Health Care Reform News Around the Nation for the Week of July 28
Earlier this month, the Foraker Group, an organization that supports not-for-profit organizations in Alaska, announced that it will offer health insurance to employees of private, not-for-profit organizations in the state, the Anchorage Daily News reports.
The coverage will be offered through Premera Blue Cross Blue Shield of Alaska and will be funded with $2 million from the Rasmuson Foundation. The program will not use state money.
Employees will be able to enroll in:
- A plan that has a $1,500 deductible, a tax-free health savings account and requires employers to contribute $750 per year to the HSA; or
- A plan that has a $2,500 deductible, covers catastrophic health costs and provides discounts on prescription drugs.
Under both plans, employers must contribute at least 75% of the cost of premiums for individuals and 50% of premiums for family coverage. Both plans cover preventive care and will offer dental and vision coverage.
To encourage enrollment, the first 2,000 employees who enroll in the $1,500 deductible plan will receive an extra $500 for their HSA over two years.
Initially, premium rates will be calculated separately for all participating not-for-profit organizations.
If at least 1,500 people enroll in the program within a year, the groups will be considered jointly as an association, which will allow them to receive a more stable group rate over time, according to Foraker President Dennis McMillian (Demer, Anchorage Daily News, 7/18).
The "Cover Florida" plan, which offers "bare-bones" health insurance to low-income residents, likely will not reduce the number of uninsured, according to a report by the Center on Budget and Policy Priorities, the Orlando Sentinel reports.
According to the report, "Bare-bones plans provide limited or no coverage for important benefits such as inpatient care, and they often have high deductibles or other cost-sharing charges."
The report states, "When low-income people do enroll in bare-bones plans, they face a significant risk of experiencing high out-of-pocket costs."
The report notes that the most limited insurance plans offered in Florida are expected to cost $150 per month, which is unaffordable for low-income residents. "Because most uninsured people have low incomes, they need subsidies to help them afford coverage," according to the report (Wessel, Orlando Sentinel, 7/21).
Harvard Pilgrim Health Care and Tufts Health Plan have signed contracts with CVS Caremark to cover member visits to the company's retail clinics in Massachusetts, the AP/Boston Herald reports (AP/Boston Herald, 7/24).
Under the contracts, copayments for visits to the clinics -- which typically cost between $59 and $69 --will range from $10 to $25, compared with usual emergency department copays of $59 to $150.
The clinics offer services that include vaccinations and treatment of common illnesses, such as ear infections, poison ivy and minor burns.
Tufts Health Plan is also considering covering member visits to Walgreen subsidiary Take Care Health Systems' clinics.
The Massachusetts Medical Society disapproves of the clinics because of concerns regarding safety, oversight of caregivers and spread of germs.
However, the state Public Health Council in January approved CVS Caremark's MinuteClinic plan, saying expanded access to care outweighed concerns about patients using the clinics as a substitute for regular physician visits (Boston Globe, 7/24).
A bill recently signed by Pennsylvania Gov. Ed Rendell (D) will require private health insurance companies in the state to provide diagnosis and treatment coverage of up to $36,000 per year for residents under age 21 with autism spectrum disorder, the Philadelphia Inquirer reports.
The law, which is scheduled to take effect in July 2009, also requires insurers to provide coverage for applied behavioral analysis therapy that experts say is a key element in treatment of the disorder.
Patients needing treatments that exceed the $36,000 limit will be eligible for state Medicaid reimbursements to cover the extra expense.
Health plans that provide coverage to businesses with fewer than 50 employees will be exempt from the new law.
Currently, children with autism can enroll in the state's Medicaid program, which is managed by the Department of Public Welfare and spends about $185 million annually on medical-assistance programs for residents under age 21 with autism.
Under the new law, those children would be transferred from the Medicaid program into private health plans that could reduce state spending by about $13 million in the first year after it is implemented, according to the Inquirer.
Pennsylvania is now one of eight states to implement laws that require some level of insurance reimbursements for autism diagnosis and treatment, according to Autism Speaks (Couloumbis, Philadelphia Inquirer, 7/24).