Health Care Reform News Around the Nation: for the Week of Jan. 14
On Wednesday, Delaware lawmakers introduced bipartisan legislation that would use information from schools to identify children who are eligible for the State Children's Health Insurance Program, the Wilmington News Journal reports.
The state last year returned about $3 million of the $10 million in federal funding it received for SCHIP because not enough children were enrolled in the program. There were about 4,800 children enrolled in the program as of December 2007.
State Insurance Commissioner Matt Denn said that the money could have provided coverage to 1,000 additional children.
The University of Delaware Center for Applied Demography & Survey Research estimates that about 8,840 uninsured children in the state might qualify for SCHIP.
Under the legislation, school districts would provide the state Department of Health and Social Services with the names of students enrolled in no-cost and reduced-price lunch programs, and the department would then send information to the students' parents (Ratnayake, Wilmington News Journal, 1/10).
On Wednesday, Texas Attorney General Greg Abbott (R) proposed a program designed to provide private health coverage for the 200,000 uninsured children in the state who are not covered through their parents' employer-sponsored plans or government programs, the Austin American-Statesman reports.
Under the plan, a private insurer would contract with the state to provide coverage to a pool of children. A court could order parents to purchase coverage based on their ability to pay, and the court could order insurance premiums withheld from a parent's paycheck. Parents would be able to opt out of the program if they provide proof of insurance.
Abbott did not give a cost estimate for the program, which would require legislative changes (MacLaggan, Austin American-Statesman, 1/10).
On Tuesday, the Iowa Legislative Commission on Affordable Health Care recommended that lawmakers extend health coverage to all children in the state as the first step to establishing universal coverage, the AP/Chicago Tribune reports.
The commission -- composed of legislators, health care providers, representatives of the insurance industry and small businesses -- recommended that the state cover the estimated 25,000 to 30,000 children who qualify for Hawk-I, the state's version of SCHIP, but are not enrolled.
According to Co-Chair and state Rep. Jack Hatch (D), enrolling eligible children would cost the state $20 million, assuming $30 million in federal matching funds.
The commission also recommended that the Legislature determine the cost of universal health care and identify potential funding sources (AP/Chicago Tribune, 1/8).
Other recommendations include:
- Developing "medical homes" for all residents, which would allow coordinated care to be provided at lower costs;
- Expanding use of electronic health records; and
- Offering incentives for employers to offer wellness programs and health insurance to employees.
On Thursday, Kansas Gov. Kathleen Sebelius (D) said state legislators should approve the 21 recommendations made by the Kansas Health Policy Authority and a 50-cents-per-pack cigarette tax increase to fund the changes, the Wichita Eagle reports.
Sebelius said the package of recommendations "seeks to really transform a system of health care and not just focus on health insurance."
The panel has recommended that the state ban smoking in public places; collect and publicize information on health care costs and quality; and establish "medical homes" that would coordinate patient care for state programs such as Medicare and HealthWave, the state's version of SCHIP (Koranda, Wichita Eagle, 1/11).
According to Sebelius, a cigarette tax increase is the only available means of funding the package, which would cost an estimated $227 million over five years. The tax increase would generate an estimated $61 million annually (Klepper, Kansas City Star, 1/10).
The state Legislature begins its 2008 session on Monday (Carpenter, Topeka Capital-Journal, 1/11).
On Tuesday, the Massachusetts Public Health Council, which sets policy for the state Department of Public Health, approved in-store health clinics to be launched in the state, the Boston Globe reports. Eight council members voted in favor of allowing the clinics and five abstained.
The council will require strict patient safety provisions, in addition to requiring that each clinic be individually licensed by the state.
The clinics will treat minor ailments, including sore throats, ear infections and poison ivy, and be staffed by nurse practitioners trained to identify more serious illnesses in patients, who would then be sent to a physician or emergency department (Smith, Boston Globe, 1/10).
The Missouri House Special Committee on Health Care Transformation will hold 23 hearings over the next six weeks to evaluate Gov. Matt Blunt's (R) plan to enroll thousands of working parents in no-cost health insurance plans later this year and discuss other ways to aid the uninsured, the St. Louis Post-Dispatch reports.
