By Matthew HisrichCOLUMBUS, Ohio -- Across the country, the 43 million Americans without health care insurance coverage are becoming a hot-button political issue. While a portion of this group has been shown to include many who opt against coverage despite having the means to acquire it, there nonetheless remain those who simply have been priced out of the market. Fortunately, policymakers have already begun to take some action.For instance, in 2002 Congress passed the Trade and Adjustment Act. This legislation offers a tax credit both to workers who have lost their jobs or pension coverage as a result of foreign competition. The credit covers 65% of insurance costs, and can be paid in advance as necessary. Ohio has been particularly hard hit in this area, and policymakers should take every advantage of this opportunity to craft a comprehensive approach to the uninsured.As it stands, the tax credit program is woefully underutilized. Of the estimated 16,000 eligible participants in Ohio, only 835 have enrolled. In a recent article on the subject, Ohio Department of Insurance Director Ann Womer Benjamin acknowledged that more can and should be done."I've been a bit disappointed," she said. "This is a very positive program with great potential, but we have to do more to publicize it and reach people who may be eligible."Indeed, Ohio is now taking steps to do just that. The Department of Insurance is in the process of distributing and then evaluating surveys from all potentially eligible individuals. ODI's Doug Anderson is heading up this effort. While he is concerned about the potential lack of coverage among Ohioans, he does stress that part of the issue with lack of participation may be a result of those who would be able to use the credit already having coverage through their spouse or other programs.This may in part be due to lack of affordability, as even a 35% payment on certain premiums may simply be more than some can afford. Ohio's current approach to coverage for these individuals includes fairly conventional offerings -- COBRA for former employees of large firms, Mini-COBRA for smaller businesses, and certain approved private insurance providers such as Anthem. While such coverage is by no means inadequate, Ohio has the opportunity to take advantage of federal assistance to develop a program that can better meet the needs of trade-affected workers and eventually expand to address the needs of other populations.As an example, The Heritage Foundation in Washington, D.C., suggests that states consider adapting the model of the Federal Employees Health Benefit Program for those eligible under the Trade Act. This would involve establishing a sort of health insurance clearinghouse from which eligible participants could select from a variety of plans all competing for their business.Expanding upon the small group of those affected by the Trade Act to include others such as state, county and municipal employees, or even some Medicaid enrollees would stabilize the population from an insurance perspective, and federal assistance would still remain available. As Heritage explains, "As long as the tax credit recipients were included in the pool, the state could apply for federal grant money to help set up a system that offers coverage options to a variety of participants."By taking the initiative to create this infrastructure, policymakers can help ensure better coverage for Ohioans, encourage the use of private insurance, and as a result potentially alleviate pressure on an overburdened Medicaid program and health care system. Such a move could have spillover effects on the state's struggling economy as well, by helping Ohio become a more competitive state and retaining those who might otherwise depart for opportunities elsewhere.Matthew Hisrich is a policy analyst with The Buckeye Institute."