States trying to keep health care systems afloat

States are having to make budgetary decisions about their health care systems as federal legislation and funding continue to be tied up in Congress.

Minnesota Daily: Lawmakers in Minnesota have revealed a plan to temporarily extend the General Assistance Medical Care plan before replacing it "with a trimmed-down delivery system managed largely by hospitals. … Under the plan, hospitals will form Coordinating Care Organizations, or CCOs, and will receive grants on a quarterly basis to provide care to the state's poorest individuals. The $71 million they'll receive from the current budget, however, likely won't cover the cost of patient care, providing incentive for them to refer patients to outside services, such as veteran's assistance."

Republican Gov. Tim Pawlenty said the plan "represents a step forward in health care reform, 'in a direction towards how we provide health care from an old way of doing it to a new way of doing it'" (Bannow, 3/7).

The York Daily Record reports that the state CHIP program in Pennsylvania is up for renewal next week. "Lawmakers are considering three pieces of legislation: One to renew it for three years, one to renew it for five years and one to renew it indefinitely. Since CHIP started in 1992, [Rosanne Placey, spokeswoman for the Pennsylvania Insurance Department] said, it has had wide bipartisan support. … Gov. Ed Rendell has proposed increasing spending on the program by $26.8 million to a total of $437.3 million, and covering an additional 10,300 children" (Joyce, 3/7).

Also in Pennsylvania, the Republican & Herald reports that Acting Department of Public Welfare Secretary Harriet Dichter "plans to lobby Washington to win congressional approval for $1 billion in aid to buttress the medical assistance program. The aid would come through two streams: $848 million in additional federal matching dollars and $102 million to extend a Medicaid drug rebate program. The rebate extension is tied up in the health care system overhaul awaiting a reconciliation vote between the U.S. House and Senate."

"The Obama administration is showing an awareness of the states' burden. The federal Department of Health and Human Services said last month it will reduce by $4.3 billion the amount that states have to pay Washington to offset the cost of prescription drugs for state residents eligible for both medical assistance and Medicare, the health program for the elderly. Pennsylvania will save $228 million through this action" (Swift, 3/7).

The New York Times: "At risk of running out of money in May, Miami's public health care system is considering closing two of its five hospitals and laying off 4,487 employees — a third of its work force, the chief executive said Friday" (Skipp, 3/5).