Competition Key Ingredient To Success Of State Health Exchanges


Stateline reports that even some of the strongest health exchange
enthusiasts are concerned that some states will still only have limited
insurance choices for consumers. Meanwhile, in other news, the Arkansas
Medicaid expansion model gains momentum, Florida’s efforts face
continued complications, Arizona’s expansion standoff continues and the
Missouri Senate rejects the concept. Also, the shape of Ohio’s
compromise exchange is beginning to emerge.

Stateline: Lack Of Competition Might Hamper Health Exchange

The White House sums up the central idea behind the health care
exchanges in the new federal health law with a simple motto: “more
choices, greater competition.” But even some stalwart supporters of the
Affordable Care Act worry that in many states, people won’t have a lot
of health insurance choices when the exchanges launch in October. Health
economists predict that in states that already have robust competition
among insurance companies—states such as Colorado, Minnesota and
Oregon—the exchanges are likely to stimulate more. But according to
Linda Blumberg of the Urban Institute, “There are still going to be
states with virtual monopolies” (Vestal, 4/23).

Health News Florida: ‘Private Option‘ Plan, Florida Model, Passes In Ark.

Arkansas’ state legislature passed a model plan to expand Medicaid last
week, even though its Legislature is dominated by Republicans and the
measure had to pass by a three-quarters vote, the Associated Press
reports. The Arkansas plan is the model for Florida state Sen. Joe
Negron’s plan, which would accept an estimated $51 billion in federal
funds over 10 years to expand insurance to about 1 million of the
state’s low-income uninsured (Gentry, 4/22).

Miami Herald: Legislators Poised To Adjourn With No Medicaid Plan

As the clock winds down on the legislative session, Florida lawmakers
are sending signals that they are likely to adjourn without resolving
the issue of whether to accept federal Medicaid money to insure the
state’s poorest residents. “It’s not something you put together in a
week,”’ said Sen. John Thrasher, R-St. Augustine, chairman of the Senate
Rules Committee and a close adviser to Senate President Don Gaetz.
“It’s a very big, complicated issue and these issues take some time.” He
said he does not expect there would be political repercussions if the
Republican-led Legislature waits another year (Klash, 4/22).

Arizona Republic: Brewer, GOP In Medicaid Standoff

Three months after she stunned political observers and made her case for
expanding Medicaid coverage in Arizona, Gov. Jan Brewer is no closer to
reaching agreement with Republican legislative leaders on the issue,
which has driven a wedge through GOP ranks and is delaying work on the
state budget. By most accounts at the Capitol, Brewer has just enough
votes in the House and Senate to get expansion approved. Even some
lawmakers who oppose the plan predict it eventually will pass, owing in
large part to the power of the governor’s veto pen and her reputation
for tenacity, as well as pressure from top-flight lobbyists and
heart-tugging health-care crisis stories (Reinhart, 4/22).

The Associated Press: Mo. Senate Votes Down Federal Medicaid Expansion

Republican senators have made it clear that there will be no Medicaid
expansion in Missouri this session. The Republican-led Senate voted down
a Democratic attempt Monday night to insert $890 million of federal
funds into Missouri’s budget to expand Medicaid eligibility to an
estimated 260,000 lower-income adults (4/23).

Cleveland Plain Dealer: Ohio’s Medicaid Expansion Alternative Could Use Private Insurance

For the first time since Gov. John Kasich won national attention by
supporting Medicaid expansion, a clear picture is emerging on how the
Republican governor’s compromise with federal regulators could work.
Some uninsured Ohioans would be enrolled in the state’s traditional
Medicaid program, while others would sign up for private health
insurance using federal funding, said Greg Moody, director of Ohio’s
Office of Health Transformation. The proposal, which Kasich hopes to
sell to GOP lawmakers reluctant to support an outright Medicaid
expansion, has been dubbed “The Ohio Plan.” And it differs from the
standard federal expansion program on one crucial point: It puts some
enrollees in the private insurance market (Tribble, 4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

John Kasich

John Kasich (Photo credit: Wikipedia)

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Roundup: D.C. Sued Over Medicaid Reimbursement; Vt. To Post Health Care Rates


English: Depiction of the House vote on H.R. 3...

