States examine how they may be impacted by reform, Medicaid expansion

Kaiser Health News: "Starting today, states can choose to take the first steps toward the massive expansion of insurance coverage that is the health overhaul's chief goal. And for some states, that move could have the benefit of reviving funding for state-run programs that insure low-income adults. As of April 1, states can apply for federal funding to expand their Medicaid programs to cover low-income people earning up to 133 percent of the poverty level, or $14,404 for an individual and $29,326.50 for a family of four. ... States that choose to take the federal government up on this offer would still have to pay their share of the new Medicaid costs until increased federal support begins in 2014, when the expansion is required of all states. ... But, for a few states, the early expansion could provide a needed windfall. Maine, Washington, Minnesota and a handful of others already offer coverage for low-income people who earn too much to receive federal help under traditional Medicaid rules - and the states pay for it out of their own coffers. For them, the provision could mean the federal government for the first time would pick up a portion of the tab for those enrollees. These states could take a variety of approaches" (Weaver, 4/1).

The Associated Press/Seattle Times: Michigan "Gov. Jennifer Granholm signed an executive order Wednesday setting up a council to oversee changes brought by the new federal health care law and said the measure will extend health insurance to hundreds of thousands of Michigan residents now without coverage. ... In Michigan this year, the law will extend health insurance coverage through Medicaid to 375,000 more residents, with the federal government picking up the entire cost for the new enrollees until 2017 and paying at least 90 percent of their costs after that, Granholm said. Some small businesses will get tax credits for providing health coverage to their employees" (Hoffman, 3/31).

The Miami Herald: "The state Senate shifted rightward Wednesday by pushing plans to give private companies more tax money to manage prison operations and healthcare for the poor. As debate over the state budget began in earnest, the one-two privatization punch drew opposition from Democrats. They managed to soften the blow to the public prison system -- job cuts had been on the table -- but failed to halt a sweeping change for the Medicaid program that Republicans proposed in reaction to President Barack Obama's signing of the new healthcare reform law. ... The Medicaid privatization effort, also wrapped into the Senate's proposed $69.4 billion budget, passed despite Democratic concerns about restructuring Medicaid, a nearly $19 billion state-federal health program for the poor that serves 2.7 million people, or 14 percent of Florida's population" (Caputo and Bousquet, 4/1).

The (Fort Myers, Fl.) News-Press: "The same Republican leaders who vowed to maintain an open and transparent legislative process are pushing a last-minute plan on the Senate floor that would completely rewrite, and essentially privatize, the state's $18 billion Medicaid program." Under the plan, the state "would ask the federal government for permission to cap the program in exchange for increasing eligibility to another 2 million recipients. Medicaid recipients would get vouchers for private insurance. ... Some would also see co-payments and deductibles." Supporters said it would allow beneficiaries "easier access to doctors and specialists who refuse to take Medicaid patients because of low reimbursement rates." Democrats "warned that such a global change should have been vetted through the normal committee process, not as a budget amendment" (Ash, 3/31).

(Medford, Oregon) Mail Tribune: "A much debated public option that died amid the creation of a new national health care plan could be brought back to life in Oregon. Oregon Sen. Alan Bates, D-Ashland, is spearheading an effort to create a state-run health care plan that would provide a public option, paving the way for universal coverage within three to four years. An amendment to the federal health care plan by U.S. Sen. Ron Wyden, D-Ore., created a provision that allows states to enact their own health care program, including the creation of a public option. The provision allows states to apply for a waiver from the federal law as long as the state health plan has provisions for cost containment and improving delivery of services. After studying Wyden's provision, Bates, a physician who practices in Medford, said he believed the amendment would allow Oregon to expand its progressive health care program, called the Oregon Health Plan" (Mann, 4/1).

The Dallas Morning News: "Texas, accused of vastly inflating its costs under the health care legislation that President Barack Obama signed last week, just upped the tab. Health and Human Services Commission chief Tom Suehs presented lawmakers Wednesday with an estimate of $27 billion over a decade to expand health insurance coverage. It had been about $24 billion. Suehs testified that in the decade following 2014, about 2.1 million Texans will begin to be added to Medicaid and the Children's Health Insurance Program. About $5.5 billion of the estimate involves paying doctors and other primary care providers more, so they'll see Medicaid and CHIP patients" (Garrett, 4/1).

The Chicago Tribune: "The health care overhaul isn't going to break the bank in Illinois any time soon, according to state officials. ... On Wednesday, they gave a first glimpse at the impact on Illinois, while cautioning that many details aren't yet clear. For example, more than 1.5 million Illinois children and adults could gain insurance coverage by 2019, according to rough estimates from the Illinois Hospital Association. Currently, more than 1.7 million Illinoisans are uninsured. But will coverage be affordable as health care costs continue to climb? And will people comply with a mandate that everyone purchase insurance beginning in 2014, or will they risk a penalty?" The article also looks at key issues including with Medicaid (Graham, 3/31). 

The (Columbia, SC) State: "During a conference call Wednesday, Sens. Lindsey Graham and Jim DeMint, both Republican, said the law would cost the state an additional $914 million and might cause some doctors not to see patients covered through government programs. But U.S. Rep. Jim Clyburn, D-S.C., disputed those concerns and said the law would guarantee needed health care coverage. Graham urged legislators to 'really get on the record and oppose this bill,' adding that candidates should have to answer where they stand on the bill" (O'Connor, 4/1).

The Missoulian highlights a visit to Libby, Mont., by Sen. Max Baucus, who added a provision to the health law "that, in Baucus' words, promises Libby's asbestos victims 'benefits greater than those received by the 9/11 victims.' Forget Obamacare. This is Libbycare, and it's as good as it gets." Hundreds of people in the small mountain town have been sickened by an asbestos-related disease cause by dust from a local mine. "Hiding in the national legislation is a provision -- authored by Baucus -- that allows for expanded health care benefits, but only for towns where health emergencies have been declared. The initial emergency declaration came with some money for screening, and about $6 million already has arrived. But the new health care bill provides even more, ensuring that future generations can receive asbestos assessments. If they test positive, the new health bill then expands Medicare to all affected, regardless of age. The third provision -- Baucus calls it a 'pilot program' -- pays for asbestos-related disease care not covered by Medicare" (Jamison, 4/1).