Health Care Reform News Around the Nation for the Week of March 31
The Kansas House on Tuesday voted 103-20 to approve legislation that would create an insurance subsidy for low-income residents and expand other health care programs, the Wichita Eagle reports. The measure would provide $4 million to fund the first year of the insurance subsidy. The state Senate eliminated the subsidy provisions from its version of the bill in favor of a modest expansion of Kansas' version of the State Children's Health Insurance Program.
The legislation also would expand Medicaid coverage, dental programs and anti-smoking programs to pregnant women with incomes up to 200% of the federal poverty level. Most services currently are limited to individuals with annual incomes up to 150% of the poverty level.
In addition, the bill would:
- Mandate that insurers offer plans that allow employees to pay their share of premiums on a pretax basis;
- Allocate additional funds for cancer screenings at safety-net clinics and rural health centers;
- Launch new efforts to increase enrollment of eligible children in programs for low-income families; and
- Increase the amount of time that workers can continue health coverage when changing jobs.
The Maryland House on Tuesday gave preliminary approval to legislation that would create a program to encourage eligible parents to enroll their children in the Maryland Children's Health Program, the state's version of SCHIP, the Washington Post reports. About 90,000 uninsured children in the state are eligible but not enrolled in the program.
Under the Kids First Act (HB 1391), the state comptroller's office this fall would mail notices with state income tax forms informing families with incomes up to 300% of the federal poverty level that their children are eligible for MCHP. The next year, the tax forms would contain a box asking parents to designate whether their children are insured or whether they were uninsured for 63 or more days during the preceding year. Qualifying families then would receive an enrollment application and information about the program in the mail.
A provision was removed from the bill that would have disqualified parents from claiming a child deduction on their state income taxes if they did not eventually enroll their children in the program. Health advocates praised the mandate, but some lawmakers expressed concern that the loss of tax deductions would cause undue harm to families who do not enroll children because of language obstacles or other issues.
If more than 3% of children in the state remain uninsured by 2010, state health officials will look into a program that disqualifies parents for the child exemption, according to the measure. The bill also calls for a study of how to make health insurance more affordable for children whose parents' incomes are too high to qualify for state programs but not enough to afford private coverage.
The bill is expected to achieve final House approval last week and move to the state Senate, where it must be approved before the General Assembly's scheduled adjournment in April (Rein, Washington Post, 3/26).
Massachusetts officials are seeking ways to address the increasing costs of the state's health insurance law as "the state faces a recession and pivotal funding decisions that could make or break health reform," the Boston Globe reports. The state faces a $1.3 billion budget shortfall, with the health insurance initiative facing about a $100 million shortfall.
According to the Globe, lawmakers could address the $100 million gap "quickly if the state approves an increase in the cigarette tax" and uses the money for health care, as proposed by state House Speaker Salvatore DiMasi (D). A $1-per-pack increase in the cigarette tax could generate $152 million a year. A "larger issue" will be securing a new three-year commitment from the federal government, which provides about half of the funds for the state's subsidized insurance program Commonwealth Care, the Globe reports. Massachusetts is seeking $1.5 billion over three years in federal matching funds.
Leslie Kirwan, the state's top budget official, said the financial situation might require additional contributions from a coalition of insurers, businesses, hospitals and consumer advocates that worked to pass the law. She added that the state also might have to revisit "some of the original assumptions of health care reform" (Dembner, Boston Globe, 3/26).
On Wednesday, Gov. Deval Patrick (D) would not rule out a possible increase in the $295 fee per employee that some businesses contribute annually for Commonwealth Care, saying that "[e]verything is on the table" for discussions about controlling costs of the program, the Boston Herald reports. The annual assessment is paid by employers that have 11 or more employees and do not offer employer-sponsored health insurance (Fitzgerald, Boston Herald, 3/27).
The Minnesota Senate on Thursday voted 41-22 to grant preliminary approval to legislation that would overhaul the state health care system and expand coverage to 47,000 state residents, the Minneapolis Star Tribune reports. The bill would require health care providers to make their fees public and would create standard benefit sets to allow consumers to compare care and prices. In addition, the state would monitor childhood obesity rates and help people manage chronic conditions, such as through nurse phone calls and physician visits.
The coverage expansion would be paid for through projected long-term cost savings. The legislation also would allow small-business employees to purchase private health insurance with tax-free dollars.
Gov. Tim Pawlenty (R) said he opposes the bill in its current form because it would expand care with no guarantee of savings (Lopez, Minneapolis Star Tribune, 3/27).
The state House on Thursday approved a $22.5 billion budget that would increase funding for the state's Medicaid program, the AP/St. Louis Post-Dispatch reports. The budget includes additional funding for:
- Nursing homes;
- A women's health care initiative;
- Payment rate increases for physicians and dentists who treat Medicaid beneficiaries; and
- An expansion of a pilot program that allows children to receive treatment while their Medicaid applications are pending.
A coalition of groups and trial lawyers sent a letter last Monday to New York Gov. David Paterson (D) opposing a proposal to establish a state-sponsored indemnity fund to pay for medical malpractice claims, the New York Sun reports. Under the proposal, a state-sponsored fund would pay any patient expenses incurred by hospitals, physicians and insurance providers due to malpractice. The fund would be tied to the state's $47 million Medicaid program or it would receive other state funding, according to a source familiar with the proposal.
The coalition -- which is called CURE-NY and includes the Center for Justice & Democracy, the Center for Medical Consumers and the New York Public Interest Research Group -- said the proposal would relieve the medical field from paying any future expenses of injured patients (Solomont, New York Sun, 3/25).
There were fewer practicing obstetricians in Ohio in 2007 five years after a law was enacted to reduce medical malpractice rates in the state, the AP/Akron Beacon Journal reports. Under the law, jury awards for noneconomic damages in medical malpractice cases with multiple victims, such as a mother and baby during a delivery, are capped at $1 million. Most other cases are capped at $350,000.
According to an Associated Press analysis of State Medical Board numbers, the number of obstetrics and gynecology physicians decreased by 5% since 2002 to 1,327 in 2007. Opponents of the caps had said that malpractice insurance rates were increasing because companies were raising prices to account for stock market losses, not because of large jury awards. However, experts said many factors could contribute to fewer practicing obstetricians in the state, such as the high cost of new technology used to deliver babies and the rising cost of health care in general.
Supporters of the caps say that medical malpractice rates in the state are still too high for physicians in high-risk specialties and that the state has not yet recovered from losing physicians who quit their specialties or left the state because of high malpractice insurance rates (Welsh-Huggins, Akron Beacon Journal, 3/24).
In a letter to Pennsylvania physicians on Thursday, Gov. Ed Rendell (D) wrote that doctors will no longer receive assistance with medical malpractice insurance premiums from the state's MCare abatement program because lawmakers have not approved a bill (SB 1137) that would expand health insurance to the uninsured, the Pittsburgh Post-Gazette reports.
Rendell said he would not approve the MCare abatement program again unless there is progress on the legislation by today, which he said in the letter will not happen. However, he wrote that if an agreement is reached on the measure, the state's physicians could receive refunds on their abatement costs (Fahy, Pittsburgh Post-Gazette, 3/28).