English: Depiction of the House vote on H.R. 3590 (the Patient Protection and Affordable Care Act) on March 21, 2010, by congressional district. Democratic yea Democratic nay Republican nay No representative seated (Photo credit: Wikipedia)

Topics: States, Medicaid, Politics, Health Reform, Insurance, Marketplace, Hospitals, Health Costs, Delivery of Care, Public Health

Apr 01, 2013

The Washington Post: Specialty Hospital Centers Sue D.C. For Reimbursement Of Medicaid Costs
Two facilities that treat severely ill poor patients could be forced to curtail services if the District does not fully reimburse them for Medicaid costs, according to a lawsuit filed this week. In the suit, Specialty Hospital of Washington Capitol Hill and Specialty Hospital of Washington Hadley claim the city has failed to reimburse them $24.7 million over the past four years (Craig, 3/29).

The Texas Tribune/New York Times: Texas Senate Bill Would Revise the State’s End-of-Life Procedure
Texas lawmakers have grappled year after year over whether families or medical professionals should decide when to end a terminally ill patient’s life-sustaining care. This year, they seem closer to a compromise (Aaronson, 3/30).

The Associated Press: Vt. To Be First State To Post Health Care Rates
Vermont is poised to become the first state in the country to let people without health insurance see how much they will have to pay to get coverage through the federal Affordable Care Act next year. On Monday, the state is going to post the proposed rates to be offered through the state’s health insurance marketplace for various levels of coverage (Ring, 4/1).

Richmond Times-Dispatch: Your Health: Virginia Graded “B” On Health Price Transparency
A recent report gave Virginia a grade of B on health care price transparency. What does that mean? The report graded states on whether consumers had access to public information that would allow them to compare prices of health care services. States’ grades were based on whether there were state laws or policies requiring price information to be made available to consumers upon request or disseminated in a report or posted to a public website (4/1).

MPR News: ‘Urgency Center’ Clinic To Open In Blaine
A new facility opening soon in Blaine (Minnesota) will serve people with medical conditions that are not serious enough for an emergency room but still require care unavailable in most medical clinics. The new facility, called an urgency center, will open in partnership with a clinic in Blaine, said Dr. Amy Kolar, the director of the emergency room at North Memorial Hospital, which is opening the center. The urgency center will be ideal for people who break a bone or dislocate a shoulder but do not need to be admitted to a hospital, Kolar said (Williams, 3/31).

MPR News: $50K Grant Targets Overused Medical Tests
The Minnesota Medical Association, the state’s largest doctor group, has received a $50,000 grant to educate physicians and patients about overused medical tests and procedures. The grant, funded by the Robert Wood Johnson Foundation, is one of nearly two dozen awarded to health organizations around the United States. The medical association’s CEO, Dr. Robert Meiches, said that the initiative, called Choosing Wisely, encourages doctors and patients to select care that is supported by evidence; does not duplicate previous tests; and is free from harm (Stawicki, 3/30).

The Associated Press: Gov. Fallin Releases Health Care Documents, Withholds Others
Oklahoma Gov. Mary Fallin’s office refused Friday to release dozens of documents surrounding decisions she made connected to the federal health care law, citing exemptions to the state’s Open Records Act that media experts say do not exist. In response to a request from several media outlets, including The Associated Press, the governor’s office released in digital form more than 50,000 pages of documents relating to the federal Patient Protection and Affordable Care Act (3/30).

EdSource: Schools Struggle To Provide Dental Health Safety Net
As California educators grapple with boosting student achievement across economic lines, the teeth of poor children are holding them back. Hundreds of thousands of low-income children suffering from dental disease, some with teeth rotted to the gum line, are presenting California school districts with a widespread public health problem. Increasingly, dental health advocates are looking to school districts to help solve the crisis (Adams, 3/31).

HealthyCal: School Clinics Put Emphasis On Wellness
Just in time for the advent of national health care reform next year, Los Angeles-area schools are opening their first campus-based wellness centers, offering services not just to students and their families, but to entire neighborhoods. On a recent day in Compton, the Dominguez High School Marching Band played and drill team dancers whirled and pranced to celebrate the opening of their new center (Richard, 4/1).

