Health Care Reform News Around the Nation for the Week of April 21
The Florida Senate on Wednesday unanimously approved a plan proposed by Gov. Charlie Crist (R) that aims to reduce the 3.7 million uninsured residents in the state, the Miami Herald reports (Caputo, Miami Herald, 4/17).
The proposal would remove mandates that require insurance plans to include coverage of up to 50 services, which would allow insurers to offer stripped-down plans with premiums as low as $150 a month. Under the proposal, two tiers of coverage for catastrophic and noncatastrophic illnesses would be available for residents who were uninsured for the previous six months (California Healthline, 4/10).
The state House is looking to pass a broader measure that would establish a public-private administrator to handle coverage for businesses with fewer than 50 employees. The administrator would be similar to the state's HealthyKids, which runs KidCare, Florida's version of the State Children's Health Insurance Program (Miami Herald, 4/17).
Cutting the Louisiana Department of Health and Hospitals' operating budget by 5% next year could lead to reduced access to care for low-income and elderly residents, and those with disabilities, DHH Secretary Alan Levine wrote in a letter to state House Appropriations Subcommittee on Health and Human Services Chair Tom McVea (R), the New Orleans Times-Picayune reports. Lawmakers say they are trying to develop measures that would reduce the state's operating expenses by about $250 million.
According to Levine, most of the agency's $8.5 billion budget is allocated to the Medicaid program, 30% of which is financed by the state with the remaining funds coming from the federal government. Levine wrote that reducing spending by $86 million could lead to a reduction of $302 million after accounting for lost federal matching funds (Moller, New Orleans Times-Picayune, 4/18).
Levine offered lawmakers several options to reduce spending, including:
- Eliminating a program that provides community-based services for the developmentally disabled to save $41 million;
- Lowering the Medicaid payment rate for nursing homes to save $8 million;
- Reducing by one day the length of time a Medicaid beneficiary is allowed to stay in a charity hospital to save $27.5 million; and
- Eliminating an adult health care day program in New Orleans, and the hospital unit and group home at Villa Feliciana medical complex to save $1.1 million.
Levine, who suggested several other possibilities, wrote, "Without knowing the Legislature's priorities as a starting point, these options are not recommendations, but rather examples of various programs the Legislature could choose to address and the potential impact of such reductions," he wrote (Millhollon, Baton Rouge Advocate, 4/18).
Maine Gov. John Baldacci (D) on Wednesday signed into law a bill that increases taxes and fees on beer, wine and soda manufacturers to fund the Dirigo Health program, the Blethen Maine News Service/Portland Press Herald reports. The law also authorizes the state to use $5 million from the state's tobacco-settlement fund and borrow $3.6 million from the state general fund for the program, and it assesses a 1.8% surcharge on health insurance claims (Cover, Blethen Maine News Service/Portland Press Herald, 4/17).
According to a legislative staff analysis, the soft drink tax will generate an estimated $9.2 million for Dirigo Health in fiscal year 2009. The increase in the beer and wine tax will generate an estimated $7.5 million for the program in FY 2009.
The new law will take effect 90 days after the state Legislature adjourns. State officials said the law will allow for limited new enrollment in the program, perhaps by late summer or early fall. Trish Riley, director of the Governor's Office of Health Policy and Finance, said program enrollment would probably remain at between 17,000 and 18,000 (Quinn, AP/Bangor Daily News, 4/17).
The law also makes changes that are designed to lower health insurance costs for residents younger than age 40. According to the governor's office, the law is supposed to lower rates for people who purchase individual health plans on the private market (Blethen Maine News Service/Portland Press Herald, 4/17).
Maryland health officials this summer will send letters to tens of thousands of state residents notifying them that family members might be eligible for state and federal health insurance programs, the Baltimore Sun reports. The General Assembly earlier this month passed legislation ordering the state Office of the Comptroller to review state tax information to identify residents who could qualify for the programs and notify their families.
One mailing would target residents who will be newly eligible for Medicaid under expanded eligibility rules approved by the Maryland General Assembly. Starting July 1, people with incomes up to 116% of the federal poverty level will be eligible for the program. The other letter would inform residents that family members are eligible for SCHIP or other federal programs. According to Joe Schapiro, a spokesperson for state Comptroller Peter Franchot, the state is not sure how many letters will be sent. Maryland has an estimated 750,000 uninsured residents.
Deputy State Health Secretary John Folkemer said rules issued by the Bush administration that limit SCHIP eligibility for children in families with incomes greater than 200% of the poverty level would not cause the state to stop efforts to enroll children in families with incomes up to 300% because the rules are being challenged by a lawsuit and congressional legislation (Carson, Baltimore Sun, 4/16).
In a supplemental budget request released last week, Massachusetts Gov. Deval Patrick (D), requested an additional $153.1 million to help cover costs of the state's health insurance law, the New York Times reports. The state had approved $472 million for the law this fiscal year, but enrollment in the state's subsidized health insurance program Commonwealth Care was higher than expected.
Cyndi Roy, a spokesperson for Patrick, said this year's shortfall would be offset with surplus revenue in the state's general fund. Patrick has requested $869 million for the program in next year's budget, but aides have said that amount will not be enough as enrollment continues to grow (Sack, New York Times, 4/17).
Cook County, Ill., Judge James Epstein on Tuesday issued a temporary injunction to block Gov. Rod Blagojevich's (D) efforts to expand the state's FamilyCare program, the Chicago Tribune reports.
Epstein ruled that Blagojevich could proceed on one part of his expansion proposal that would provide uninsured women in the state with breast and cervical cancer screenings. In his written ruling, Epstein noted that state lawmakers had allocated $6 million toward the screening program without setting income restrictions, which gives the governor legal authority to further expand the program (Mendell, Chicago Tribune, 4/16).
New Mexico Gov. Bill Richardson (D) might call a special session of the state Legislature in May, but Senate leaders say they need more time to reach an agreement on health care proposals, the Santa Fe New Mexican reports. During the legislative session that ended in February, lawmakers rejected Richardson's plan to cover 400,000 uninsured state residents. Many lawmakers cited costs as a reason for not supporting the measure.
Richardson has met with Senate leaders since the end of the session to discuss elements of a potential agreement. He also has requested greater accountability and efficiencies in the state health care system.
Senate President Pro Tempore Tim Jennings (D) and Majority Leader Michael Sanchez (D) said that questions remain about Richardson's proposal and that fall is a more realistic time to further discuss the matter (Nash, Santa Fe New Mexican, 4/11).