Blunt's Insure Missouri plan would cover about 54,431 working parents with incomes below the federal poverty level. According to estimates, the plan could cost nearly $600 million by 2010, $47 million of which would be funded by the state. Blunt has asked the Legislature for $43 million in funding for the program next year.
The program is scheduled to begin on March 14.
State Rep. Rob Schaaf (R) and other legislators say they have questions about how the program would work and how it would affect MO HealthNet. Schaaf said the hearings will focus on all areas of the plan, from demographics of the uninsured to federal funding (Young, St. Louis Post-Dispatch, 1/11).
On Monday, Montana Auditor and Insurance Commissioner John Morrison (D) submitted changes to a proposed ballot measure that would expand SCHIP and Medicaid eligibility to an additional 30,000 children, the Billings Gazette reports. Morrison in October 2007 submitted, and later withdrew, a similar health care initiative that included a coverage mandate.
The revised proposal does not include a mandate, but it would extend SCHIP eligibility to children in families with incomes up to 250% of the federal poverty level and Medicaid coverage to children in families with incomes up to 185% of the poverty level.
In addition, the measure would encourage parents who already have health insurance to add their children to the policy and would pay the cost of adding a child to a policy if the family qualifies for Medicaid or SCHIP and the cost of coverage is less than the government-sponsored programs.
The measure also would increase outreach efforts to help enroll eligible children in the programs.
Morrison said the expansion, which would take place only if federal funds are available, could cost the state as much as $20 million annually and generate up to $70 million a year in federal matching funds. State officials will review the measure before supporters of the initiative can start collecting signatures to qualify it for the November statewide ballot (Dennison, Billings Gazette, 1/9).
On Wednesday, New Mexico lawmakers proposed alternatives to Gov. Bill Richardson's (D) plan to expand health coverage to all state residents, the AP/Las Cruces Sun-News reports.
Richardson's plan would cover all state residents through a combination of existing private and expanded government programs. The plan would require that all state residents obtain health coverage by 2010.
One of the proposals is to establish a single-payer system that would provide near-universal coverage by guaranteeing a benefits package similar to the one provided to state employees, which allows people to choose their own physicians.
State Sen. Sue Wilson Beffort (R) proposed legislation that would expand services at college health centers and require that college students have catastrophic health coverage.
In addition, state Sen. Dave Feldman (D) proposed the creation of an independent health care authority to recommend a plan to the state Legislature by 2009 (Baker, AP/Las Cruces Sun-News, 1/9).
For the first time in more than three years, Oregon will begin accepting new beneficiaries in its Oregon Health Plan in March, the Oregonian reports.
The state will use a lottery system to enroll 2,000 eligible applicants per month for 11 months. The new enrollment will not expand the program but will fill positions lost to attrition since the program froze enrollment in 2004.
Karen House, a medical director with the state Department of Human Services, said that about 19,000 people currently are enrolled in the program and that the program can enroll up to 32,000 beneficiaries and still maintain budget solvency.
House said more than 100,000 uninsured Oregon residents are eligible for the program.
Eligibility is restricted to state residents ages 19 to 65 who do not qualify for Medicaid and have incomes less than the poverty level (Graves, Oregonian, 1/8).
Pennsylvania is taking steps to implement a "state strategy to shift more individuals into home and community care," the Pittsburgh Post-Gazette reports.
According to the Post-Gazette, the administration of Gov. Ed Rendell (D) has increased funding of home-assistance programs and is "preparing financial incentives to encourage nursing homes to eliminate skilled-care beds."
In addition, new assisted-living regulations that would offer some public funding for home-based care are under development. The state also has offered financial assistance to nursing homes that are willing to shift their focus to alternative types of care.
Michael Hall, state deputy secretary of long-term living, said that the shift to home- and community-based care will save the state money. Hall said, "It's about rebalancing the system and services so we have a healthier array of more cost-effective services that do better in meeting consumer preferences" (Rotstein, Pittsburgh Post-Gazette, 1/6).