Health Care Reform News From Around the Nation: August 20
Illinois Gov. Rod Blagojevich (D) on Tuesday announced he will cut $500 million from a budget approved by the General Assembly and use the money to increase spending on several health care programs, the AP/Chicago Tribune reports.
Blagojevich's office did not provide specific examples of programs that would be cut but said more detailed information would be released later in the week.
Blagojevich's plan would:
- Increase funding for programs that provide subsidies to help lower-income residents purchase private insurance;
- Raise the income threshold for parents enrolling in health programs; and
- Increase funding for breast and cervical cancer screenings for uninsured residents.
Blagojevich aims to expand coverage to an additional 500,000 residents under the plan.
Any changes he makes to the budget will need to be accepted or overwritten by the Legislature.
State Senate President Emil Jones (D) said he would block any attempts to override the governor's changes to the budget, but some other state lawmakers questioned the legality of Blagojevich's plan (Wills, AP/Chicago Tribune, 8/15).
Louisiana will apply for federal approval to allow low-income parents in the New Orleans and Lake Charles areas to be eligible for basic Medicaid coverage as early as spring 2008, the Baton Rouge Advocate reports.
The state Joint Legislative Committee on the Budget on Tuesday gave final legislative approval of the plan (Shuler, Baton Rouge Advocate, 8/15).
The expansion is part of Gov. Kathleen Blanco's (D) administration's plan to steer uninsured area residents into "medical homes," or HMO-like networks of primary care clinics and specialists. Medical providers participating in the expanded Medicaid program would agree to be measured on quality of care and to implement electronic health records to track beneficiaries.
State officials estimate that 80% of the 33,000 eligible state residents would participate in the program within the first five years, according to state Department of Health and Hospitals Secretary Fred Cerise.
Lawmakers allocated $25 million to develop the medical homes program in New Orleans and Lake Charles and $10 million to develop EHR systems. The program, when fully implemented in the 2011-2012 budget year, is expected to cost almost $96 million, with $26 million contributed by the state.
In the current budget year, the program is expected to cost $4.7 million, with additional federal funds. The state in the future hopes to expand the program to childless adults, Cerise said (Moller, New Orleans Times-Picayune, 8/14).
Thousands of Massachusetts residents are unable to enroll in state-subsidized health insurance plans because the number of applicants is overwhelming state offices, the Boston Globe reports.
According to the Globe, as many as 50% of applicants for MassHealth, the state's Medicaid program, and Commonwealth Care, a program under MassHealth that provides fully or partially subsidized insurance, are forced to submit paperwork multiple times because original documents are being lost at state offices.
Although the number of people affected is unclear, the delays have resulted in thousands of residents failing to obtain health insurance by the state-mandated July 1 deadline. Penalties for not obtaining coverage will not be assessed until Dec. 31.
To date, nearly 105,000 people have enrolled in Commonwealth Care -- 21,000 more than projected for the July 1 deadline -- and 57,000 have enrolled in MassHealth. During the two weeks before and one week after the deadline, offices received more than 18,000 applications.
The number of applications has declined this month, but there still is nearly double the number of applications MassHealth received last year before implementing Commonwealth Care.
MassHealth Director Thomas Dehner said that the state is reaching its goal of responding to applications within five days for those who apply electronically but that about half of the applications are on paper and are taking about 22 days to complete (Dembner, Boston Globe, 8/11).
The Healthy Kids Oregon coalition on Thursday launched a campaign in support of a state ballot measure that would increase cigarette taxes to provide health care for more than 100,000 uninsured Oregon children, the Oregonian reports.
The group has raised approximately $700,000 in cash and commitments for the campaign, which is urging voters to support Measure 50 in the Nov. 6 election, according to campaign manager Carol Butler.
The ballot measure would amend the state constitution to increase cigarette taxes by 84.5 cents per pack. The measure would generate an estimated $153 million from 2007 to 2009 and $233 million from 2009 to 2011.
Democratic lawmakers this year were unable to secure sufficient support to pass legislation to raise the tax, but there were enough votes to put it on the ballot as a constitutional measure.
Lobbyist Mark Nelson, whose clients include the tobacco industry, said if cigarette makers "decide to oppose [the measure], they'll form a political action committee and file with the secretary of the state." He added that the tobacco industry objects to how the funds would be used, as well as the constitutional amendment.
Coalition members include the:
- American Cancer Society;
- American Heart Association;
- American Lung Association;
- Oregon PTA;
- Children First for Oregon;
- Several unions; and
- Physicians, nurses and other health care advocates (Graves, Oregonian, 8/10).
South Carolina will move more than 550,000 Medicaid beneficiaries to managed care plans starting Nov. 1, the Columbia State reports.
State officials say the shift will improve preventive care and provide beneficiaries with a primary care physician, which will reduce costs associated with care received in hospital emergency departments. Beneficiaries who do not choose a managed care plan will be assigned one.
The enrollment process is expected to be finished by the end of 2008. Insurers who offer the plans will receive a payment for each Medicaid beneficiary they enroll (Werner, Columbia State, 8/15).
About 7% of eligible residents in three West Virginia counties have enrolled in the state's enhanced benefits Medicaid pilot project since February, according to agency records from mid-July, the Charleston Gazette reports (Caron, Charleston Gazette, 8/13).
Under the program, called Mountain Health Choices, beneficiaries are eligible to receive enhanced benefits in exchange for signing contracts that pledge healthy behavior, such as regular physician visits and use of necessary medications.
The program offers options to help beneficiaries maintain a healthy lifestyle through weight management, cardiac rehabilitation and nutritional education programs. The goal of the program is to improve state residents' overall health and reduce the long-term costs of Medicaid (California Healthline, 7/30).
The program requires beneficiaries to meet with their health care provider within 90 days of the annual re-determination date to sign the agreement. Beneficiaries who do not sign an agreement will be enrolled in a basic Medicaid plan that provides fewer benefits, limits the number of covered monthly prescriptions to four and does not provide coverage for cardiac rehabilitation or smoking cessation classes.
The first enrollment deadline for the program was Aug. 1.
Health care advocates maintain that few residents enrolled in the enhanced benefits program because outreach efforts have been inadequate and that the state has not made clear how it will hold individuals accountable for adhering to the contracts.
Enrollment for the program opens again next year (Charleston Gazette, 8/13).