Health Care Reform News for the Week of December 15
The Universal Health Care Foundation of Connecticut is preparing to offer a proposal to expand health insurance coverage in the state, the Hartford Courant reports.
Under the proposal, the state employees' health plan would be greatly expanded over six years, making it available to individuals, not-for-profit groups, municipalities, small employers and eventually to any size employers.
The plan would include state health programs, such as Medicaid and the state's HUSKY health plan. The pool is aimed at helping the 326,000 uninsured state residents, underinsured residents or people who cannot afford their employer's coverage, the Courant reports.
Janet Davenport, vice president for communications for UHCFC, said the pool's premiums, copayments and deductibles would be on a sliding scale based on enrollees' income.
The plan calls for increased use of electronic health records and an emphasis on preventive care, management of chronic conditions and better coordination of care between physicians and other care providers.
Experts from the Urban Institute and the Massachusetts Institute of Technology are working with the foundation to determine the cost of the proposal but the foundation has not said who will pay for it. However, UHCFC officials said that taxpayers will pay for at least part of the plan.
Further details, including costs, will be released by the foundation at an event on Jan. 13, 2009 (Levick, Hartford Courant, 12/9).
Last week, Florida Gov. Charlie Crist (R) signed contracts with six health insurance companies to offer affordable health coverage plans to the state's 3.8 million uninsured residents under the new Cover Florida Health Care program, the Tallahassee Democrat reports.
Beginning Jan. 5, 2009, residents who are unemployed or have been without health insurance for at least six months will be eligible to select from the 25 available health plans that have an average monthly premium of $155 (Ash, Tallahassee Democrat, 12/11).
Although the plans offered are targeted for residents between ages 19 and 64, four of the six insurance providers also offer low-cost plans for children, the Orlando Sentinel reports.
Blue Cross and Blue Shield of Florida and United Healthcare will offer policies statewide, while the remaining four insurers will offer coverage in specified regions of the state (Hafenbrack/Deslatte, Orlando Sentinel, 12/10).
According to the Miami Herald, the type and cost of the plan depends on which county the residents live in and whether they have opted for a 'preventive' or 'catastrophic' plan, which includes the most hospital care and costs about $290 per month. The least expensive plan would cost about $51 per month (Caputo, Miami Herald, 12/11).
Health insurance officials said that the new program would be beneficial mainly to residents with chronic illnesses or pre-existing conditions who are unable to find other coverage options, but it falls short for healthy individuals who already can purchase comparable coverage elsewhere for similar costs (South Florida Sun-Sentinel, 12/11).
Louisiana Medicaid spending soon will outpace education, law enforcement, infrastructure and other state budget items if growth of the program is not contained, state Department of Health and Hospitals Secretary Alan Levine said this month at the annual meeting of the Council for A Better Louisiana, the Baton Rouge Advocate reports.
Medicaid provides health coverage for about 25% of the state's residents, according to the Advocate.
Louisiana currently spends 16% of state revenue on Medicaid, up from 10% in 2004, and it is expected to account for 21.5% of state revenue spending by 2011, Levine said. He said that the federal government is projecting an 8% annual Medicaid growth rate in the future, which means next year the state will need an additional $450 million in state and federal funding to sustain the program at current levels.
In addition, Louisiana is within $50 million to $70 million of reaching the $1.5 billion limit for federal participation of uninsured care costs, after which the state must pay 100% of the cost, Levine said.
Based on the estimated growth in uninsured care, the state would have to raise $300 million to $600 million annually in addition to the normal Medicaid program growth if the cap is reached, according to Levine.
Levine touted Gov. Bobby Jindal's (R) Medicaid overhaul plan -- which would change the way that providers are reimbursed and create incentives for improving health and penalties for deficiencies -- as the solution to curb spending in the program (Shuler, Baton Rouge Advocate, 12/6).Â Â
Healthy Steps, North Dakota's version of SCHIP, would be expanded to nearly double the number of beneficiaries if Gov. John Hoeven's (R) budget is approved, the Fargo Forum reports.
Under Hoeven's proposal, the program's income eligibility cap for families would be raised from 150% of the federal poverty level to 200%, which would expand the number of eligible children from 3,800 to 6,021 -- a 58.4% increase. According to the Forum, "Legislators have balked at expanding Healthy Steps beyond 150% for fear that federal support could drop in the future" (Springer, Fargo Forum, 12/8).
Rhode Island Gov. Don Carcieri (R) and acting CMS Administrator Kerry Weems last week announced that they are close to a deal on a "global Medicaid waiver," which would provide all of the state's federal dollars for its Medicaid program in one lump sum, the Providence Journal reports (Peoples, Providence Journal, 12/9).
In adopting a global waiver, the governor would agree to limit Medicaid spending to $12.4 billion through 2013.
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.
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 (California Healthline, 8/4).
The two parties have agreed to cap the amount the state receives for five years, but other provisions must be worked out.
Carcieri said negotiators are categorizing potential Medicaid changes into three categories:
- Those that could be adopted without federal oversight;
- Those that would require expedited federal approval; and
- "Dramatic kinds of changes" that would require further discussion with CMS.
Carcieri said, "It's the details of what are in each of those categories that we're really trying to work our way through." He added, "I am very hopeful that we'll have this thing resolved in the next week" (Providence Journal, 12/9).
Weems said, "Medicaid is eating into state budgets at a very, very rapid rate," adding, "We're going to run the experiment. The states are the great laboratories of democracy."
According to the AP/Boston Herald, it "remains unclear" whether the incoming Obama administration could overturn such Medicaid agreements struck by states with the Bush administration (AP/Boston Herald, 12/8).
In an effort to close a $7 million budget gap, the state Department of Health will drop three of its programs, the Seattle Post-Intelligencer reports.
The three programs are:
- A colorectal cancer screening program for low-income residents;
- A monitoring system to inform providers about patients' medical histories; and
- Containment-testing for drinking water systems.
The cuts represent a 16% reduction to the department's $42.8 million budget (Ho, Seattle Post-Intelligencer, 12/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.