Health Care Reform News Around the Nation for the Week of March 17
The Connecticut Senate Human Services Committee on Thursday voted to separate two health care proposals -- a move that Gov. M. Jodi Rell (R) says could delay the Charter Oak Health Care Plan by six months, the AP/Hartford Courant reports (AP/Hartford Courant, 3/13).
The plan is designed to provide affordable health coverage for uninsured residents who do not have employer-sponsored coverage or qualify for other government-sponsored health programs. Health coverage would be available based on a sliding fee scale, with residents paying between $75 per month and $250 per month depending on income. The state has allocated $11 million for fiscal year 2009 to subsidize the plan, which is expected to begin on July 1 (California Healthline, 1/7).
Rell also has proposed making changes to the state's HUSKY program, which provides coverage mostly for children, by moving beneficiaries into managed care plans. Both proposals would operate under a shared procurement arrangement, but lawmakers voted to separate the proposals, AP/Courant reports. Rell has threatened to veto legislation that could delay the creation of the proposed Charter Oak Health Care Plan (AP/Hartford Courant, 3/13).
On Tuesday, the Iowa House voted 97-0 to pass a bill (HF 2539) that would expand health insurance to nearly all children in the state by 2011, the Des Moines Register reports. Lawmakers said the bill, which also would create a plan to cover all adult residents by 2013, is the first step toward establishing universal coverage in the state.
The measure does not include a funding mechanism for the coverage expansion but says that coverage will occur "as funding becomes available." Extending coverage to all children would cost the state $30.8 million annually, according to the state Legislative Services Agency. Covering all uninsured state residents would cost $550 million annually, including the cumulative costs that state residents or businesses would pay, according to the agency.
A Senate committee approved a similar proposal (SSB 3140) the week before. State Rep. Ro Foege (D) said the Legislature also is considering a more affordable and voluntary plan. (Clayworth, Des Moines Register, 3/12).
Gov. John Baldacci (D) has proposed cuts to the state's two-year general fund budget that would address a $190 million shortfall in part by eliminating prescription drug coverage for Medicaid beneficiaries who have annual incomes up to 100% of the federal poverty level and have no children living at home, the Portland Press Herald reports.
The proposal would eliminate drug coverage for more than 18,000 beneficiaries and save the state about $7 million, according to the state Department of Health and Human Services. Baldacci also has proposed requiring about 5,600 Medicaid beneficiaries to contribute an annual $25 enrollment fee (Carrier, Portland Press Herald, 3/10).
Nearly 7,500 low- and moderate-income seniors in Maryland who fall into the so-called "doughnut hole" gap of the Medicare drug benefit will be able to qualify for subsidized coverage under legislation approved by the state General Assembly on Friday, the Washington Post reports (Rein, Washington Post, 3/14). Gov. Martin O'Malley (D) in February announced a partnership with CareFirst BlueCross BlueShield to subsidize prescription drug costs for seniors.
Under the partnership, the subsidized coverage would begin when drug costs for an individual reach $2,510 and end when spending reaches $5,725. Residents with annual incomes up to 300% of the federal poverty level would receive a subsidy during the coverage gap. The amount of the subsidy would vary based on how far seniors fall into the gap. The subsidy, which is expected to cost $7 million annually, would be paid for by CareFirst and would not require state funds (California Healthline, 2/19).
O'Malley is expected to sign the bill into law (Washington Post, 3/14).
In other Maryland news, the state Senate on Wednesday gave preliminary approval to a state budget that includes about $315 million in cuts and spending transfers -- some related to health care, the AP/Washington Times reports. The budget would delay until Jan. 1, 2009, a Medicaid expansion that was approved by the state Legislature last year.
The budget also would scale back the small-business subsidy program that was part of the Medicaid measure. Both changes will save the state about $24 million. The Senate bill also would cut $20 million from the general fund for inpatient hospital costs (Witte, AP/Washington Times, 3/13).
Gov. Jon Corzine's (D) proposed fiscal year 2009 budget would reduce charity-care funding to hospitals by $108 million to $608 million and reformulate the way hospitals receive such funding, according to state health officials said, the Bergen Record reports.
Under the new formula, hospitals would be classified into three different tiers based on the percentage of care provided to the uninsured. The formula also would take into account total revenues at each hospital (Layton, Bergen Record, 3/11).
The Pennsylvania House on Wednesday voted 114-18 to give preliminary approval to a bill (SB 1137) that would expand the state's adultBasic program to residents with incomes up to 200% of the federal poverty level, the Pittsburgh Post-Gazette reports. The proposal -- crafted by House Democrats and called Pennsylvania Access to Basic Care -- is intended to serve as an alternative to Gov. Ed Rendell's (D) Cover All Pennsylvanians health care initiative, the Post-Gazette reports. The proposal "faces an uncertain future in the Republican-controlled Senate," according to the Post-Gazette.
House Democrats have estimated that the program would cost about $579.2 million in the first year, with $291.4 million coming from state funds. By the fifth year, the program would cost about $1.11 billion, with the state contributing $370.1 million (Fahy, Pittsburgh Post-Gazette, 3/13). Democratic lawmakers said the program would be funded in part by contributions from employers and individuals, and money from existing programs, in addition to the $500 million from the state's MCare malpractice coverage program (Fahy/Barnes, Pittsburgh Post-Gazette, 3/11).
The plan would require an additional $120 million in the first year, according to the Post-Gazette (Pittsburgh Post-Gazette, 3/13). Other potential funding sources include a cigarette tax increase, new cigar and smokeless tobacco taxes, and excess funds from legislative accounts.
Under the Democrats' proposal:
- Residents with annual incomes up to 200% of the poverty level would be eligible for subsidized coverage and contribute premiums of $50 per month;
- Residents with incomes greater than 200% of the poverty level would share the premium costs with their employers; and
- Residents with incomes greater than 300% of the poverty level would have to show proof that they were unable to obtain coverage because of cost or pre-existing medical conditions.
A plan proposed by Tennessee Gov. Phil Bredesen (D) aims to reduce state health care spending by allowing elderly residents to receive care in their own homes rather than moving to a nursing home, the AP/Knoxville News-Sentinel reports. Bredesen said the proposal would simplify the process for how elderly residents or those with disabilities find out whether they qualify for home-based care.
Officials estimate that the plan could direct about half of the $1.2 billion the state's Medicaid program, TennCare, spends on long-term care to home-based care over the next 10 years. About 98% of TennCare spending on long-term care goes to nursing home facilities (Schelzig, AP/Knoxville News-Sentinel, 3/7).