Health Care Reform News Around the Nation for the Week of Sept. 15

Illinois Gov. Rod Blagojevich's (D) All Kids Bridge plan still does not exist one year after it was announced, the AP/Chicago Tribune reports. The plan is intended to expand health coverage of seriously ill or injured young adults ages 19 to 21.

In August 2007, Blagojevich said that he could authorize an expansion of All Kids, a program that offers state-subsidized coverage for young adults with serious medical conditions. Blagojevich said he could authorize the program without legislative approval because he was changing eligibility rules for an existing program, not creating a new one.

The expansion was estimated to cost up to $20 million annually.

Susan Hofer, a spokesperson for the state Division of Insurance, said Illinois continues to be "entirely committed to All Kids Bridge" (AP/Chicago Tribune, 9/8).

Last week, Partners HealthCare warned that Massachusetts could face a federal lawsuit if it implements a proposed rule to increase some companies' contributions to their workers' health coverage, the Boston Globe reports. Partners is the state's largest private employer.

Partners, a supporter of the state's health insurance law, was one of dozens of business and consumer groups to testify at a public hearing on the proposed regulation (Lazar, Boston Globe, 9/6).

Under existing state law, businesses with more than 10 full-time workers must offer health coverage or pay an annual penalty of $295 per worker. Employers could choose either to cover at least 33% of their workers' premiums within the first 90 days of employment or ensure that at least 25% of their full-time workers are enrolled in an employer-sponsored plan.

The proposed regulation would require employers to comply with both requirements or pay the annual penalty (California Healthline, 8/18).

Matt Fishman, Partners vice president for community health, said courts have thrown out state laws that directly impose requirements on employer-sponsored health benefits and the proposed regulation could prompt a federal court ruling that would eliminate a portion of the state's health insurance law.

In a later interview, Fishman said, "That would say to the nation that Massachusetts' health reform law is perhaps not as successful as many thought, even though the coverage numbers are so strong." Fishman said that Partners does not intend to file a legal challenge (Boston Globe, 9/6).

In related news, Massachusetts could be facing a $600 million budget shortfall in fiscal year 2009 and tax collections could fall short by $400 million for the fiscal year, according to a report prepared last month by the state treasurer and the state secretary of administration and finance, the Springfield Republican reports.

The report attributed the unexpected costs primarily to energy prices and increased expenses for Medicaid and Commonwealth Care, which provides subsidized health care for low- and moderate-income residents, among other programs (Ring, Springfield Republican, 9/4).

Last week, Mississippi Gov. Haley Barbour (R) said he is withdrawing plans to cut Medicaid services and raise hospital taxes because the state's budget problems will be resolved when more than $92 million in unexpected federal Medicaid repayments are received this week, the Jackson Clarion-Ledger reports.

Barbour said a payment error made five years ago resulted in the state paying more than it should have for Medicaid, which serves about 600,000 low-income state residents. Barbour said the money was expected to arrive by wire transfer on Sept. 9.

The payment of more than $92 million will provide the amount needed by the state Medicaid program to shore up its FY 2009 budget. In addition, the money will allow the state to balance its budget for that year.

Mississippi legislators will meet next week to discuss the FY 2010 budget. Disagreement is expected between Democratic lawmakers and Barbour, who has said Medicaid shortfalls in the past four years have been averted because of "one-time" federal payments.

Such disagreements have taken place since the federal government prohibited the way Mississippi previously paid for Medicaid, the Clarion-Ledger reports (Chandler, Jackson Clarion-Ledger, 9/9).

On Sept. 9, South Carolina Gov. Mark Sanford (R) said the state Legislature needs to target its budget cuts instead of instituting a 3% across-the-board cut of $188 million, which a state budget panel approved last month, the Columbia State reports.

Sanford has suggested that the lawmakers prioritize health care and education funding, which comprises 70% of the state's budget, according to state House Ways and Means Committee Chair Dan Cooper (R).

Cooper said, "We dealt with budget cuts at the Budget and Control Board meeting," adding, "If we exempt those two areas, then what agencies would be the ones shut down?"

During a cabinet meeting on Tuesday, state Department of Health and Human Services Director Emma Forkner said that cuts to Medicaid would reduce matching federal money by $95 million. She added that the cuts would eliminate planned nursing home care, reduce hospice services and reduce the number of doses in a monthly prescription from 34 to 31.

According to Forkner, additional cuts would lead to reduced Medicaid benefits or limits on the number of new beneficiaries.

Sanford wants the adjourned Legislature to return to discuss the budget, but lawmakers are unable to return until state revenues are cut by 4%, according to an adjournment resolution (O'Connor, Columbia State, 9/10).

The West Virginia Board of Pharmacy has relaxed proposed rules for pharmacies at no-cost clinics that critics said would have jeopardized the prescription drug programs at the state's clinic network, the Charleston Gazette reports.

The proposed rules would have required clinics to designate a "pharmacist in charge" and would have required a pharmacist or pharmacy technician be at the clinic whenever a doctor was dispensing drugs.

The changes will allow doctors, dentists, physician assistants and other state-licensed health practitioners to fill, refill, check and dispense prescriptions even when a pharmacist or pharmacy technician is not present. In addition, pharmacy technicians will be permitted to process and fill prescriptions without a pharmacist present but will not be able dispense the drugs.

The pharmacy board also added a provision that would exempt no-cost clinic pharmacies from any state law that restricts who might receive drug samples from manufacturers. The final proposal will be presented to the state Legislature in January 2009 (Eyre, Charleston Gazette, 9/4).