Roundup: States limit Medicaid mental health prescriptions; Mass. to vote on assisted suicide; Insurer earnings drop in Mass.

A selection of health policy stories from Massachusetts, California, Kansas and Minnesota.

Stateline: States Crack Down On Mental Health Prescriptions
Medicaid is the largest funder of mental health services in the United States. In 2008, in all 50 states, Medicaid spent a total of $4.5 billion on behavioral health drugs, about a fifth of the $22.5 billion spent by the program on all pharmaceuticals combined. Roughly a third of the participants in Medicaid and the Children's Health Insurance Program experience a mental health episode annually, according to a 2010 report by the Mental Health Services Administration. The billions spent on mental health drugs have made them a target for cost containment strategies. All but a handful of state Medicaid programs have imposed some limits on beneficiaries' access to the drugs (Vaida, 8/14).

Politico Pro: Massachusetts To Vote On Assisted Suicide
Massachusetts in November will vote on whether to become the third state to legalize physician-assisted suicide. Oregon and Washington voters have approved similar laws. A court has allowed the practice in Montana, although there has not been a ballot initiative or legislation. Massachusetts's "Death with Dignity" initiative, like Oregon's and Washington's, would allow a physician to prescribe life-ending drugs to a terminally ill patient. The patient has to be able to express his wishes, and take the drugs himself. The physician cannot administer the lethal dose. A poll in May by the Western New England University Polling Institute found that 60 percent of registered Bay State voters support "allowing people who are dying to legally obtain medication that they could use to end their lives" (Cheney, 8/16).

The Boston Globe: Health Insurer's Earnings Plunge For 2d Quarter
Massachusetts health insurers, ­under sustained pressure from small business customers and the Patrick administration to hold down premium increases, Wednesday posted sharply lower earnings for the second quarter compared with the same period a year ago. Net income in the three months ending June 30 plunged 49.9 percent at the state's largest health insurance company, Blue Cross Blue Shield of Massachusetts. The drop was even steeper for the state's other major health plans -- 56.3 percent at Harvard Pilgrim Health Care, 93.6 percent at Tufts Health Plan, and 68.4 percent at Fallon Community Health Plan (Weisman, 8/16).

HealthyCal: Report: Coachella Valley Residents Lack Insurance
A new study by the Health Access Resource Center (HARC) shows that 28.6 percent of residents 18-64 are uninsured. That's compared to 21.3 percent nationwide, according to the 2011 National Health Interview Survey (NHIS). That same survey showed that 1 in 5 Californians under age 65 lack health insurance and 9.2 percent of children in the Golden State are uninsured. The data show that the problem is getting worse (Potter, 8/16).

Kansas Health Institute News: Work Starts On Defining Kansas 'Essential Benefits'
The Kansas Insurance Department has scheduled a public hearing to collect input on what basic benefits should be included in the health insurance plans that will be available through the state's new online insurance exchange after Jan. 1, 2014. "A number of our stakeholders have a great deal of interest in what the basic plan might look like, what the benefits would be and what the costs might be," said Linda Sheppard, director of the department's division of accident and health insurance (Ranney, 8/15).

Minnesota Public Radio: Some State Workers' Families Caught In Middle Of Insurance Audit
McDonnel-Forney, whose husband has worked for the Department of Vehicle Services since 2007, is eligible for health care coverage. But she only found out she'd been dropped when she went to the pharmacy earlier this month. "We did not find out until I went to fill a prescription after the first of August and was told I had no insurance and would have to play the full price," she told me today. "We still didn't receive notice until about a week after the first of the month." How did she end up in this situation? (Collins, 8/15).

California Healthline: What Paul Ryan's Reforms Would Mean For California
The Golden State's deficit is nearing $16 billion. Lawmakers are counting on new taxes that may never come. The state's obligations are enormous, even as public-sector cuts mean that social services are being stretched thin. It's a microcosm of the budget wrangling happening on a national level. But the fiscal debate in liberal-leaning California looks tame next to the arguments in Washington, D.C., where Republicans have pushed for austerity measures that would dramatically cut social programs favored by Democrats. … There's little indication that either of Ryan's cost-cutting proposals would be successful in practice. Shifting more health costs to consumers may slow their health care utilization, as demonstrated by a well-known RAND study, but there's no evidence that it would ultimately slow costs, as patients may put off routine care that could later manifest as expensive emergency conditions (Diamond, 8/15).

California Healthline: Amendments Could Move Basic Health Program To Floor Vote
Today a bill to create a state Basic Health Program comes before the Assembly Committee on Appropriations, with the intention of getting sprung out of committee and to the legislative floor for a vote. SB 703 by Ed Hernandez (D-West Covina) is currently "on suspense" -- a kind of legislative limbo for bills with significant potential fiscal impact on California. All bills with a financial impact of $150,000 a year or more have to be put on the suspense file. The appropriations committee can then evaluate all of those bigger-ticket items collectively, so that the committee can better regulate how much spending it approves. Hernandez has been proposing amendments that would lessen the potential financial impact of SB 703, and today the committee will decide whether or not to remove the bill from suspense (Gorn, 8/15).