.

We at the DLCC were shocked, just shocked to discover that there is hypocrisy in the Republican Party:

First they tried to pass a constitutional amendment in the state Senate to declare that no Georgian could be mandated by government to buy health insurance, as if Georgia law could somehow supercede federal law. The amendment failed.

(The amendment was sponsored by state Sen. Judson Hill, who three years earlier had introduced legislation that would have — wait for it — forced Georgians to buy health insurance, even giving state officials the power to garnish wages of those who refused. At the time, Hill attributed the legislation to House Speaker Newt Gingrich, who is now one of the sternest critics of “Obamacare”. In other words, mandated health insurance was a good idea until it became part of the Democratic health-reform bill, at which point it became unconstitutional and the most dire threat to American liberty since General Cornwallis surrendered at Yorktown.)

Frustrated in the Senate, Republicans then tried to pass a similar constitutional amendment in the House.

They failed. Again.

The reason the mandate is so crucial is because it makes it possible to ban exclusions for pre-existing conditions without sending premiums sky-rocketing. That’s why these Republicans thought mandates were such a brilliant idea just a few years ago.

Georgia Democrats saw right through the Republican double-talk and voted against it, preventing the proposed amendment from getting the 2/3 vote necessary to pass. That was a risky thing to do in a conservative state like Georgia, but kudos to both caucuses for standing up for health care for 32 million Americans.

The GOP-led Arizona legislature offers a perfect illustration of why national, comprehensive health care reform is such an important priority.

While conservatives in other states are trying to gut President Obama's plans, Arizona lawmakers are busy rolling back coverage for their own citizens:

The budget passed earlier this month eliminates KidsCare, which provides health coverage to children from low-income families, as well as reduces eligibility for the state's Medicaid program. The reduction will cause 310,000 adults to be kicked off the rolls of the Arizona Health Care Cost Containment System.

The cuts are so drastic that they actually disqualify the state from receiving $7 billion in federal funds for Medicaid. The new health care law requires states to demonstrate a "maintenance of effort" to qualify for fed dollars.

Recognizing their error, albeit belatedly, GOP leaders are now scrambling to restore the cuts before KidsCare expires on June 15th.

The President’s reform plan hasn’t even passed yet, but right-wing state lawmakers are already trying to strip out key elements of the plan at the state level.

They’ve only managed to pass their bills in a few states like Arizona and Utah, but they’ve filed new legislation to obstruct federal health care reform in 35 states. And if reform supporters win the final showdown in Congress this week, we can expect this trend to continue.

But the stakes are just as high at the state level as they are in Congress. If Democrats fail to protect health care reform from state-level obstruction, millions of Americans who are counting on health care reform to improve -- or potentially save -- their lives will be left out in the cold:

But the $28 billion in Medicaid money is not the whole picture. These reforms will extend Medicaid coverage to nearly 8 million individuals in these states, while millions more will qualify for premium subsidies to help purchase private coverage through health insurance exchanges. This will reduce costs for employers, state governments, and insured individuals, because as these uninsured individuals and families gain coverage, the cost-shift of uncompensated care will diminish. It will also help states out because these new Medicaid eligibility levels will absorb those under 133 percent of the poverty level in state insurance programs, with full federal support for the first several years of the program.

We spend a great deal of time on this blog talking about what states are doing to reform health care. A number of states have made us proud during the last legislative session, and we expect them to continue pushing the envelope for reform, no matter what Congress decides to do.

But if we win the vote this week for health care reform, this won’t be over. The fight will just move to the state legislatures, and we predict it will be every bit as ferocious as the fight to pass the President’s health care plan in Congress.

Here at the DLCC, we’re determined to be ready.