States play a major role in the delivery and financing of health care and public health in the United States. Insurance regulation, Medicaid policy and financing of public health services, and many reproductive health policies are under state jurisdiction. States operate their own Medicaid programs within broad federal guidelines, the State Children’s Health Insurance Program (SCHIP) for low-income children, and in some cases also offer additional health care programs such as discount drug programs for seniors.
In recent years, states have been facing major budget shortfalls. These fiscal constraints have broad implications for many aspects of the health care financing and delivery system. Recent reductions to Medicaid coverage and benefit packages have been a reversal from the programs expansions of the late 1990s when states experienced unprecedented budget surpluses. State legislatures are also playing an increasingly important role in health policy, enacting legislation on issues that have been controversial and slow-moving at the national level, such as patients’ rights and reproductive health.
The Foundation’s work in state health policy cuts across nearly all of the Foundation’s policy priority areas. The Kaiser Commission on Medicaid and the Uninsured analyzes state Medicaid and SCHIP programs, and tracks changes states are making to their Medicaid programs as a result of their deteriorating fiscal conditions. The California Health Policy Program provides information and analysis about health policy issues and key trends in the nation's largest and most diverse state. Nearly all of the Foundation’s priority areas collect and conduct analyses on state-based policies. Much of this information is presented in State Health Facts Online, a web-based interactive database, including demographic information, health insurance coverage rates, Medicaid and Medicare enrollment, spending and policies, private insurance mandates, health care financing and delivery information, as well as disease and mortality statistics.