Kaiser Daily Health Policy Report Rounds Up State of the State Addresses
The new year finds governors across the country facing difficult health care choices, as rising costs and increasing Medicaid expenditures combine with the recession to pressure state budgets. Throughout January and February, the governors will give their yearly state of the state addresses, highlighting prior accomplishments and outlining their goals and proposals for the next 12 months. Over the next few weeks, the Kaiser Daily Health Policy Report will summarize the health care issues discussed in these addresses. The following is a look at the speeches given Jan. 16-Jan. 23:
- Alaska: In his Jan. 16 speech, Gov. Tony Knowles (D) said that Alaska "must continue to increase our investments for Alaska's children ... for their health and safety." In particular, Knowles said that the state's immunization rate for children "need[s]" to be 100%; in the last four years, the state's childhood immunization rate increased from 67% to 77%. Knowles added that the state's Smart Start program has made "great progress," including "critical improvements" in teenage tobacco use, substance abuse and suicide. In addition, Knowles said that 800 pregnant women and 21,000 additional children currently receive health care through the state's CHIP program, Denali KidCare. Further, Knowles requested that lawmakers approve his budget proposal, which includes health care funds for seniors and state residents with disabilities, as well as money for programs that would improve children's health and safety (Knowles speech text, 1/16).
- Florida: In his Jan. 22 speech, Gov. Jeb Bush (R) noted that since he took office four years ago, health and human services spending has increased by a "record" $4 billion and an additional 1.3 million children have health coverage through the state's CHIP and Medicaid programs, a 69% increase (Bush speech text, 1/22).
- Hawaii: In his Jan. 22 speech, Gov. Benjamin Cayetano (D) said that the state Legislature's approval last year of a $300 million bio-medical research center is a "major step" toward his goal of making Hawaii the "premier health care center of the Pacific" (Cayetano speech text, 1/22).
- Maine: In his Jan. 22 speech, Gov. Angus King (I) said that the state has "experienced progress in the health and strength of our people." King mentioned several examples of this progress, such as that the state now has "one of the lowest" teen pregnancy rates in the nation; the nation's highest childhood immunization rate; and "one of the highest" rates of insured children in the nation. King said, "[W]e're going to keep moving on all of these." Looking toward the future, King said that one of the "fundamental challenges" that Maine faces is the "looming crisis in health care." The governor predicted that the cost of health care "will come to dominate the politics of this state and this country for the better part of the next decade" (King speech text, 1/22).
- Michigan: In his Jan. 23 speech, Gov. John Engler (R) said Michigan residents have "understandable concern" about several issues, including health care. The "good news," Engler said, is that 800,000 more residents -- including 400,000 children -- have health insurance now than did 10 years ago. Although the state's attempts to increase access to care and contain costs had been "thwarted ... [f]or the longest time" by "bewildering" federal regulations and "excessive cost[s]," Engler said that changes instituted by President Bush and HHS Secretary Tommy Thompson will allow Michigan "to do even more to improve health care." To that end, the governor announced plans to submit to HHS a fast-track waiver request to create the MI-Family health plan, which aims to provide health insurance to 200,000 Michigan residents (Engler speech text, 1/23). The plan would increase income eligibility limits under Medicaid to expand coverage to more low-income and disabled people but also would cut some services to current beneficiaries (Wendland-Bowyer/Bell, Detroit Free-Press, 1/22).
- Missouri: In his Jan. 23 speech, Gov. Bob Holden (D) said that while the state's fiscal situation has forced him to make "hard decisions," he is "not willing" to cut the budget "so deeply" that it would "leave [the] most vulnerable Missourians defenseless." On that note, Holden said that he plans to ask the General Assembly to release $135 million from the state's rainy-day fund to provide services for people with mental illnesses and disabilities. In addition, Holden promised to enact the Senior Prescription Drug Program approved by the state Legislature last year (Holden speech text, 1/23). The program would cover seniors earning $12,000 or less and couples with incomes of $17,000 or less, as well as singles earning $17,000 or less and couples with incomes of $23,000 or less. Seniors in the lower income bracket would pay a $25 annual enrollment fee and a $250 deductible, and those in the higher income bracket would pay a $35 enrollment fee and a $500 deductible. Once participating seniors pay the deductible, the state would pay 60% of their remaining drug costs (Kaiser Daily Health Policy Report, 9/14/01).