Health Care Reform News Around the Nation for the Week of Feb. 11

More than 21,000 Indiana residents have applied for the Healthy Indiana Plan since its launch on Jan. 1, but only about 6,000 of those applications have been processed by the state Family and Social Services Administration, the Indianapolis Star reports.

FSSA Secretary Mitch Roob said that the volume of applicants was unexpected and that the state will increase the number of employees who are working to process applications. The state also will suspend marketing of the program until the backlog is addressed. Roob said with staffing increases, he expects the agency to process about 12,000 applications per month.

The program seeks to provide coverage for state residents between ages 18 and 64 who have been uninsured for at least six months and do not have access to employer-sponsored health coverage. Residents with incomes up to 200% of the federal poverty level are eligible for the program (Ruthhart, Indianapolis Star, 2/7).

Massachusetts House Speaker Salvatore DiMasi (D) and state Senate President Therese Murray (D) are considering an increase to the state's cigarette tax as one of several proposals to address the greater-than-expected costs of the state's health insurance law, the Boston Globe reports.

DiMasi and Murray are examining several different options to ensure that the initiative is successful in light of recent projections that subsidized coverage under the law could cost as much as $1.35 billion by June 2011, according to the Globe.

A $1-per-pack cigarette tax increase could generate $152 million annually, according to estimates by the Campaign for Tobacco-Free Kids. The New England Convenience Store Association is expected to strongly oppose any effort to increase the tax, the Globe reports.

Murray also is considering efforts to reduce costs by streamlining billing, expanding primary care services and holding hearings on insurance rate increases. In addition, state lawmakers will consider increasing the penalties that businesses must pay if they do not offer health insurance to employees (Dembner, Boston Globe, 2/6).

A Minnesota task force on Tuesday recommended that the state require all residents to obtain health coverage and that the state use savings from reducing inefficiencies and insurers' administrative costs to extend health coverage to the uninsured, the St. Paul Pioneer Press reports.

The task force, which was appointed by Gov. Tim Pawlenty (R), also recommended paying physicians based on patients' health outcomes. In addition, it called for reductions in the state's smoking, binge drinking and obesity rates.

The task force estimates that adopting the recommendations could reduce Minnesota's health care spending by 14% by 2011 and by nearly 20% by 2015 (Olson, St. Paul Pioneer Press, 2/5).

The task force report is available online (.pdf).

A health insurance exchange program proposed by Mississippi Gov. Haley Barbour (R) would improve access to health care for workers at more than 50,000 small businesses, proponents of the plan say, the Jackson Clarion-Ledger reports. In addition, supporters say the program would reduce businesses' overhead costs and allow employees to purchase a policy with pretax dollars.

Under the proposal, a not-for-profit agency or another agency established by the state would serve as the clearinghouse for multiple health insurance plans and other coverage options. State officials estimate that it would cost about $1.5 million to launch the program, and legislative action would be needed to create the agency.

The program would target uninsured residents who do not have access to private health insurance and do not qualify for Medicaid (Rupp, Jackson Clarion-Ledger, 2/4).

The New Mexico House on Tuesday voted 56-6 to approve a bill (HB 147) that would create a Health Care Authority to develop a plan by January 2009 for "accessible and affordable" health care for all state residents, the AP/Santa Fe New Mexican reports. The measure now moves to the state Senate.

The bill, sponsored by State Rep. Danice Picraux (D), would create the 11-member Health Care Authority, comprising the state insurance superintendent, five members appointed by the governor and five members appointed by the Legislature. All decisions by the committee would need to be supported by at least seven of the authority's members. If the bill is approved by the state Senate, the Health Care Authority would take over the New Mexico Health Policy Commission and its budget in July. The commission's executive director would serve as the interim head of the authority.

Gov. Bill Richardson (D) has asked lawmakers to pass separate legislation that would require all state residents to obtain health insurance, expand government programs and require businesses to contribute to the cost of health care. That bill remains in committee (Baker, AP/Santa Fe New Mexican, 2/5).

On Tuesday, Pennsylvania Gov. Ed Rendell (D) released a $28.3 billion state budget proposal for fiscal year 2009 that includes $500 million to provide health coverage for uninsured state residents, the Philadelphia Inquirer reports (Worden et al., Philadelphia Inquirer, 2/6). The proposal also would provide prescription drug coverage for Medicare beneficiaries and autism services for adults.

Rendell also is requesting $750 million in capital funds to help pay for hospital expansion and construction of new community-owned facilities (Mauriello/Barnes, Pittsburgh Post-Gazette, 2/6). The budget proposal includes a 10-cent-per-pack increase to the state cigarette tax to fund health care initiatives (Philadelphia Inquirer, 2/6). Republican lawmakers said that Rendell's plan does not effectively reduce spending (Pittsburgh Post-Gazette, 2/6).

The Washington state Senate on Wednesday voted 31-18 to approve a bill (SB 5261) that would allow the Office of the Insurance Commissioner to reject "unreasonable" rate increases for individual health insurance plans, the Seattle Times reports.

Under the measure, state officials' authority to review and approve annual rate increases would be extended from small-group plans to individual plans. Insurance Commissioner Mike Kreidler and others have said that a lack of oversight has enabled insurers to raise individual plan premiums more than necessary, according to the Times.

The House is expected to approve the measure (Song, Seattle Times, 2/1).

Enrollment in Wisconsin's new BadgerCare Plus program began on Thursday, and state officials plan to enroll at least 25,000 children within the next 12 to 18 months, the Milwaukee Journal Sentinel reports. The program consolidates and streamlines the state's existing Medicaid, Healthy Start and Badger Care programs.

The initiative allows families to purchase coverage for their children, with premiums based on income. Parents whose employers cover 80% of the cost of family coverage and undocumented immigrant children do not qualify for the program.

In most parts of the state, children will receive basic coverage through an HMO run by a private company. The coverage will include some copayments and will pay for generic prescription drugs.

The program is expected to cost $50 million over the next year and a half, and the federal government will pay more than 60% of the costs. The program also will be funded through premiums paid by families, as well as savings from expanded use of HMOs and administrative savings. Gov. Jim Doyle (D) hopes to expand the program next year to cover low-income workers who do not have children (Boulton, Milwaukee Journal Sentinel, 1/31).