Ray Scheppach was appointed executive director of the National Governors Association (NGA) in January 1983. As executive director, Ray oversees the day-to-day operations of the association and works closely with NGA’s chair and vice chair and their staffs to help identify priorities for the nation’s governors. Through NGA, governors deal collectively with issues of public policy and governance at both the national and state levels. The association's mission is to provide a forum for governors to exchange views and experiences among themselves; assistance in solving state focused problems; information on state innovations and practices; and a bipartisan forum for governors to establish, influence and implement policy on national issues.
Prior to NGA, Ray worked for seven years at the Congressional Budget Office, serving the last two years as Deputy Director.
Under his leadership, NGA has risen to become one of the most powerful lobbying groups in Washington. NGA was ranked 12th by Fortune magazine in its 1999 annual survey of the most influential trade associations, labor unions and interest groups.
Professional health care experience and publications include: leading a team of six state Medicaid and Governor’s health policy advisors to negotiate state issues as part of President Clinton’s health care initiative; member of the Jackson Hole Health Care initiative that developed a proposal and series of policy papers for managed competition; participant and speaker in the Council on Health Care Economics and Policy seminars under the direction of Stuart Altman, Ph.D.; published “The State Healthy Agenda: Austerity, Efficiency and Monitoring the Emerging Market” The Future U.S. Health Care System: Who Will Care for the Poor and Uninsured, edcited by Stuart H. Altman, Uwe E. Reinhardt, Alexandra E. Shields, Health Administration Press; and published “The Clinton Plan: How Does it Play for Governors and State?” with Carl Volpe, Journal of American Health Policy, November/December 1993 issue.
He has written numerous professional articles on various public policy issues and has authored and co-authored four books on economics, including co-writing the 1984 book New Directions in Economic Policy: An Agenda for the 1980's.
Ray received his bachelor’s degree in business administration from the University of Maine, and his master’s and doctorate degrees in economics from the University of Connecticut.
The issues of malpractice and the practice of defensive medicine have been a concern for states, as they contribute to increasing health care costs. States have varied experiences addressing these challenges, with different versions of tort reforms as the most frequent tool. But other efforts to tackle aspects of medical malpractice also have been implemented in states, including insurance reforms and patient safety efforts. Like all things in health care, this is a complex issue, and no silver bullet solution has been identified. However, malpractice reform should be part of any comprehensive health care reform package. There is no solid… Read more
In response to concerns about the pandemic potential of the H5N1 virus, states have been working with the federal government and with each other over the past several years to develop and refine plans and strategies for use in a pandemic or other public health emergency. The plans developed by the states are now guiding and coordinating the activities of state public health and emergency management officials. They have helped define roles and responsibilities; address the stockpiling and distribution of anti-viral drugs, personal protective equipment and other medical supplies; and include protocols for containment and isolation of infected or at-risk… Read more
Long term care is an important health care issue that is seldom mentioned. What most consumers and even many policymakers do not realize is that Medicare coverage for long term care services is extremely limited, leaving huge gaps in the types of services most elderly and disabled Americans need. The absence of any national strategy has thrust the responsibility to the states and to the Medicaid program in particular. In turn, Medicaid now serves as the de facto long term system of care, spending more than $118 billion to provide services to more than three million individuals. This also means… Read more
The major compelling question of the current health reform debate is not necessarily WHAT to do, but how much can be done, and whether or not there is enough political will and capitol to force those often painful changes through. Health care is 16 percent of the nation’s GDP and growing. Quality is often poor, costs are undeniably high and there are more than 45 million uninsured. What that means is that fundamental change is needed everywhere. Fundamental change does not come quickly and certainly will not come without broad bipartisan political support. Complicating matters, with an economic stimulus/recovery package… Read more
Medicaid is a vital health care safety net and has been incredibly successful in that mission. Over the years, however, Medicaid has been stretched thin to the point of breaking by being asked to fill in the gaps that continually appear in our health care system State budgets (even in relatively healthy economies) struggle to sustain Medicaid’s increasing role as the only payer of long term care and the primary source of care for people with disabilities. Adding more responsibilities, whether long term or short term, further stretches this safety net, endangering everyone currently protected by it. In the current… Read more
The State Children’s Health Insurance Program (SCHIP) is a very successful program, ensuring millions of children have access to health care coverage. SCHIP reauthorization remains a top priority for new the Administration, Congress and the nation’s governors. During this national economic and state fiscal crisis, now more than ever, SCHIP program stability is essential to protect the health of our nation’s most vulnerable children. This economic uncertainty elevates the need to reauthorize SCHIP well in advance of the March 31st, 2009, deadline. SCHIP reauthorization should not be held hostage by the important discussions already underway about the future of health… Read more
The economic recovery package currently being discussed contains funding for broader adoption of health information technology (health IT) across the nation. Creating a nationwide health IT infrastructure—which includes health records exchange and e-prescribing—is essential to improving health care quality and care coordination. The draft House bills appear to be on the right track, but some questions will need to be answered in the next several weeks to clarify the role states will play in helping build out the infrastructure that would allow for exchange of medical records. There are two primary reasons why states should serve as the chief organizing… Read more
COBRA works well for its intended purpose, i.e., to assist workers make the transition to another job or possibly Medicare. It never was intended to be on option to assist the long-term unemployed. It could be possible, however, to modify COBRA during this economic downturn to make it viable. This would require a temporary federal subsidy in the form of a targeted, advance able, refundable tax credit that would help many individuals maintain their current form of coverage until the economy recovers. The amount can be debated, but should be a significant percentage of the overall cost to acknowledge that… Read more
The creation of a Federal Health Board, if done properly, could be one of the more meaningful acts of health care reform that the 111th Congress undertakes. One of the important lessons learned from the Massachusetts health care reform experience is that no legislative act could ever hope to fully and finally make all the decisions necessary to govern serious health care reform. Legislative bodies are not fluid or nimble enough to quickly and adequately respond to constantly changing health care needs (and state legislative bodies are MUCH more nimble than federal). In a reform effort like in Massachusetts, if… Read more
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