California Healthline: New Survey Offers First Data On Managed Care Shift
A survey released yesterday revealed strengths and weaknesses in the state’s 2011 transition of about 172,000 seniors and persons with disabilities into Medi-Cal managed care plans. Two-thirds of the responding beneficiaries said their care was the same or better than it had been before the transition but the survey raised concerns on several fronts, most notably a lower level of notification and communication, according to Carrie Graham, assistant director of research at Health Research for Action at UC-Berkeley School of Public Health. Health Research for Action conducted the survey in partnership with the California HealthCare Foundation, which publishes California Healthline (Gorn, 3/29).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Years After Law, Kennedy Continues Mental Health Coverage Parity Battle


English: Centre for Mental Health logo

English: Centre for Mental Health logo (Photo credit: Wikipedia)

Topics: Politics, Mental Health, Insurance, Delivery of Care, States

Apr 01, 2013

A mental health parity law passed in 2008, yet one of the measure’s key backers — former Congressman Patrick Kennedy — continues the fight for equal coverage of mental illness. He is meeting mixed success.WBUR: CommonHealth: Kennedy Calling For Equal Coverage Of Mental Health — Yes, Still
Mental health “parity” is officially a done deal. Congress passed a law back in 2008 requiring health insurers to treat mental health on a par with physical health, covering care for mental illness and addiction no less than they cover physical care. Many states have also passed their own mental health parity laws. So why has former Congressman Patrick Kennedy of Rhode Island — lead sponsor of the 2008 bill together with his late father, Sen. Ted Kennedy — spent much of the last couple of years criss-crossing the country to advocate for mental health parity? (3/29).

In Texas, mental health funding faces a tough road ahead after budget gaps appear —

The Associated Press: Texas Mental Health Funding Leaves Gaps
Standing in a courtyard by the state Capitol, Sen. Judith Zaffirini reached out to touch the Mental Health Bell, forged in the 1950s from chains once used to shackle asylum patients, brought to Texas this year on display as a 300-pound symbol of hope. … But while advocates for the mentally ill roundly cheer their gains, it is becoming clear the money will go only so far. Lawmakers are scrambling to repair a patchwork system spread among community centers, state agencies and all levels of the criminal justice system (Brick, 3/30).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Louisiana Health Secretary Submits Resignation


, member of the United States House of Represe...

, member of the United States House of Representatives. (Photo credit: Wikipedia)

Topics: States, Medicaid, Politics

Apr 01, 2013

Louisiana Gov. Bobby Jindal‘s health secretary — Bruce Greenstein — is resigning amid a probe into a Medicaid contract he awarded to a former employer.

The Associated Press: La. Gov. Jindal’s Health Secretary Resigns As Probes Continue Into Medicaid Contract
Louisiana Gov. Bobby Jindal’s health secretary and close ally, Bruce Greenstein, is resigning amid ongoing state and federal investigations into the awarding of a Medicaid contract to a company where Greenstein once worked, officials said Friday. The Jindal administration canceled the nearly $200 million contract with Maryland-based CNSI last week after details leaked of a federal grand jury subpoena involving the contract award (3/29).

New Orleans Times Picayune: DHH Secretary Bruce Greenstein Resigns In Wake Of Federal Investigation
Louisiana Department of Health and Hospitals Secretary Bruce Greenstein has resigned, a statement from Gov. Bobby Jindal’s office confirmed Friday. Speculation Greenstein would resign was rampant after news broke he allegedly used his influence as department head to secure a contract for a former employer. … Asked whether the hospitals secretary was forced out, Jindal spokesman Sean Lansing said in an email, “The governor did not ask Bruce to resign.” He later added that no one in the administration or among Jindal’s advisers asked Greenstein to resign (McGaughy, 3/29).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Concerns Raised About Effect Of Medicare’s Readmission Penalty


English: Created by vectorizing Image:Medicare...

English: Created by vectorizing Image:Medicare and Medicaid GDP Chart.png with Inkscape (Photo credit: Wikipedia)

English:

English: (Photo credit: Wikipedia)

Image representing New York Times as depicted ...

