Health Care Reform Update for the Week of Jan. 5, 2009

Connecticut

Approximately 60,000 households with family members enrolled in HUSKY must switch from Anthem Blue Care, one of the program's managed care providers, to a new managed care network by Feb. 1, according to letters sent by the state Department of Social Services, the Hartford Courant reports.

According to the Courant, the switch is "staunchly opposed by advocates who say the new networks" -- AmeriChoice and Aetna Better Health -- "don't have enough doctors."

The switch is required following the program's decision to end its relationship with Anthem.

According to DSS officials, Anthem's participation in the program has prevented physicians from joining the other HUSKY plans. In March 2008, HUSKY withdrew from bidding for the program but has continued to provide coverage.

As of Dec. 1, 2008, 138,126 of the state's 343,785 HUSKY beneficiaries were covered by Anthem, but DSS spokesperson Matthew Barrett said the number likely has since declined (Levin Becker, Hartford Courant, 12/30/08).

Louisiana

Last week, Gov. Bobby Jindal (R) proposed reducing state spending by $341 million, including some cuts to health care, the Baton Rouge Advocate reports.

Jindal's proposal includes reducing health care spending by $118 million in part by reducing the number of prescriptions Medicaid beneficiaries can receive monthly from eight to five, unless additional prescriptions can be medically justified. The plan also calls for reductions to consultant contracts for services for individuals with developmental disabilities (Millhollon, Baton Rouge Advocate, 12/31/08).

Massachusetts

Enrollment in a Massachusetts program designed to help unemployed state residents pay health insurance premiums has increased by 73% in the past year, the Boston Globe reports.

The state Medical Security Program, which is funded by a tax on employers, pays 80% of a laid-off worker's monthly insurance premium for up to 46 weeks. For people who cannot afford to retain their coverage, even with the assistance money, the program offers full basic coverage and charges a copayment of about $15 per doctor visit.

To be eligible for the program, an individual's family income for the six months prior to being unemployed plus projected income for the next six months must not exceed 400% of the federal poverty level.

About 13,000 unemployed state residents were enrolled in the program at the end of November 2008 -- up from 7,710 in 2007 -- and officials say the number continues to rise rapidly.

The program is unique to Massachusetts. Health benefits under the program end when unemployment benefits are exhausted, but the federal government twice this year has extended the time limits for collecting unemployment.

The Globe reports that other state-sponsored health insurance programs, such as Commonwealth Care, have not experienced such large increases in applications (Lazar, Boston Globe, 12/28/08).

Rhode Island

The state Senate's first task on Jan. 6 will be to vet a waiver between Gov. Don Carcieri (R) and the Bush administration that would set a $12 billion, five-year spending cap on the state's Medicaid program in exchange for greater Medicaid spending flexibility, the AP/Boston Globe reports.

In an interview last week, incoming Senate President Teresa Paiva-Weed (D) said that the state might lack the medical resources necessary to implement the changes.