Democratic governors have bold ideas to transform health care: Harvard researchers

January 16, 2019

Republican and Democratic governors have strikingly different visions for the future of health care, according to a new analysis published in the American Journal of Public Health. While Republican leaders favor maintaining or shrinking public health insurance programs, Democratic leaders are advancing several new proposals to expand public coverage, including "public option" and single-payer health reforms.

Researchers analyzed the health care platforms of the 72 Republican and Democratic nominees running for governor in the 2018 election, examining position statements posted on campaign websites. They identified four major health care reform proposals advanced by gubernatorial candidates: introducing work requirements for Medicaid, expanding Medicaid in states that have not yet done so, creating a public insurance option, and transitioning to a state-based single-payer system.

Five Republican nominees proposed adding work requirements for their state's Medicaid program, of whom one was elected (in Ohio). In the 22 states that had previously expanded Medicaid, no candidate from either party proposed rolling back coverage.

Six Democratic nominees proposed creating a new public insurance option to compete alongside private plans, of whom five were elected. Importantly, a public option was proposed by newly elected governors in Illinois, Colorado, New Mexico, and Maine who will be working with Democratic state legislatures, bolstering the political viability of reform. Seven Democratic nominees proposed single-payer health care plans, of whom three were elected. These newly elected governors--in California, Colorado, and New Mexico--will all be working with Democratic-controlled state legislatures.

All Democratic nominees included health care platforms on their campaign websites, but only half of Republican nominees did so. Their omission did not appear to have electoral consequences: 13 of the 18 Republicans offering no health care platform won their elections.

According to Micah Johnson, an author of the AJPH article and M.D. candidate at Harvard Medical School, "With a divided government in Washington, states have an opening to provide leadership on health reform in the next two years. State efforts to expand public coverage could serve as a model for future national reform, much as the Massachusetts health reform plan in 2006 provided the blueprint for the Affordable Care Act."

Sanjay Kishore, an author of the article and M.D. candidate at Harvard Medical School, said, "At a time when many voters consider health care their top priority, it's remarkable that ten candidates for governor led with a platform of single-payer or a public option, reforms never achieved anywhere in the U.S. This may signal a desire for more progressive health policy."
-end-
"Laboratories of Democracy: Health Care Reform Platforms in the 2018 Governor Elections." Micah Johnson and Sanjay Kishore. American Journal of Public Health, Jan. 16, 2019.

DOI: 10.2105/AJPH.2018.304890

A copy of the full study is available to media professionals upon request from Mr. Johnson, Mr. Kishore, or Ms. Fauke.

Physicians for a National Health Program is a nonprofit research and educational organization of more than 22,000 doctors who support a single-payer national health program. PNHP had no role in funding or otherwise supporting the study above.

Physicians for a National Health Program

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.