Voters in Colorado will head to the polls this November not only to cast their ballots for the next president of the United States, but also to determine whether they will become the only state in the nation to adopt single-payer health care.

More than 20 legislators from 16 states--many of them in key leadership positions on health or budget committees that deal with Medicaid in their home states--attended a CSG policy academy in Washington D.C. on September 21-23, 2016, to learn how states are making reforms in their Medicaid program that pursue the health "triple aim": improving the quality of care for individuals, improving the health of populations, and reducing per capita costs of health care.

No state can ignore the challenge of controlling the cost of health care, estimated to reach one-fifth of GDP by 2020. Medicaid budget growth continues to strain states’ abilities to grow program priorities in other arenas. The uncertainty of federal commitment to current Medicaid matching formulas is exacerbated by the 2016 election. Promising state strategies to control costs of health care generally and Medicaid specifically were explored.

In September, the U.S. Census Bureau released the highly anticipated Health Insurance Coverage in the United States: 2014 report and the Income and Poverty in the United States: 2014 report. The Census Bureau’s annual survey of health insurance coverage found that significantly fewer American adults remained without health insurance in 2014 compared to the year before.

Medicare pays between $16,500 and $33,000 for hip or knee replacements depending upon the hospital and geographic area of the country, but with a new payment program Medicare expects to save $343 over the next five years.

On Nov. 16, 2015, the Centers for Medicare & Medicaid Services announced they would begin to make bundled payments for these surgeries in 800 hospitals in 67 geographic areas under a model program over the next five years.

A ballot initiative to establish a single-payer health care system in Colorado has been approved for the Nov. 2016 ballot. Supporters turned in 158,831 signatures and after reviewing a five percent sample, the secretary of state’s office certified Initiative 20, the “State Health Care System.”

Gov. Mike Pence announced today federal approval of his state’s Medicaid waiver to expand eligibility to all persons with incomes below 138 percent of the federal poverty level, according to the Indy Star newspaper.

Pence has lobbied hard for what he calls HIP 2.0, expanding a smaller consumer-driven health plan called Healthy Indiana Plan, rather than expand the traditional Medicaid program.

“The expanded and updated HIP 2.0 is based on a program that has been serving 60,000 low-income Hoosiers in our state for seven years,” said Governor Pence in a press release. “It is a proven model for Medicaid reform across the nation.”

Up to 350,000 people will be eligible according to the press release. The state will start taking applications today, Jan. 27, for coverage to begin on Feb. 1, 2015.

New Arkansas governor, Asa Hutchinson, will ask the legislature to continue to fund the private option Medicaid expansion through the end of 2016, according to the Arkansas Times. Then he intends to come up with a new plan for 2017 and beyond.

Gov. Hutchinson alluded to Section 1332 waivers, sometimes called waivers on steroids, that will be available to states in 2017 to implement wholesale reforms of Medicaid while releasing an approved state from many, if not all, of the requirements of the Affordable Care Act.

Calling his proposal Insure Tennessee, Gov. Bill Haslam said yestereday he is requesting an amendment to the state’s TennCare demonstration project for a two year pilot project to cover as many as 200,000 low-income individuals under the Medicaid expansion available through the Affordable Care Act, according to numerous press reports.

Apparently having health insurance matters. Not as many people die.

That is the chief finding of a new health study that looked at mortality in Massachusetts following the enactment of health reform in 2006 that resulted in nearly universal health insurance coverage in that state.

Today’s New York Times summarized the study which was published online Monday in the ...