State highlights: New York state faces $1.3B Medicaid payback problem while Mayor De Blasio advances plan to reduce city employees' health costs

A selection of health policy stories from California, North Carolina, Iowa, Massachusetts and Illinois.

The New York Times: De Blasio's Plans To Reduce Worker Health Costs Have A Carrot And A Stick
When Mayor Bill de Blasio announced his first labor agreements with New York City unions this spring, he was sharply criticized for granting long-awaited wage increases in exchange for promises of unspecified though sizable savings on health care expenses (Greenhouse and Stewart, 7/29).

The Wall Street Journal: State's $1.3 Billion Medicaid Problem
The federal government has demanded that New York state pay back nearly $1.3 billion in Medicaid money distributed in 2010, prompting a rebuke from Gov. Andrew Cuomo's administration and a promise to appeal the decision. At issue are the costs of caring for about 1,300 developmentally disabled people-;about $2 million per patient in 2013-;in nine state facilities from Staten Island to Rochester. New York's Medicaid program is among the nation's most expensive (Kravitz, 7/29).

Los Angeles Times: County Wants Plan Before Funding Ways To Divert Mentally Ill From Jail
The proposal -; suggested by Supervisor Mark Ridley-Thomas -; comes as the county is under federal pressure to improve treatment of mentally ill jail inmates and as it embarks on a $2-billion overhaul that includes a new Men's Central Jail centered around treatment beds for mentally ill inmates (Sewell, 7/29).

Kaiser Health News: Capsules: Rx For Clarity: Calif. Considers Bilingual Drug Labels
This week California's Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. New York approved a similar rule last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes (Dembosky, 7/30).

Raleigh News & Observer: NC Budget Deal Includes Teacher Raises, But No Medicaid Overhaul
House and Senate budget writers reached agreement Tuesday on a $21.3 billion state spending plan that averts significant cuts to Medicaid but leaves unresolved a major overhaul of the health insurance program for the poor. The budget compromise, legislative leaders said, cuts $135 million from the state's Medicaid program but makes no changes to eligibility and no shift in how the care is provided. The Senate had previously approved a budget that called for major changes to Medicaid – including a proposal to cut eligibility for thousands of elderly and disabled people – but the House and Gov. Pat McCrory opposed the plan. The issue became a sticking point in the budget negotiations that stretched a month and derailed the legislative session (Frank, 7/29).

North Carolina Health News: Health Care Advocates Anxiously Await Details Of Medicaid Budget Or Cuts
After two long months of negotiating and haggling over lottery numbers, Medicaid and teacher pay, Speaker of the House Thom Tillis and Senate President Pro Tempore Phil Berger came together Tuesday to present a compromised "budget framework." Though Tillis and Berger discussed major points of the budget – including a 7 percent raise for teachers, preservation of current Medicaid eligibility and a 1 percent cut to Medicaid provider rates – specific details of the budget have yet to be released on Jones Street (Namkoong, 7/29).

Des Moines Register: Medicare Touts $12M Drug Cost Savings For Iowans
Iowa seniors and disabled people have saved nearly $12 million on medications this year because of a reduction in the "doughnut hole" in Medicare's prescription-drug program, federal officials estimated today. Medicare administrators said 16,150 Iowa participants have saved an average of $728 so far this year because of the change, which is part of the Affordable Care Act. U.S. Sen. Tom Harkin, an Iowa Democrat who helped pass the Affordable Care Act in 2010, applauded the report's findings. "Improving coverage for Medicare beneficiaries and shifting the program's focus to keeping people healthy is at the heart of the health reform law," he wrote in a prepared statement (Leys, 7/30).

WBUR: As Mass. Lawmakers Take Up Addiction Bill, What's Most Effective Treatment?
As Massachusetts lawmakers work on differences in the $20 million bill designed to address the state's opioid crisis, questions remain about which treatments are best. Several business and insurance leaders have written to Gov. Deval Patrick saying that some parts of the bill may not encourage the most effective addiction treatment. Essentially, they say, more beds may not be the answer, but more medication and longer outpatient care might be better (Becker, 7/29). 

The Associated Press: Illinois Warns Insurers Of Discrimination Ban
Illinois regulators issued a reminder to health insurers that it is illegal to deny coverage to someone because they are transgender, drawing praise from the gay rights community. The bulletin, which was dated Monday and announced Tuesday, notes that both new and amended policy filings should comply with provisions in the Affordable Care Act, the Illinois Human Rights Act and the Illinois Mental Health Parity Act -; which prohibit discrimination against transgender persons because of general identity or health conditions (Lester, 7/29).