Health Care Reform Around the Nation: June 11
Gov. Bill Ritter (D) on June 1 signed into law a bill that prohibits health insurance companies from considering employees' claims history and current health when setting premiums for small businesses, the Colorado Springs Gazette reports. The law does not prohibit insurers from raising or lowering premiums based on age, geographic location, smoking history and certain other factors.
Sponsors of the bill said it would help prevent small businesses from dropping insurance coverage by protecting them from rate hikes if an employee or dependent becomes seriously ill (Sealover, Colorado Springs Gazette, 6/1).
The state House and Senate approved a health care reform package that would increase income eligibility limits for many state health insurance programs, the AP/Hartford Courant reports (AP/Hartford Courant, 7/7). The package is expected to cost at least $390 million over two years (Poitras/Keating, Hartford Courant, 6/6).
Gov. Jody Rell (R) said she will not sign or veto the measure until lawmakers pass a budget plan (AP/Hartford Courant, 7/7).
The bill would:
- Establish two panels to study possibilities for universal health insurance in Connecticut;
- Increase Medicaid reimbursements for physicians and hospitals (AP/Hartford Courant, 7/7);
- Raise income limits for enrollment in the state-subsidized HUSKY A health insurance program for children from 150% to 185% of the federal poverty level and raise income limits for the HUSKY B program from 300% to 400% of the poverty level;
- Require mandatory enrollment in HUSKY for all uninsured newborns, with the state paying the premiums for the first two months after birth;
- Raise income limits for pregnant women enrolling in Medicaid from 185% to 250% of the poverty level;
- Provide additional grants and financial aid for school and community health clinics; and
- Fund development of a statewide electronic health record system (Hartford Courant, 6/6).
The legislative session ended Wednesday, and lawmakers said they would return for a special session to address the budget (AP/Hartford Courant, 6/7).
The state Senate on Tuesday approved a bill that would give state insurance regulators the same authority to review health insurance rates as they have for automotive and homeowner insurance policies, the Wilmington News Journal reports.
State Insurance Commissioner Matt Denn proposed the legislation, which now moves to the House.
Denn said the bill mostly would benefit individuals and small businesses, which have little power to negotiate with health insurers (Jackson, Wilmington News Journal, 7/6).
The state Supreme Court ruled 5-1 to uphold a funding mechanism in Gov. John Baldacci's (D) Dirigo Health initiative that health insurers challenged in a lawsuit, the AP/Portland Press Herald reports.
The Dirigo Health law was designed to expand coverage while reducing charity care and bad debt for insurers. Under the law, insurers are required to return their bad debt savings to the state through "savings offset payments."
The Maine Association of Health Plans and two other groups sued over the savings figure for the first year of the program, arguing that it included additional categories of savings that state lawmakers had not considered when approving the measure.
In the majority opinion, state Chief Justice Leigh Saufly wrote that the former insurance superintendent who calculated the savings figure gave a "reasonable interpretation of an ambiguous statute" in determining that Dirigo Health generated $4 million in savings in its first year (AP/Portland Press Herald, 6/1).
The board charged with implementing the state's mandatory health insurance law delayed a vote on Tuesday on proposed rules for exemptions because they would have exempted more people than intended, the Boston Globe reports. Under the law, residents who do not obtain health insurance could face tax penalties.
The vote was postponed after a board member discovered an error in a table of exemption standards that was presented at the meetings. The board now will vote on July 12 at the latest.
In other action, the board finalized rules on minimum coverage requirements under the law. The requirements will take effect in January 2009 and include:
- Coverage for prescription drugs, primary care, hospital care and mental health services;
- Deductibles that do not exceed $2,000 for an individual;
- Out-of-pocket expenses for physician, hospital and diagnostic care that do not exceed $5,000 for an individual; and
- No limit on annual benefits or payments for specific diseases (Dembner, Boston Globe, 6/6).
Gov. Brad Henry (D) on Monday signed into law two bills designed to make health insurance more affordable for state residents, the Daily Oklahoman reports.
One law will allow about 45,500 families with incomes between 185% and 300% of the poverty level to purchase private health insurance for children for an annual premium of about $4,200.
The other law will increase eligibility for Insure Oklahoma, a state program that provides subsidies to help businesses purchase health insurance for employees.
Both programs will be funded with tobacco tax money (Mock/Gollob, Daily Oklahoman, 6/5).
CMS rejected Utah's request to use Medicaid funds to restore eye care benefits for about 60,000 blind, elderly and disabled beneficiaries because the proposed copayment amount would exceed federal limits for individuals with incomes below the poverty level, the Salt Lake Tribune reports.
State lawmakers approved the proposal under a managed care plan aimed at reducing costs. The plan would have required beneficiaries to pay copays of $10 for eye exams and eye glasses, exceeding federal copay limits of $3 for beneficiaries with incomes below the poverty level.
The plan would have taken effect July 1.
Michael Hales, the state's Medicaid director, said lawmakers either could agree to fund the program with a $3 copay or develop a new proposal and apply for a federal Medicaid waiver (Stewart, Salt Lake Tribune, 6/6).