Health Care Reform News Around the Nation for the Week of Nov. 17
Arizona voters in the Nov. 4 election rejected the ballot measure Proposition 101, known as the Freedom of Choice Healthcare Act, the Vail Sun reports (Grimes, Vail Sun, 11/12).
The measure would have amended the state's constitution to prohibit laws that mandate people obtain health coverage or that restrict an individual's choice of private health care systems or private health plans.
Proposition 101 also would have prohibited laws that interfere with an individual's "right to pay directly for lawful medical services" or that impose a penalty or fine on an individual who chooses not to obtain coverage (California Healthline, 10/27).
Ultimately, 867,642 Arizona residents voted for the proposition and 869,752 voted against it (Vail Sun, 11/12).
CMS has asked Connecticut health officials to clarify that HUSKY Health beneficiaries are not required to switch to new insurers by the end of December, the New Haven Register reports. HUSKY is the state's Medicaid program (O'Leary, New Haven Register, 11/11).
Last month, Gov. Jodi Rell (R) announced that she has postponed until February 2009 the mandatory switch for 345,000 low-income HUSKY beneficiaries to new insurers.
Rell's administration proposed the switch as a way to encourage insurers to participate in the new Charter Oak Health Plan for adults.
However, Aetna Better Health and AmeriChoice -- two of the new insurers that would cover the HUSKY beneficiaries -- have had difficulties in setting up adequate provider networks (California Healthline, 11/3).
Mary Kahn, a spokesperson for CMS, said that CMS will continue to observe the situation, adding that if HUSKY beneficiaries do not have sufficient network options to choose from by the end of the year, "we will deal with it then. We just have to take it a day at a time."
Meanwhile, Sheldon Toubman, an attorney with New Haven Legal Aid Assistance, in a letter to CMS called on the agency to stop the voluntary switching of beneficiaries until the new networks are in place.
The state's health care advocate, Kevin Lembo, also has asked the state to allow beneficiaries to switch from their new insurers to their previous coverage and said the popularity of Community Health Network of Connecticut is unfair to the other insurers and fails to provide real choices for beneficiaries (New Haven Register, 11/11).
On Wednesday, the Illinois Supreme Court placed a temporary hold on a judge's order to shut down an expansion of the state's FamilyCare program, which will require the administration of Gov. Rod Blagojevich (D) to start paying providers again, the Chicago Tribune reports (Chicago Tribune, 11/13).
Cook County Judge James Epstein last month renewed an ordered prohibiting the state from making payments under the expansion (California Healthline, 10/20).
However, court documents indicated that the state hadÂ stopped paying providers treating all FamilyCare beneficiaries, not just those who received coverage under Blagojevich's expansion.
The administration said it stopped all payments because it wanted the judge to clarify his ruling (Chicago Tribune, 11/13).
Maine Department of Health and Human Services Commissioner Brenda Harvey this week proposed eliminating some services for low-income MaineCare beneficiaries to help reach the state goal of $100 million in cuts each year for the next two years, the Bangor Daily News reports.
MaineCare is the state's Medicaid program.
Harvey said the goal is to create a package of services under MaineCare that best serves beneficiaries.
In a memo sent to state Finance Commissioner Ryan Low, Harvey lists social services, podiatry, optometry, physical therapy and psychological services among those that could be eliminated for people older than 21 who have incomes between 100% and 150% of the federal poverty level, childless adults and some people with disabilities.
Other proposed cuts would reduce reimbursements to critical-access hospitals and pay hospital doctors on a fee schedule (Leary, Bangor Daily News, 11/12).
Earlier this month, a coalition of health care advocates presented Maryland state lawmakers with a multibillion-dollar universal health care proposal, the Baltimore Sun reports.
The Maryland Citizens' Health Initiative proposes the creation of a health insurance pool for coverage of individuals and employees of small businesses, reinsurance for high-cost care, an expansion of Medicaid eligibility and subsidized premiums for those who qualify.
The plan would cost $15.5 billion over five years and would be partially funded by a 2% employer payroll tax on wages and increases in tobacco and alcohol taxes.
Delegate James Hubbard (D) said he would introduce the proposal as legislation in January 2009.
However, the Sun reports "such a proposal faces an uphill battle," as state lawmakers look to address budget shortfalls and consider rolling back earlier health care expansions (Smitherman, Baltimore Sun, 11/12).
On Wednesday, the Massachusetts Public Health Council unanimously approved measures to increase oversight of teaching hospital expansion projects with the aim of ensuring that new facilities do not duplicate services offered by community hospitals or imperil existing facilities, the Boston Globe reports.
