Health Care Reform News Around the Nation for the Week of March 3

The Georgia Senate unanimously approved a bill (SB 395) that would provide grants of up to $150,000 for community health clinics, the Savannah Morning News reports. The legislation is part of a health care initiative proposed this year by Lt. Gov. Casey Cagle (R).

The measure would allow communities to apply for planning grants of up to $30,000 annually to start clinics, and existing clinics would be eligible to receive up to $200,000 over two years. Services at the clinics would be available to uninsured residents in families with incomes up to 250% of the federal poverty level who cannot afford to pay for medical care.

The second part of Cagle's plan would establish a marketplace for health insurance consumers. Legislation for that initiative was approved by a state House committee last month (Armstrong, Savannah Morning News, 2/22).

On Wednesday, Louisiana received federal approval to expand eligibility for LaCHIP -- Louisiana's version of the State Children's Health Insurance Program -- to children in families with incomes up to 250% of the poverty level, according to acting CMS Administrator Kerry Weems, the Baton Rouge Advocate reports. The current income eligibility threshold is 200% of the poverty level. The expansion will extend eligibility to about 6,500 children in families with moderate incomes.

Coverage under the expansion will be provided through the State Group Benefits program, which insures state government employees. Families will be required to contribute $50 in monthly premiums, as well as deductibles and copayments. Parents can begin enrolling their children in late spring or early summer, according to state Department of Health and Hospitals Secretary Alan Levine (Shuler, Baton Rouge Advocate, 2/28).

Massachusetts officials canceled a meeting scheduled for last Wednesday at which they were to review contract bids from insurers in the state's subsidized health insurance program and vote on ways to partially offset costs, the Boston Globe reports.

Leslie Kirwan, the state's top budget official and chair of the Commonwealth Health Insurance Connector Authority, said, "The bids we received were not satisfactory."

In December 2007, before the bidding process began, Connector officials predicted that premiums for Commonwealth Care could increase by as much as 14% without any changes in coverage and copayments. Three sources close to the bidding process said that initially, some of the four insurers' bids would have raised premiums by more than 14%. According to the Globe, the second bids "were more moderate, but apparently still too high for the state."

Representatives of the insurers have said the companies are losing money under the existing contracts. Several insurers said they hoped to reach a new agreement with the state after their bids were rejected and Wednesday's meeting was canceled (Dembner, Boston Globe, 2/29).

The New Hampshire Legislature approved $50 million in cuts to the fiscal year 2008 state budget, including reductions in Medicaid hospital payments, AP/Foster's Daily Democrat reports.

Funding for the state Health and Human Services Department will be reduced by $22 million, and the largest cut is about $7 million in Medicaid payments to hospitals. According to the AP/Daily Democrat, state spending for the department also generates federal matching funds, "so the total impact on the agency's budget is much larger."

In addition, funding for the New Hampshire Cancer Plan will be reduced by $1.7 million this year.

Gov. John Lynch (D), who requested the reductions, said that unforeseen economic events led to the need for budget cuts. He added that he also will propose reductions to the FY 2009 state budget proposal (Love, AP/Foster's Daily Democrat, 2/22).

Utah Gov. Jon Huntsman (R) said he will no longer seek a federal waiver to expand the state's version of SCHIP to children in families with incomes up to 250% of the poverty level, the Salt Lake Tribune reports.

The expansion would have made 10,000 additional children eligible for the program.

Huntsman's health adviser, John Nielsen, said the governor will leave the decision to lawmakers, who could consider an SCHIP expansion as part of a proposal to create a health care reform task force. If the task force is approved, lawmakers will be required to develop a reform plan by November (May, Salt Lake Tribune, 2/22).

On Wednesday, Washington, D.C., Mayor Adrian Fenty and district Department of Health interim Director Carlos Cano released a plan to ensure that only qualified residents receive coverage under the district's Healthcare Alliance program, the Washington Post reports.

A recent audit of the program from June 2006 to mid-November 2007 found that a lack of eligibility verification by the district Income Maintenance Administration meant applicants could "misrepresent facts to obtain eligibility and the misrepresentation may go undetected." The Alliance is intended to provide coverage for district residents with incomes up to 200% of the poverty level who do not qualify for Medicaid.

The audit also found many cases in which multiple payments were made to the same person or payments were made after an individual's eligibility had expired.

Fenty and Cano's plan would provide additional staff training on how to screen and enroll beneficiaries; additional community education on program rules; and prompt transfers of seniors to Medicare and Medicaid, among other measures (Levine, Washington Post, 2/28). The audit also recommended:

• Making further inquiries into applicants' citizenship status to ensure they are not eligible for other programs;
• Improving the investigative arm of IMA; and
• Investigating addresses where an unusually high number of applicants reside (Washington Times, 2/28).