Health Reform Around the Nation: February 25, 2008
Gov. Bill Ritter (D) on Wednesday announced a series of health care proposals that would expand coverage to an additional 200,000 uninsured state residents, the AP/Denver Post reports (Paulson, AP/Denver Post, 2/13).
The proposals, which must be approved by the state Legislature, include:
- Expanding eligibility for Colorado's version of the State Children's Health Insurance Program to children in families with incomes up to 225% of the federal poverty level;
- Increasing outreach efforts to enroll 70,000 children who are eligible for but not enrolled in SCHIP or Medicaid;
- Increasing Medicaid reimbursement rates to encourage more physicians to accept beneficiaries (Brown, Denver Post, 2/14);
- Creating an online report card on insurance companies (Sealover, Colorado Springs Gazette, 2/14); and
- Establishing a Center for Improving Value in Health Care within the state Department of Health Care Policy and Financing that would discuss strategies to reduce health care costs with business leaders, hospital executives and insurance companies.
Florida Gov. Charlie Crist (R) on Tuesday announced a package of health care proposals that aim to reduce the number of uninsured state residents and make health coverage more affordable, the Orlando Sentinel reports.
Crist said the Cover Florida Health Access Act is among his top three priorities of the 2008 legislative session. Under the plan, private insurers would negotiate with the state to develop coverage options that include fewer benefits (Kennedy, Orlando Sentinel, 2/20).
Insurers that participate in the program would be required to guarantee coverage to adults ages 19 to 64 regardless of pre-existing medical conditions. According to a draft legislative proposal, insurers would be required to provide coverage for:
- Annual physician visits and immunizations;
- Inpatient hospital stays;
- Mammograms and prostate screenings;
- Emergency department visits; and
- Prescription drugs.
The program could offer catastrophic health coverage that would limit services over a beneficiary's lifetime, as well as a noncatastrophic plan that would cost less and would not include certain services that younger, healthy individuals might choose to drop. The proposal would not impose an individual coverage mandate or require employers to provide coverage to workers.
Crist also proposed expanding KidCare coverage to all children, regardless of family income. KidCare is the state's version of SCHIP. Under the proposal, children in families with higher incomes would pay the full cost of coverage, while children in low-income families would continue to receive subsidized coverage.
In addition, Crist proposed increasing Medicaid reimbursement rates for dentists by 23% to encourage greater participation in the program. Half of the state's 67 counties have one dentist who accepts Medicaid beneficiaries, and one-quarter of the counties have none (Orlando Sentinel, 2/20). The plan would loosen licensure restrictions for retired dentists (Hollis, South Florida Sun-Sentinel, 2/20). The plan also would make it easier for dentists who relocate to Florida to obtain their licenses (Royse, AP/Florida Times-Union, 2/19).
Crist proposed eliminating a requirement known as a certificate of need for acute care hospitals, which must show an unmet need before doing business. According to Crist, the regulation stifles competition and delays availability of new beds because of lawsuits (St. Petersburg Times, 2/20).
Iowa Gov. Chet Culver (D) proposed four measures designed to increase state residents' access to health insurance and lower coverage costs, the Des Moines Register reports.
Under Culver's plan, insurers would be required to provide coverage for individuals who have qualified for group coverage, even if they have pre-existing medical conditions. Insurers also would be required to provide coverage for adult children of family policyholders up to age 25.
In addition, the plan would cap long-term care premium increases at 12% annually, and a group would be created to develop a plan to convert the state's medical record-keeping to an electronic system. The Iowa Hospital Association and Iowa Health Systems already have received a $17 million grant to assist with the conversion.
Culver said the state eventually could require all residents to obtain health coverage, adding that an insurance mandate "might be part of the long-term plan" to achieve universal health coverage, but "right now, we've looked at a few easy steps to take that we thought, we believe, there could be quite a bit of consensus on" (Beaumont, Des Moines Register, 2/19).
Maryland Gov. Martin O'Malley (D) on Friday announced a partnership with CareFirst BlueCross BlueShield to subsidize prescription drug costs for lower-income beneficiaries who fall into the so-called "doughnut hole" coverage gap of the Medicare drug benefit, the Baltimore Sun reports. The gap begins when drug costs for an individual reach $2,510 and ends when spending reaches $5,725.
Under the partnership, residents with annual incomes up to 300% of the federal poverty level would receive a subsidy during the coverage gap. The amount of the subsidy would vary based on how far seniors fall into the gap.
The subsidy, which is expected to cost $7 million annually, would be paid for by CareFirst and would not require state funds. Chester Burrell, CEO of CareFirst, said that the subsidy will help the insurer fulfill its public service mission, as well as lower hospital costs that are a result of Medicare beneficiaries not taking their medications. The partnership requires approval from the General Assembly (Smitherman, Baltimore Sun, 2/15).