Image via CrunchBase

Topics: Delivery of Care, Health Costs, Hospitals, Marketplace, Medicare, States

Apr 01, 2013

The New York Times explores the new policy that penalizes hospitals if they have too many patients return within 30 days. Meanwhile, in Maryland, officials are weighing an ambitious plan to control hospital costs.

The New York Times: Hospitals Question Medicare Rules On Readmissions
While federal statistics show the effort is beginning to reduce costly and unnecessary readmissions, a growing chorus of critics is asking whether the government policy, which penalizes hospitals that have high readmission rates, is unfair. They are also questioning whether hospitals should be responsible for managing the personal lives of patients once they are released — or whether they should focus on other ways to improve care (Abelson, 3/29).

Kaiser Health News: Maryland’s Tough New Hospital Spending Proposal Seen As ‘Nationally Significant’
Maryland officials have proposed what analysts call the most ambitious initiative in the country to control soaring medical spending, a plan that would bring relief to employers and consumers footing the bill while bluntly challenging the state’s powerful hospital industry. The blueprint, which needs the Obama administration’s approval, would use Maryland’s unique rate-setting system to keep hospital spending from growing no faster than the overall economy — roughly half its recent rate of increase (Hancock, 4/1).

In other health industry news, federal officials release more details about hospital problems and a federal watchdog focuses on Medicare spending for equipment.

The Associated Press: Reports Of Hospital Mistakes Now Available Online
At St. Charles Medical Center in Bend, (Oregon) employees failed to notice that a cleaning machine was accidentally reprogrammed to leave out the disinfection cycle. Eighteen patients received colonoscopies with scopes that had been only rinsed with water and alcohol. … Hospitals make mistakes. When they are reported — by patients, employees or family members — state and federal officials investigate. Now, for the first time, the U.S. Centers for Medicare and Medicaid (CMS) has released those inspection reports for hospitals nationwide from the past two years. The release was in response to requests from the Association of Health Care Journalists, which has compiled them into a searchable database available to the public
(Peterson, 3/31).

Kaiser Health News: Capsules: IG Report Slaps Medicare For Not Recouping More Overpayment For Equipment
Medicare has made nearly $70 million in overpayments to suppliers of consumer medical equipment and more than half of that money is unlikely to be recovered, according to a new report from the Department of Health and Human Services Inspector General (Carey, 4/1).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

States Boost Laws, Regulations Governing Abortion


English: Histogram of abortions by gestational...

English: Histogram of abortions by gestational age for the United States in 2004. Horizontal axis is weeks and vertical axis is thousands of abortions. Data is taken from the Centers for Disease Control and Prevention.http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm#tab6 Updated version of Image:US abortion by gestational age 2002 histogram.svg, but data is almost identical. (Photo credit: Wikipedia)

Time series of induced abortions in Norway

Time series of induced abortions in Norway (Photo credit: Wikipedia)

Topics: Delivery of Care, Women’s Health, Politics, States

Apr 01, 2013

States have passed a record number of abortion bills since 2011, including curbs on clinics and chemically induced abortions, and in North Dakota, a ban on abortions as early as six weeks. On the other side, New York and Washington are weighing measures to ensure abortion rights.

The Wall Street Journal: States Harden Views Over Laws Governing Abortion
States are becoming increasingly polarized over abortion, as some legislatures pass ever-tighter restrictions on the procedure while others consider stronger legal protections for it, advocates on both sides say. … At the same time, Washington state is weighing a measure that would require all insurers doing business in new health insurance exchanges created by the Affordable Care Act to reimburse women for abortions. And New York Democratic Gov. Andrew Cuomo is seeking to update his state’s laws to clarify that women can obtain an abortion late in pregnancy if they have a medical reason (Radnofsky, 3/31).

The Associated Press: Abortion Clinics Need License, Check For Coercion
Michigan abortion clinics will need a state license and must check to make sure women are not being bullied or pressured into getting an abortion under a new law that took effect Sunday. Other regulations make clearer the proper disposal of fetal remains, after anti-abortion advocates expressed concern some were not disposed of with dignity (Eggert, 3/31).

In Montana, lawmakers are seeking to cut funding to some organizations that provide women’s health care.

