Power and Opportunity in the States
Apr 18, 2019, 2:00 PM, Posted by Giridhar Mallya, Tara Oakman
State policymakers have more flexibility than ever to advance health-promoting policies and programs, and to showcase effective strategies from which other states—and the nation as a whole—might learn. RWJF helps inform their efforts through research and analysis, technical assistance and training, and advocacy.
Why States Matter
States have long been laboratories for innovations that influence the health and well-being of their residents. This role has only expanded with the greater flexibility being given to the states, especially as gridlock in Washington, D.C. inspires more local action. The bevvy of new governors and state legislators who took office early this year also widens the door to creativity.
Medicaid is perhaps the most familiar example of state leadership on health. With costs and decisions shared by state and federal governments, the program allows state policymakers to tailor strategies that meet the unique needs of their residents. Among other examples, efforts are underway in California to expand Medicaid access to undocumented adults, and in Montana to connect unemployed Medicaid beneficiaries to employment training and supports.
In Washington state and elsewhere, Medicaid dollars can now cover supportive housing services, while Michigan is among the states requiring Medicaid managed care organizations to submit detailed plans explaining how they address social determinants of health for their enrollees. All of this experimentation is happening as states struggle to control the growth of their health care spending—a balancing act of immense proportions.
