Health Reform Around the Nation: February 4, 2008
On Thursday, the Colorado Blue Ribbon Commission for Healthcare Reform released its final recommendations for overhauling the state's health care system, including a requirement that all state residents obtain health coverage, the AP/Denver Post reports.
The commission also recommended that the state increase funding for Medicaid and children's health care. The panel was appointed to make recommendations that would extend health coverage to the state's 800,000 uninsured residents.
Other recommendations include:
- Creating subsidies for low-income workers to purchase private insurance;
- Requiring insurers to provide coverage to any applicant who does not have a pre-existing health condition;
- Extending eligibility in CoverColorado to residents with pre-existing conditions whose incomes are too high to qualify for low-income health programs;
- Requiring businesses that do not offer workers health coverage to provide plans to help employees purchase private insurance;
- Streamlining health care-related administrative functions to bring down costs; and
- Encouraging wellness programs and insurance rewards for maintaining healthy behaviors and undergoing preventive care.
Gov. Charlie Crist (R) on Thursday unveiled a $70 billion state budget for fiscal year 2009 that would reduce spending on health care by $132 million and that includes new initiatives to expand health coverage, the Orlando Sentinel reports (Kennedy/Deslatte, Orlando Sentinel, 2/1). Crist proposed reducing Medicaid reimbursements for HMOs by $60 million (Follick, Sarasota Herald-Tribune, 2/1).
Crist also proposed a $63.9 million pilot program to help uninsured adults obtain coverage (Orlando Sentinel, 2/1). Under the program, health care workers would go door-to-door to identify uninsured residents and then determine if they are eligible for Medicaid or KidCare, the state's version of SCHIP. Residents also could be given a health screening and then directed to county health departments or local health clinics.
Crist also has proposed spending $60 million to expand KidCare to an additional 46,000 children, which would increase enrollment to more than 311,000 (Royse, AP/Florida Times-Union, 1/31). He also said that he is planning to announce a program that would offer low-cost coverage to all of the state's uninsured residents (Kleindienst, South Florida Sun-Sentinel, 2/1).
Gov. Sonny Perdue (R) recently proposed a $21.4 billion budget for fiscal year 2009 that includes increases in Medicaid payments to physicians and hospitals, the Macon Telegraph reports.
The state currently reimburses physicians for 84.6% of costs they incur while treating Medicaid beneficiaries based on federal data from 2000. The proposed budget would increase the rate to 88.5% based on 2007 cost data.
Hospitals in the state's trauma network would receive 100% funding for outpatient costs and 98.6% for inpatient costs, up from 95.1%. Other hospital payments would increase from 90.1% of inpatient costs to 92.6% (Billips, Macon Telegraph, 1/26).
The Missouri House Special Committee on Healthcare Transformation on Wednesday sent a letter to Secretary of State Robin Carnahan asking her to prevent the Insure Missouri program from starting as scheduled, the AP/Kansas City Star reports (AP/Kansas City Star, 1/30).
The Insure Missouri plan, proposed by Gov. Matt Blunt (R), would extend health coverage to about 54,431 working parents with incomes below the federal poverty level. According to estimates, the plan could cost nearly $600 million by 2010, $47 million of which would be funded by the state. Blunt has asked the Legislature for $43 million in funding for the program next year. The program is scheduled to begin on March 14 (California Healthline, 1/14).
The state Department of Social Services has filed an emergency rule to allow the program to begin in mid-March, but lawmakers claim there is no emergency to justify a quick start to the program, according to the AP/Star. A spokesperson for Carnahan said the rule is being reviewed under the normal process (AP/Kansas City Star, 1/30).
Nevada has shifted oversight of the J-1 visa program from another bureau of the state Health Division to the Health Planning and Statistics Bureau, and the new overseer of the program said she will aggressively enforce the program's guidelines, the Las Vegas Sun reports (Allen, Las Vegas Sun, 1/29). The program allows foreign physicians to practice in medically underserved communities of the state.
A recent Sun investigation of the program found that some foreign physicians were forced by their sponsors to work up to 100 hours per week, were being "cheated out of their salaries" and "diverted from the patients" in underserved areas that they were supposed to help (California Healthline, 1/17).
Lynn O'Mara, the new overseer, said she will meet privately with J-1 physicians over the next six months to address program abuses reported by the Sun (Las Vegas Sun, 1/29).
New York Gov. Eliot Spitzer (D) in his budget for the next fiscal year has proposed increasing eligibility for Child Health Plus, New York's version of the State Children's Health Insurance Program, to children in families with incomes up to 400% of the federal poverty level from 250% of the poverty level, the Albany Times Union reports.
The budget seeks an additional $37 million for the expansion, which would fund coverage for about 17,000 additional children. Under the expansion, about 70,000 uninsured children would become eligible for the program. Child Health Plus currently provides coverage to 396,000 children at a cost of $663 million annually (Crowley, Albany Times Union, 1/30).
The Covering Carolina Collaborative last week unveiled a $230 million plan to cover 160,000 of the state's approximately 700,000 uninsured residents, the Charleston Post and Courier reports.
The collaborative's plan would:
- Extend Medicaid coverage to parents with incomes below 100% of the federal poverty level and to children in families with incomes between 200% and 250% of the poverty level;
- Provide tax credits to individuals and small businesses to help people with incomes between 100% and 250% of the poverty level purchase coverage; and
- Create a high-risk pool for low-income residents who have pre-existing medical conditions and cannot obtain other coverage.
The collaborative includes:
- The South Carolina Hospital Association;
- The South Carolina Medical Association;
- The South Carolina Chamber of Commerce; and
- The South Carolina Alliance of Health Plans (Coley, Charleston Post and Courier, 1/25).
Several advocacy groups -- including the Utah Health Policy Project, Voices for Utah Children and United Way -- said a provision of the health care bill being considered by the state Legislature would cause children to be moved from SCHIP to less comprehensive health coverage or lose coverage altogether, the Salt Lake Tribune reports.
The provision, introduced by state Rep. Dave Clark (R), would deny children SCHIP eligibility if their parents qualified for Utah's Premium Partnership for Health Insurance, a state subsidy program to buy private or employer-sponsored coverage.
The groups claim that after moving children off SCHIP, private insurance companies' premiums could increase to a point where families could no longer afford coverage or that employer-based plans could provide less comprehensive coverage (May, Salt Lake Tribune, 1/25).
Washington state health care providers no longer will charge for preventable hospital errors under a resolution announced on Tuesday by Gov. Chris Gregoire (D) and officials of several state health care associations, the Seattle Times reports.
The resolution -- by the Washington State Medical Association, the Washington State Hospital Association and the Washington Ambulatory Surgery Center Association -- will apply to 28 "never events," such as surgical procedures on the wrong patient or wrong part of the body, leaving medical instruments inside a body following surgery, illnesses or disabilities resulting from tainted medications or instruments, and other avoidable errors. The resolution is voluntary, but leaders of the associations say they expect hospitals, physicians and surgery centers around the state to comply.
The resolution is similar to agreements adopted in several other states, as well as to a rule introduced last year by CMS to ban Medicare payments for eight preventable conditions that can be acquired in hospitals (Ostrom, Seattle Times, 1/29).