Health Care Reform News Around the Nation for the Week of August 4
The Arizona Legislature and Gov. Janet Napolitano (D) have eliminated the SSDI-Temporary Medical Coverage program to save about $8.35 million as the state tries to reduce a $2 billion fiscal year 2008-2009 budget deficit, the Arizona Republic reports.
The program, which ended July 15, provided temporary health care coverage for people who are ineligible for Medicare or the Arizona Health Care Cost Containment System because they must wait two years after receiving a disability determination before enrolling in Medicare.
About 1,300 people with disabilities in the state had no health coverage because of the rule, so the program was created two years ago to allow them to pay a premium to gain coverage through AHCCCS until they were eligible for Medicare.
Rainey Daye Holloway, a spokesperson for AHCCCS, said that about 538 people enrolled as of November 2007, when the state froze enrollment in the program because costs were double the projected spending. She said that 250 of those people have not yet been able to enroll in Medicare (Wagner, Arizona Republic, 7/31).
Fewer than 3,000 primary care physicians and one hospital are currently participating in Connecticut's Charter Oak Health Plan for uninsured adults, which began accepting applications in July, the Hartford Courant reports. The program is expected to ultimately serve 19,000 people.
So far, 16,000 people have called the state's hotline and 5,351 have applied for coverage. Twenty-four residents began coverage on Thursday (AP/Hartford Courant, 7/31).
Under the plan, state residents ages 19 to 65 who do not qualify for existing state health insurance programs and are not insured through an employer are eligible for coverage, as well as those paying high premiums through private insurance, such as COBRA. Residents also must be uninsured for at least six months to qualify for the plan (California Healthline, 7/7).
The Hospital of St. Raphael in New Haven is the only medical center to sign a contract with one of the insurers operating the program for the state.
Stephen Frayne, senior vice president of the Connecticut Hospital Association, said reimbursement rates are the reason most hospitals are not participating.
Lawmakers and advocates also are concerned that the 320,000 children and adults enrolled in HUSKY, Connecticut's version of the State Children's Health Insurance Program, will have less access to physicians when beneficiaries of that program are switched to one of three plans offered under Charter Oak on Sept. 1 (Somma, Hartford Courant, 7/31).
Preferred Health Systems, Kansas' largest health insurer, announced last week that it will stop reimbursing hospitals for costs related to avoidable medical complications, the Wichita Eagle reports.
Beginning Oct. 1, treatment for "never events" -- including objects left in patients during surgery, use of the wrong blood type during a transfusion and certain infections -- will no longer be covered by the insurer. On the same date, Medicare also will stop paying hospitals the higher rates for the increased cost of care that results from such mistakes.
Blue Cross and Blue Shield of Kansas has said it will formalize its long-standing policy of refusing payment for avoidable complications effective Jan. 1, 2009 (Atwater, Wichita Eagle, 7/28).
On Tuesday, the Massachusetts House voted 135-21 to approve a bill that would require insurance companies and health care providers in the state to contribute more money to close a funding gap in the state's health insurance law, the AP/Boston Globe reports. The bill would generate $89 million.
A proposal by Gov. Deval Patrick (D) to raise an additional $33 million by increasing contributions from businesses was eliminated from the measure. Patrick had proposed closing a loophole that allowed companies with more than 10 workers or without employer-based insurance coverage to avoid paying an annual penalty of $295 per worker, according to the AP/Globe (Johnson, AP/Boston Globe, 7/29).
On Tuesday, Minnesota Gov. Tim Pawlenty (R) unveiled a plan to allow all Minnesotans to access their personal health records and compare prescription and procedure costs online, the Minneapolis Star Tribune reports (Lopez, Minneapolis Star Tribune, 7/29).
Pawlenty said that private health insurers have agreed to create a shared Web site that would report prices for the most common health procedures and quality data from providers.
The Web site is expected to be fully operational by January 2009.
In addition, Pawlenty said that by next year, all state employees will have access to Microsoft's HealthVault, which allows people to store their health information online. Pawlenty said he wants all state residents to be able to access the system by 2011.
Pawlenty said state employees will be able to access their flexible health spending accounts using a debit card. Other health care initiatives being considered in the state include the creation of a uniform billing system that all health insurers must use, investing in electronic health records for clinics and developing other policies to improve efficiency and lower costs (Stassen-Berger, St. Paul Pioneer Press, 7/30).
On Tuesday, the administration of Rhode Island Gov. Don Carcieri (R) released an application for a "global Medicaid waiver" that would allow the state to make broad changes to the program in exchange for capping spending, the Providence Journal reports.
In adopting a global waiver, the governor would agree to limit Medicaid spending to $12.4 billion through 2013.
State Department of Human Services Associate Director Murray Blitzer said that if the state runs out of its allotted funds before the five-year mark it will lose matching federal funds, which would force the state to pay the program's full cost or cut services.
In exchange for capping spending, the state would receive broad authority to change services, such as nursing home care; subsidized transportation for the elderly and beneficiaries with disabilities; health insurance for low-income children and parents; and prescription drug coverage for seniors, according to the Journal.
If approved, the waiver is expected to save the state an estimated $67 million this year.
The Carcieri administration released the waiver application to the General Assembly 10 days before it will be submitted to federal regulators (Peoples, Providence Journal, 7/30).
On Tuesday, Utah advocates for children and low-income residents said that a federal waiver sought by the state that would allow more low-income families into the state's premium subsidy plan will, in effect, push out children now covered by SCHIP, the Salt Lake City Deseret News reports. Advocates made the statements in written and spoken testimony at a public hearing about the waiver.
If the waiver is approved, children whose parents enroll in Utah's Premium Partnership, which helps families pay private insurance premiums, would be denied SCHIP coverage. The waiver also extends the time a family must remain uninsured before enrolling in either plan from 90 days to six months (Thalman, Salt Lake City Deseret News, 7/30).