Health Care Reform News Around the Nation for the Week of June 30
On June 21, the Louisiana Legislature approved a nearly $30 billion budget for fiscal year 2009 that maintains spending levels for most state programs and increases funding for education and health care, among other programs, the New Orleans Times-Picayune reports.
Under the budget, state general fund spending would increase by more than $1 billion, although overall spending would decline by 13% because of fewer federal hurricane funds.
State Rep. Jim Fannin (D), chair of the House Appropriations Committee, said spending for the state Department of Health and Hospitals would receive an additional $747 million in FY 2009. Most of the increase would go toward the state's Medicaid program, Fannin said.
The FY 2009 budget also includes $14 billion in federal funds, including funding for hurricane recovery and matching funds for health care programs. The current budget contains about $19 billion in federal funding.
Gov. Bobby Jindal (R) is expected to sign the budget into law (Moller, New Orleans Times-Picayune, 6/22).
Last week, Massachusetts state officials said a mailing glitch in May left 16,000 residents without proper notice that they could lose their health coverage under Commonwealth Care and information about how to appeal the decision, the Boston Globe reports.
Commonwealth Care offers coverage to state residents whose incomes make them ineligible for MassHealth, the state's Medicaid program, but who are unable to purchase private insurance.
The Massachusetts Health Insurance Connector Authority administers Commonwealth Care, but MassHealth determines who is eligible for the program.
The notices were mailed last week, about a month later than they should have been sent, according to the Globe.
MassHealth said it would cover out-of-pocket medical expenses incurred by beneficiaries who lost coverage as a result of the late notices.
Of the 16,000 residents affected by the glitch, 1,000 had their coverage canceled because they did not contribute monthly premiums; 6,200 were eligible to enroll in health plans offered by employers; and 8,700 should have received health coverage from other sources (Krasner, Boston Globe, 6/24).
On June 16, Montana State Auditor John Morrison said an initiative to expand coverage to as many as 30,000 additional uninsured children through Montana's version of the State Children's Health Insurance Program and Medicaid will be placed on the state's November ballot, the Missoulian reports.
Morrison said that a sufficient number of registered voters had signed a petition to place the measure on the ballot for the general election. About 37,000 children in the state are uninsured.
The proposed measure would increase the SCHIP income eligibility threshold from families with incomes up to 175% of the federal poverty level to those with incomes up to 250% of the poverty level.
The measure also would increase the Medicaid income eligibility limit and would help pay the cost of adding children to their parents' health insurance policies if their incomes are lower than the threshold.
In addition, the measure would require the state to launch a campaign to enroll eligible children in the programs through schools, hospitals, public health agencies, youth sports programs and other entities.
Gov. Brian Schweitzer (D), who has not taken a position on the measure, last week said that he told the state budget director to assume the measure would be approved and to include the estimated $20 million cost of the measure in next year's state budget.
Morrison said that polls have shown broad support for expanding children's health coverage in the state and that he believes the measure will be approved by voters (Dennison, Missoulian, 6/19).
Last week, the New Jersey Legislature approved legislation that would expand health care coverage for parents and mandate that all children have coverage, the Asbury Park Press reports.
The bill passed unanimously in the state Senate and by a 59-18 vote, with two abstentions, in the Assembly.
Gov. Jon Corzine (D) is expected to sign the bill into law.
The bill would require all uninsured children in the state to obtain private or state-funded health coverage within the first year of the bill's enactment. The plan is expected to begin in September.
The program also will expand NJ FamilyCare, the state's version of SCHIP, to parents with incomes up to 200% of the federal poverty level.
State Sen. Joseph Vitale (D), the bill's sponsor, said he expects 25,000 parents to enroll in the expanded program within a year and as many as 80,000 to enroll within three years.
The plan would be funded with $8.9 million that has already been added to the state's proposed fiscal year 2009 budget. The state Department of Human Services estimated that within three years, the annual cost of the program would be $68 million.
Vitale said the program's cost would be offset by a reduction in state charity care spending. Vitale said savings from charity care funds, which are paid by the state to hospitals for treating the uninsured, are anticipated to be $913 per adult enrolled in FamilyCare.
Changes also would be made to individual health care programs to make coverage more affordable for younger residents by charging older residents three-and-a-half times more for a policy than younger people. Premium increases would be capped at 15% per year in each of the next four years.
In addition, the state health department would be responsible for creating guidelines for a "hardship waiver," which would waive FamilyCare premiums for certain children (Rispoli, Asbury Park Press, 6/24).
Pennsylvania Gov. Ed Rendell (D) said the state could save $95 million annually under a plan to centralize Medicaid prescription drug purchasing within the state Department of Public Welfare, but state Republicans say those savings would be offset by hidden expenses in the plan, the Philadelphia Inquirer reports.
Pennsylvania already spends $400 million to purchase drugs for Medicaid beneficiaries in rural areas. Rendell's administration wants to expand the purchases to urban regions of the state where Medicaid beneficiaries are covered by managed care plans.
Drug costs for beneficiaries in urban areas are $800 million annually.
Donna Cooper, Rendell's policy director, said that because of the state government's purchasing power, it "can get a 30% rebate on the cost of the pharmacy, and the managed care companies cannot."
According to the Inquirer, an actuarial study commissioned by the administration found that the state could receive a $20.36 rebate per prescription, compared with the rebates HMOs receive of $2.93 per prescription.
Opponents of the plan say that it would not reduce costs and would compromise beneficiaries' care.
Republicans have introduced legislation to prevent the Public Welfare Department from taking over drug purchasing from HMOs (Goldstein, Philadelphia Inquirer, 6/21).
Earlier this month, the Rhode Island House unanimously approved a $6.89 billion FY 2009 budget that includes cuts to programs for elderly, low-income and disabled residents, the Providence Journal reports.
The proposed budget would increase the tax on medical and dental premiums paid to insurers from 1.1% to 1.4% to generate $5.6 million.
The budget plan also would allow Gov. Ron Carcieri (R) to pursue a "global Medicaid waiver" from the federal government, which would give the state broad authority to reshape RIte Care programs in exchange for capping program spending for the next five years. If approved, Rhode Island would be the first state to be granted such a waiver.
The budget also includes a measure that would allow the Assembly to block any proposed Medicaid changes within 30 days after being proposed by the Carcieri administration.
In addition, lawmakers approved a measure that would prohibit municipal health care contracts from specifying a health insurance provider.
According to the Journal, the Senate was expected to pass the budget last week, after which it will be sent to Carcieri, who is not expected to veto the budget (Peoples/Needham, Providence Journal, 6/19).