State roundup: Gov't workers face benefit changes; worry over social service cuts

Stateline: Governors Set The Agenda For A Lean 2011
For many states, 2011 is the most trying budget year of a fiscal crisis now in its fourth year. Revenues generally remain lower than what they used to be; widespread joblessness is putting unprecedented strains on safety-net programs like Medicaid; and all this is happening as federal stimulus money runs out. In this Stateline look at the agendas that the nation's governors have laid out for 2011, it's clear that ambitions have been trimmed. ... But an unusually high number of governors have the odds — or at least politics — on their side. In 20 states, Republican governors are working with a legislature controlled by their own party. Democrats enjoy that advantage in 11 states (2/17).

Minnesota Public Radio: Health Care Providers 'Stunned' By Dayton Budget Cuts
[Gov. Mark] Dayton's plan raises surcharges on providers, cuts rate payments and eliminates health coverage for 7,200 adults on MinnesotaCare. The DFL governor said he did what he could to protect core health services for the state's neediest residents, while also taking steps to control dramatically rising health care costs. ... The Dayton plan does raise revenue by substantially increasing surcharges on nursing facilities, hospitals and health plans. ... The overall pain of the spending cuts is set at $383 million. Cullen says $87 million of that comes out of long-term care programs, primarily through rate reductions. Nursing homes, for example, would have their rates cut by 2 percent across the board (Benson, 2/16).

The Wall Street Journal: Wisconsin Public Workers Protest Governor's Proposal
For a second straight day, thousands of Wisconsin public employees converged on the state capitol in Madison to protest Gov. Scott Walker's plan to close the state's projected $3.6 billion budget shortfall by increasing the cost of their pensions and health benefits and taking away their collective bargaining rights (Maher and Belkin, 2,17).

Health News Florida: State Workers, Get Ready
[W]ith the state facing massive budget problems, Republican leaders want to squeeze tens of millions of dollars out of the insurance plan for state workers, retirees and their family members. ... in Scott's most far-reaching proposal, he wants to begin giving employees flat amounts of $5,000 each to buy health insurance starting in January 2013. That would save the state more than $7,000 for each employee who has family coverage -- and likely push many workers into high-deductible insurance plans (Saunders, 2/17).

Connecticut Mirror: Health And Social Service Cuts Bring Relief And 'Grave Concern'
Poor adults in Medicaid would get fewer dental cleanings and have to chip in for the cost of medical care under Gov. Dannel P. Malloy's proposed budget. Seniors receiving home care would have to pay more for the services, and a portion of the program aimed at keeping seniors out of nursing homes would be capped. ... and state funding to help people pay for HIV and AIDS medication would be eliminated. The budget calls for cuts to a wide range of programs that help some of the state's most vulnerable residents. But some advocates for people served by the programs said they had expected worse, and were relieved at much of what was and wasn't, in the budget (Becker, 2/16).

Houston Chronicle: Lawmakers Look To Pay Doctors, Hospitals Based On Quality Of Care 
Lt. Gov. David Dewhurst and Sen. Jane Nelson, the bills' sponsors, said the legislation would overhaul the health care payment system, creating incentives that tie funding to patient outcomes. Currently, funding is tied to the number of procedures ordered. ... It's not clear if the legislation would reduce the Medicaid reimbursement cut that health care providers expect. Lawmakers are facing a shortfall of up to $27 billion for the coming two-year budget cycle, and Medicaid, which constitutes 25 percent of the state budget, is a prime target (Ackerman and Fikac, 2/16).

Georgia Health News: Bill Would Allow Out-Of-State Health Policies
The issue of [insurance] mandates has erupted again in the Georgia General Assembly with the introduction of House Bill 47. The legislation would allow insurance companies to sell any policy in Georgia that they now offer in other states. Thus, an insurer could skirt Georgia's required coverages with barer policies sold in states with fewer consumer protections. An out-of-state plan could lower the sticker price of insurance for uninsured Georgians, the bill's proponents say. ... A similar bill cleared the House last year but stalled in the state Senate (Miller, 2/16).

Related, earlier KHN story: FAQ: Selling Health Insurance Across State Lines (Galewitz and Verdon, 1/25).

The Texas Tribune: Amid Budget Mess, Should Texas Be in Cancer Business?
[A] $300-million-a-year cancer institute championed by Gov. Rick Perry and now-retired cyclist Lance Armstrong and approved by voters in 2007 has so far escaped the budget knife. Advocates for the Cancer Prevention and Research Institute of Texas say they believe it will be spared for two key reasons: First, it's funded by voter-sanctioned bonds — $3 billion over 10 years — and the state's only financial responsibility in the next budget is roughly $14.5 million in debt service. Second, they say, it's been an early success, using its funding to draw prominent cancer researchers to Texas, launch prevention programs statewide and lay the foundation for drug development locally, a potential economic driver. ... [But some] question whether it even makes economic sense for the state to be in the cancer business. At a minimum, they argue, the institute, which comes before the Senate Finance Committee today, should be subject to the same kind of belt-tightening every other agency is (Ramshaw, 2/17).

San Francisco Chronicle: Released Hospital Patients' Many Unhappy Returns
Patients who are released from the hospital too early or without proper planning and instructions often wind up back in the hospital after a few days, a problem that's costly to taxpayers and distressing to patients. A study released today calculated that reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year. An estimated 81,000 Medicare patients in California - or 20 percent - end up back in the hospital within 30 days of being discharged for some reason related to the same condition, the study found (Colliver, 2/16). 

The Denver Post: Children's Hospital Would Lose $7 Million For Training Under Obama Budget 
The Obama budget, a starting point in the debate that will be under further cutting pressure from Republicans, wipes out a national pediatric training program. Children's, on the Anschutz Medical Campus in Aurora, has received an average of $7 million a year to host more residents, conduct research and expand care for underserved patients, officials said. ... Lawrence McAndrews, president of the National Association of Children's Hospitals ... said stopping the program would worsen an existing shortage in pediatric specialists that already results in long wait times for care. The $317.5 million budget helped pay for 5,631 residents nationally, the hospital group said (Booth, 2/17).