Health Care Reform Around the Nation: July 16

Fewer than 700 people have enrolled in ARHealthNet -- an Arkansas health insurance program that provides subsidized health coverage to low-income workers at small businesses -- since it launched in December 2006, the Arkansas Democrat-Gazette reports. The program requires contributions from employers, employees or both based on an employee's income.

State officials had expected the program to cover 80,000 residents by the end of 2008, but such a goal by that date "appears unlikely," according to the Democrat-Gazette.

The state Department of Human Services has spent about $200,000 on advertisements to promote the program this summer, with another $200,000 available for the current fiscal year. The program is funded in part with money from the 1998 national tobacco settlement (Manthey, Arkansas Democrat-Gazette, 7/10).

The Georgia Department of Community Health Board on Thursday unanimously approved a policy that will allow 22,000 children to begin receiving benefits through the state's version of the State Children's Health Insurance Program, Morris/Augusta Chronicle reports. The program, called PeachCare, has not enrolled new beneficiaries since March because of a funding shortfall.

President Bush since has signed legislation that gives PeachCare an additional $121 million. PeachCare's new enrollment cap of 295,000 children will be re-evaluated after Congress approves legislation reauthorizing SCHIP.

SCHIP currently is scheduled to expire on Sept. 30 (Larrabee, Morris/Augusta Chronicle, 7/13).

Blue Cross and Blue Shield of Massachusetts, the state's largest insurer, said it will not enact a new policy that would have reduced businesses' minimum contributions for employees' health plan premiums, the Boston Globe reports. The policy would have dropped the premium from 50% to 33% for businesses with 50 or fewer employees (Krasner, Boston Globe, 7/13).

The state health care finance division last summer reduced to 33% the minimum amount that small businesses must contribute to the cost of workers' health coverage. Employers that do not contribute must pay an annual $295-per-employee surcharge to a state fund (California Healthline, 7/9).

Blue Cross said it made the change in response to a request from Gov. Deval Patrick (D). Patrick's administration was concerned that other insurers also would lower employer contributions, "sparking a race to the bottom in which employers contributed as little as possible to their employees' health care," according to the Globe (Boston Globe, 7/13).

In other Massachusetts news, the state on Thursday released proposed rules that would require low-income, uninsured patients to pay deductibles and copayments for care received at hospitals as part of the state's effort to encourage all residents to obtain health insurance, the Globe reports.

Under the proposed rules:

• Uninsured residents with incomes between 150% and 200% of the federal poverty level would be required to pay a $35 monthly deductible;
• Those with incomes between 100% and 200% of the poverty level would be required to contribute a $5 copay for office visits in a hospital and $50 for emergency department visits that do not result in an inpatient admission;
• Residents with incomes between 200% and 400% of the poverty level would pay a larger deductible based on income; and
• There would be no copays or deductibles for children or for care received at community health centers, except for a $3 copay per prescription (Dembner, Boston Globe, 7/13).

Gov. Eliot Spitzer (D) has ordered the state health commissioner and state insurance superintendent to develop a universal health insurance plan for the state by next summer, the governor and state officials said on Tuesday, the New York Times reports. The Spitzer administration last week also requested formal proposals from consulting groups to study universal health insurance plans.

Spitzer administration officials said that, based on a recent study, universal health insurance in New York would cost the state between $3 billion and $6.2 billion annually but also could reduce costs for employers.

Spitzer supports a plan that includes expansions of current state health insurance programs over a number of years to cover more low- and middle-income residents, according to New York Deputy Secretary of Health Dennis Whalen.

The plan likely also will include provisions similar to those in the recently implemented Massachusetts health insurance law, the Times reports (Hakim, New York Times, 7/11).

Wyoming's version of the State Children's Health Insurance Program began providing new mental health, vision and dental benefits to children on July 1, the Wyoming Tribune-Eagle reports. The updated benefits were proposed by a state benefits committee that meets every two years.

Under the changes:

• Beneficiaries are eligible for nine additional days of inpatient mental health care;
• Beneficiaries can opt for contact lenses instead of glasses under their vision care benefit; and
• The cost of dental cleanings will not be counted as part of the $1,000-maximum dental care benefit (Frazer, Wyoming Tribune-Eagle, 7/6).