Health Reform Around the Nation for the Week of March 10, 2008
The Florida Senate on Thursday approved about $500 million in cuts to the state's $70 billion fiscal year 2009 budget, including reductions in Medicaid funding, the South Florida Sun-Sentinel reports (Kennedy, South Florida Sun-Sentinel, 3/7).
The Senate voted 27-13 to approve legislation (SB 1852) that would eliminate automatic cost-of-living increases in payments to hospitals, nursing homes, county health departments and intermediate care facilities for the developmentally disabled (Liberto, St. Petersburg Times, 3/7). The rate cut will reduce payments to all Medicaid providers by $316 million (South Florida Sun-Sentinel, 3/7).
The Washington state House voted 68-21 to pass a bill (SB 5261) that would require insurers to receive approval from the state insurance commissioner before changing premium rates for individual health plans, the Seattle Times reports. Gov. Chris Gregoire (D) is expected to sign the bill into law, according to the Times.
The bill would give state Insurance Commissioner Mike Kreidler the ability to reject "unreasonable" rate proposals and compare insurers' claims costs with projections. He also would be able to order insurers to return excess profits to the state (Song, Seattle Times, 3/4).
The Georgia Senate on Thursday voted 42-12 to approve a bill (SB 404) that would create a Web site to allow consumers and business owners to compare and purchase health insurance products, the Atlanta Journal-Constitution reports. The bill, called the Georgia Health Marketplace Act, would allow people to compare deductibles, copayments, benefits and premiums. In addition, they could purchase a plan using pre-tax dollars.
The site would sell five different portable insurance plans:
- A traditional health insurance plan;
- A plan for businesses with less than 50 employees;
- PeachCare for children, which is the Georgia's version of the State Children's Health Insurance Program;
- A plan where consumers purchase coverage directly from medical providers; and
- A catastrophic care plan for 18- to 25-year-olds.
The Iowa Senate Human Resources Committee on Thursday voted 11-2 to approve a bill that would require that nearly all families in the state obtain health coverage for their children by 2011, the Des Moines Register reports.
The bill would provide coverage to children in low-income families through Hawk-I, the state's version of SCHIP. According to state Sen. Jack Hatch (D), a sponsor of the bill, the measure would extend coverage to nearly all of the 3% of Iowa children who are uninsured.
The bill also would:
- Encourage use of electronic health records;
- Require physicians and hospitals to submit "quality measures" that would be publicly reported; and
- Encourage the use of medical homes and coordinated care.
Gov. John Baldacci (D) on Wednesday proposed a FY 2009 state budget that would reduce funding for the state Department of Health and Human Services and charge some Medicaid beneficiaries fees, the Portland Press Herald reports. The state is facing a $190 million budget shortfall.
The state HHS and Education departments would lose a combined $61.6 million under the proposed budget. Baldacci's plan also would require Medicaid beneficiaries with incomes between 150% and 200% of the federal poverty level to pay a $25 annual fee.
In addition, the proposal would increase funding for Medicaid by $8.4 million to compensate for the loss of federal funds. The budget proposal also would eliminate Medicaid prescription drug coverage for childless adults (Carrier, Portland Press Herald, 3/6).
The state Senate last week gave preliminary approval to about $280 million in budget cuts, including $18 million from stem cell research, $20 million from malpractice insurance subsidies and $40 million from Medicaid, the Baltimore Sun reports. The cuts aim to help offset an expected $330 million drop in state revenue (Olson, Baltimore Sun, 3/7).
Massachusetts state Senate President Therese Murray (D) introduced legislation that aims to control rising health care costs in the state, including a measure that would ban all gifts to physicians from pharmaceutical companies, the Boston Herald reports. Murray said the legislation is the next step in the state's effort to establish universal health coverage (Ross, Boston Herald, 3/4).
The measure would prohibit drug companies from giving gifts and ban physicians, their families or employees from receiving gifts. The measure would allow distribution of drug samples to doctors for the exclusive use of the patients. Violators of the ban would face fines of up to $5,000, two years imprisonment or both.
The legislation also includes provisions that would:
- Require all state physicians to adopt electronic health records by 2015;
- Allow patients to choose nurse practitioners as primary care providers; and
- Require public reviews of insurance company efforts to increase annual premiums by more than 7% (Woolhouse, Boston Globe, 3/4).
Iselin attributed the reduction to the state's health insurance law, which has shifted uninsured residents to Medicaid or the state's Commonwealth Care program. About 200,000 low-income residents have obtained coverage since the law took effect, according to state figures (Dembner, Boston Globe, 3/3).
The state Legislature will hold a special session this summer to attempt passage of a health care reform proposal backed by Gov. Bill Richardson (D), Sacramento Bee's "Capitol Alert" reports.
Richardson's proposal would:
- Require most state residents to obtain health insurance;
- Require health insurers to offer coverage to all applicants, regardless of health status; and
- Impose fees on some employers to help fund the measure.
In other New Mexico news, Richardson last week signed into law a bill that will make it harder for health insurers to cancel policies or deny claims, the AP/Houston Chronicle reports.
Under the law, insurers will only be able to deny claims or rescind coverage if they can prove that policyholders made "willful or fraudulent misstatements" in their applications. The previous standards allowed insurers to refuse to pay claims or cancel coverage even if application mistakes were inadvertent.
The law also raises the annual cap on medical claims paid by insurers from $50,000 to $100,000 starting next year. In addition, it increases from 63 days to 95 days the period for individuals to obtain new health insurance coverage without being considered previously uninsured (Massey, AP/Houston Chronicle, 3/5).
Oklahoma has joined Maine, Maryland and New Jersey in a federal lawsuit against HHS that claims the agency overstepped its bounds by implementing Medicaid rule changes that would eliminate tens of millions of dollars in appropriations for each state, the Daily Oklahoman reports. One rule change, which took effect last week, narrows a field of state workers paid by Medicaid who connect youth and developmentally disabled residents with appropriate social services.
Mike Fogarty, CEO of the Oklahoma Health Care Authority, said the agency can no longer pay claims related to targeted case management because of the new rule (Rabe, Daily Oklahoman, 3/4).
Oregon began drawing names last week in a lottery to determine who will fill open slots in the Oregon Health Plan, the Los Angeles Times reports (Glascock, Los Angeles Times, 3/10). More than 80,000 people have registered for the lottery since it opened in January, but only a few thousand slots are available, according to the AP/Houston Chronicle.
People selected in the lottery will be eligible for a standard benefit program that provides coverage for basic health services, medications, and limited dental, hospital and vision care. The program is intended for people whose incomes are too high to qualify for Medicaid but who cannot afford private insurance. The lottery winners will be chosen in a series of drawings that could take several months, the AP/Chronicle reports (Skidmore, AP/Houston Chronicle, 3/4).