The Associated Press: Women’s Health Funding Faces Cuts: House Budget Excludes $4.5M For Title X Funds
When Jennifer Strickley first learned she had ovarian cancer, it was Planned Parenthood that detected the disease. She had been going to a clinic in Billings (Montana) for about a decade, as the discounts on Pap tests, contraception and regular checkups provided an essential break for the single mom working without health insurance as a waitress to support her two kids … Strickley is one of 26,000 Montanans who rely upon clinics that receive federal family planning and preventive health funds in the form of Title X. … But the Montana House unanimously passed a state budget that excludes these funds — some $4.5 million — accounting for 30 percent of the budgets for 20 community clinics and five Planned Parenthood Clinics in the state (4/1).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Supporters Of Medicaid Expansion Fight To Be Heard In Some Statehouses


Topics: Medicaid, Politics, Health Costs, Health Reform, States

Apr 01, 2013

Mississippi House Democrats blocked passage of the state’s Medicaid budget Sunday to force a vote on expanding the program, while supporters and critics do battle in Missouri, Montana and Arkansas.

Clarion Ledger: Mississippi House Democrats Block Medicaid Budget
House Democrats on Sunday night blocked passage of the $840 million Medicaid budget, a move to try to force a vote on expanding the program and to block Gov. Phil Bryant from running it by executive order. “The federal government is offering venture capital to expand the largest industry we’ve got in this state, and we can’t even get a vote and debate on it,” said Rep. Steve Holland, D-Plantersville. “So we’re doing what we have to do. We are going to have an up-or-down vote on Medicaid expansion — it may be in a special session — or we are not going to have Medicaid” (Pender, 3/31).

The Associated Press: FACT CHECK: Corbett And The Medicaid Expansion
For now, (Pennsylvania) Gov. Tom Corbett has decided against embracing an expansion of Medicaid that could extend taxpayer-paid health care coverage to hundreds of thousands of low-income adult Pennsylvanians. The 2010 Affordable Care Act pledges to shoulder the lion’s share of the cost of the expansion, but Corbett says he is still concerned about the cost to Pennsylvania taxpayers and cautions that the federal government cannot always be trusted to deliver on its funding promises to states. Here is a look at the validity of some of his claims about the Medicaid expansion (Levy, 3/31).

The Associated Press/Kansas City Star: Medicaid Debate In Missouri Gets Hyperbolic
If Missouri expands Medicaid health coverage for lower-income adults, could it create a crisis for public schools? If Missouri fails to expand Medicaid, could it result in millions of Missourians‘ tax dollars going to health care in other states? In the tense Medicaid debate at the Missouri Capitol, both assertions have been put forth as plain facts by opponents or supporters of a plan that could add as many as 300,000 adults to the Medicaid rolls. But they might best be labeled as hyperbole (Lieb, 3/31).

Helena Independent Record: Democrats Vow To Pass Medicaid Expansion As Republicans Say It Will Blow State Budget
Last week, Republicans on two legislative committees used their majorities to kill Democrat-sponsored bills to expand the program starting in 2014. Gov. Steve Bullock and fellow Democrats vow to keep searching for a way to pass the expansion, although it could be difficult, as long as Republican majorities at the Legislature oppose it (Dennison, 3/31).

The Associated Press: Health Care, Tax Cuts Issues Colliding (AP Analysis)
How do you convince Republicans who took over the Arkansas Legislature by vowing to fight “Obamacare” to support government-subsidized health insurance? The same way you convince a Democratic governor who has said his budget can’t include more tax cuts to agree to a large package of reductions. As Arkansas lawmakers approach what could be the final weeks of this year’s session, it’s becoming clearer that proposals to expand health insurance to low-income workers and to cut $100 million in taxes are colliding (DeMillo, 3/31).

Baltimore Sun: Health Reform’s Changes Stir Worries As They Take Shape In Md.
State lawmakers put finishing touches last week on plans to apply federal health care reforms in Maryland come Jan. 1. But who becomes newly insured — and at what cost —still worries stakeholders as the state speeds toward becoming one of the first to adopt a revamped system. Under legislation passed by the House of Delegates and Senate, more low-income Marylanders would qualify for government-funded health care through Medicaid, and an existing tax on health insurers would sustain a new insurance marketplace once federal support wanes (Dance, 3/31).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Image representing Associated Press as depicte...

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