Health Care Reform News From Around the Nation: January 7, 2008
Proposed cuts to Florida property taxes could reduce funding for safety-net hospitals in fiscal year 2009, the Tampa Tribune reports.
The "low-income pool" of local and state tax dollars, which receives federal matching funds to reimburse hospitals that provide care to low-income and uninsured residents not covered by Medicaid, is mostly funded by ad valorem property tax revenue. Gov. Charlie Crist (R) and state lawmakers have proposed cutting those taxes this year.
According to the Tribune, the pool and related programs in FY 2009 will require an additional $98.1 million from local sources to cover the projected costs of charity care. If the taxes do not provide adequate revenue, state officials will have to decide whether to fill the gap with state funding at a time when Florida faces an estimated $2.5 billion budget shortfall in FY 2008 and FY 2009 (Dolinski, Tampa Tribune, 1/3).
The number and percentage of uninsured Louisiana residents declined last year compared to 2005 before Hurricane Katrina, according to the 2007 Louisiana Health Insurance Survey, the New Orleans Times-Picayune reports.
According to the Louisiana Department of Health and Hospitals, the post-Katrina population loss accounts for part of the decline, but the biggest factors are the state's strong economy and a low unemployment rate that has resulted in more residents having employer-sponsored health coverage.
The survey found that 64,355 Louisiana children, or 5.4%, lacked insurance in 2007, compared with 97,403, or 7.6%, in 2005. The decline was attributed mainly to increasing enrollment in LaCHIP, Louisiana's version of the State Children's Health Insurance Program.
The percentage of uninsured adults decreased from 23.4% in 2005 to 21.2% this year, according to the survey. The survey found 546,348 adults in the state were uninsured in 2007 -- a decrease of 108,381 over two years (New Orleans Times-Picayune, 12/26/07).
The Louisiana Health Insurance Survey is available online (.pdf).
U.S. District Judge John Woodcock overturned a Maine law that would have restricted medical data companies' access to physician prescribing information, the AP/Wall Street Journal reports (AP/Wall Street Journal, 12/24/07).
IMS Health, Wolters Kluwer Health and Verispan filed lawsuits seeking to block Maine from enforcing its law, which was set to take effect Jan. 1.
According to the complaints, the law violated the First Amendment by prohibiting the transfer of legally obtained information and the 14th Amendment by impeding interstate commerce. The complaint also said the law went against a national trend toward greater health care transparency.
A similar law in New Hampshire was overturned in April 2007 by U.S. District Judge Paul Barbadoro, who ruled that it placed unconstitutional restrictions on free speech (California Healthline, 8/31/07).
In his decision, Woodcock wrote that the law would prohibit "the transfer of truthful commercial information" and "violate the free speech guarantee of the First Amendment." Woodcock also cited the April 2007 ruling by Barbadoro.
Maine state Rep. Sharon Treat (D), who sponsored the law, said she anticipates an appeal of the decision (AP/Wall Street Journal, 12/24/07).
Maryland health officials this spring hope to work with state Comptroller Peter Franchot to identify children who are eligible but not enrolled in SCHIP, the Baltimore Sun reports.
Under the plan, the state Office of the Comptroller would examine state income tax records to identify families that qualify to enroll their children in SCHIP and then notify the families via letter that the program is available.
Franchot in October 2007 agreed to use this method to identify families for a new Howard County, Md., health program. Letters will be sent to 22,000 families this month. Franchot said he has extended that offer to all counties, and officials in four counties have expressed interest in such a service (Carson, Baltimore Sun, 1/4).
The penalty for Massachusetts residents who can afford but do not purchase health insurance in 2008 could quadruple compared with the penalty in 2007 under draft regulations released by the state Department of Revenue on Monday, the Boston Globe reports.
If the regulations are approved, the maximum penalty this year for residents who do not obtain health coverage would increase to $912 per year from $219 last year. The proposed penalties, which are based on half the cost of the least expensive state-sponsored health plan, are capped to avoid excessive fees, according to the Globe.
Under the draft regulations, fines would vary based on income, age and the length of time a resident has been uninsured. Fines would be prorated for residents who have health coverage for a portion of the year. Residents with incomes less than 150% of the federal poverty level would not be penalized, according to the draft regulations.
The regulations will be finalized early this year. Residents can comment on the proposed penalties until Jan. 15, and they will not face the penalties until they file their 2008 tax returns (Krasner, Boston Globe, 1/1).
New Jersey on Tuesday more than tripled Medicaid reimbursements for physicians who treat beneficiaries younger than age 21, the AP/Long Island Newsday reports. Medicaid physician reimbursements for a child's office visit increased from $23.03 to $73.70, and dentist reimbursements increased from $18.02 per child's exam to $64.
Gov. Jon Corzine (D) last summer set aside $10 million in state funds to pay for the increases, and the state will receive an additional $10 million in matching federal funds.
An April 2007 study by Public Citizen's Health Research Group found that New Jersey provided the lowest Medicaid reimbursements of all the states, although the analysis included adult and child services (Johnson, AP/Long Island Newsday, 1/2).
Kentucky is "among the worst states nationally in the proportion of low-income residents served by free or subsidized dental clinics, and less than a fourth of the state's dentists regularly take Medicaid, according to 2005 federal data," the New York Times reports in an analysis of dental health among state residents. Kentucky has the highest proportion of adults under 65 without teeth, and about half of state residents lack dental insurance, according to the Times.
Until August 2006, the state had one of the lowest Medicaid reimbursement rates nationwide, which contributed to a shortage of dentists in low-income and rural areas. Julie Watts McKee, the state's dental director, said that in 2006, Medicaid reimbursements for children's dental services were raised by about 30%.
However, despite the increase, which was funded by cutting orthodontic benefits, reimbursement rates still are about 50% below the market rate, according to Ken Rich, the state's dental director for Medicaid. Reimbursement rates for adult dental care are about 65% below the market rate, Rich said (Urbina, New York Times, 12/24/07).