The measure would apply to companies looking to establish outpatient clinics that cost more than $25 million and private physician-owned outpatient surgery centers, regardless of cost.
The measures were authorized by health care legislation sponsored by state Senate President Therese Murray (D) and approved by the state Legislature over the summer.
The new rules are expected to take effect next month (Smith, Boston Globe, 11/13).
On Wednesday, the New Hampshire Supreme Court heard arguments in a lawsuit the New Hampshire Association of Counties filed against the stateÂ about the way Medicaid bills are shared, the Concord Monitor reports.
In 2007, the state enacted a law that required county governments to cover the entire nonfederal cost of Medicaid expenses for nursing home and home-based care patients. The costs not covered by the federal government previously were split evenly between the states and counties.
In exchange for the counties shouldering all nonfederal costs, the state agreed to pay the counties' share of other health programs.
Following the law's enactment, the state's 10 counties filed the lawsuit, claiming that the new arrangement is a violation of a state constitution provision against unfunded mandates, which forbids the state from assigning additional costs to municipalities without consent from the counties (Barrick, Concord Monitor, 11/13).
On Wednesday, Gov. David Paterson (D) proposed budget cuts intended to save $5.2 billion over the next 16 months, including cuts to Medicaid and other health care programs, the New York Times reports.
Paterson's proposal would reduce health care spending by $572 million this year and by $1.2 billion next year (Hakim, New York Times, 11/13).
Under the plan, hospitals and clinics would experience a $154 million cut this year and a $458 million cut next year. He also has proposed an 8% across-the-board cut in the Medicaid reimbursement rate this year and an additional 2% cut next year.
The proposal would reduce funding for grants for public hospital recruitment and retention and eliminate annual inflation adjustment payments.
In addition, the proposal would increase taxes on health insurers, reduce reimbursements to pharmacies participating in Medicaid and the Elderly Pharmaceutical Insurance Coverage program, and reduce Medicaid payments to nursing homes and home care agencies (Wang/Swingle, Rochester Democrat and Chronicle, 11/13).
Last week, Gov. Ed Rendell (D) asked the state Senate to act on his health coverage expansion proposal in a lame-duck session, but Republicans, who control the chamber, refused the request, the Philadelphia Inquirer reports.
The Democrat-controlled House has approved Rendell's proposal, which the governor says would extend health coverage to 176,000 state residents by 2012. That number includes 47,000 people who already have "adult basic" coverage through the state, as well as the 129,000 on the waiting list.
Rendell's proposal would add coverage for prescription drugs and some behavioral-health services.
According to Rendell, the $1.9 billion program could be funded using money already held in a tobacco sales tax account set aside for health care purposes, as well as federal matching funds.
Senate Majority Leader Dominic Pileggi (R) said, "We continue to be ready and willing to work on health care issues, which remain a priority for Senate Republicans," but in the "current economic downturn ... our top priority must be to ensure that we can continue to provide existing services under these difficult conditions."
According to Pileggi, Senate Republicans will wait to see what President-elect Barack Obama proposes on health care next year to ensure any state action is "fully compatible with federal laws."
Rendell also reiterated that he would not continue to extend state funds for a medical malpractice insurance subsidy program for doctors until a health coverage bill is approved (Worden, Philadelphia Inquirer, 11/11).
The Utah Legislature's Health System Reform Task Force presented a blueprint for prospective legislation to be drafted and debated, the Salt Lake Tribune reports.
The panel suggested that lawmakers:
- Focus on ways to preserve the private insurance industry while creating more affordable plans;
- Remove barriers -- such as coverage mandates -- to affordable policies;
- Allow businesses to let employees shop for their own plans;
- Increase transparency of brokers' compensation and create standards for the exchange of electronic health records;
- Simplify administrative processes;
- Require that state-contracted firms provide coverage for workers; and
- Implement medical malpractice reforms that would protect doctors (Rosetta, Salt Lake Tribune, 11/12).
Some changes suggested by the panel could be made into legislation and proposed in January 2009, but most probably will not come until 2010, according to the Salt Lake City Deseret News (Thalman, Salt Lake City Deseret News, 11/10).
Some state Senate Democrats say they will try again to pass the Healthy Wisconsin universal health care proposal now that the party holds the majority in the Assembly, but Gov. Jim Doyle (D) and others are opposed to the plan, the Milwaukee Journal Sentinel reports.
Doyle said the state should wait for the Obama administration and congressional leaders to take action on a national health system overhaul.Supporters of Healthy Wisconsin said it would lower costs for firms and employees by eliminating private health care plans, but opponents say it would double state taxes (Walters/Marley, Milwaukee Journal Sentinel, 11/12). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.