Both the House and Senate reform proposals would change the federal structure surrounding state health policy.  Part I of this NASHP State Policymakers’ Guide provides an overview of existing state roles in the health care system and how they will be impacted by federal reform.

From the report executive summary:

Leaders in state health policy have been working for decades to improve the health care system. They have toiled using the tools at their disposal while sometimes lamenting the barriers federal policy creates and sometimes appreciating the support federal policy provides. Both the House and Senate health reform proposals would dramatically change the federal structure within which state health policy operates. Part I of this State Policymakers’ Guide provides a high-level view of existing state roles in the health care system and how federal reform will affect those roles. In our work with state health policy leaders, we have identified five themes around which current state reform efforts focus. For each of these themes, states have a broad array of tools that they do or could employ to attain their goals. This brief first describes those tools. It then examines how national health reform expands, contracts or modifies the array of tools. Part I of the State Policymakers’ Guide looks at federal health reform squarely through the lens of the state policymaker, asking the question: Will reform support or impede progress toward existing state health system improvement goals?

Full report:  A State Policymakers' Guide to Federal Health Reform: State Roles (PDF | 176.31 KB)

National Academy for State Health Policy. (2009). A state policymakers’ guide to federal health reform – part I: anticipating how federal health reform will affect state roles. Weil, A., Witgert, K., Scott, J., Gauthier, A., Justice, D., Schwartz, S., Cantrell, C. and Zemel, S.