North Carolina to penalize smokers, the obese; states face Medicaid cliff

State news Thursday explores Medicaid cuts, highlighting a new North Carolina policy for state employees — they pay more if they're heavy or smoke — and examines San Francisco's unusual city health program for the uninsured.

Charlotte Observer: North Carolina is poised to become only the second state to penalize state employees by placing them in a more expensive health insurance plan if they're obese." Smokers would also be penalized (Johnson, 10/7).

WNCT Eyewitness News: The North Carolina smokers, and people with body mass indices higher than 40, will pay 10 percent more than other workers for their insurance, unless they quit smoking or join programs to lose weight (Phelps, 10/8).

Bloomberg/Long Island (N.Y.) Newsday: The added cost to North Carolina state employees is expected to save the state health plan $13 million next year, and will lower medical costs in the future as more people quit smoking. The insurance plan needed an emergency cash infusion last year (Hart, 10/7).

The New York Times: A former Bush economic adviser is studying Healthy San Francisco, the city's effort to provide care to the uninsured. He said, "What's interesting is, San Francisco has robust competition in the market for health insurance. There are great private insurance options for those with middle and high incomes. But it's really hard for low-income residents to buy a private insurance plan with low cost-sharing that won't bankrupt them" (Underwood, 10/7).

Sarasota Herald-Tribune: "Florida is heading for a cliff when it comes to Medicaid spending." The shortfall could hit $2.6 billion in the 2010-11 budget. When Florida and other states lose federal stimulus funding in December, they could face cuts "perhaps on a scale not ever seen in Medicaid," a new report concludes (Dunkelberger, 10/8).