Kaiser Daily Health Policy Report Highlights News Coverage of Recent Developments in Medicaid, Other State Health Insurance Programs

The following summarizes recent news coverage of state Medicaid and other health program developments.

• Illinois: The state on Jan. 1 changed eligibility standards in the Illinois FamilyCare health insurance program to allow an additional 56,000 low-income Illinois families to enroll, the AP/Chicago Sun-Times reports. The expansion changed the qualifying annual income to 185% of the federal poverty level, or about $36,000 for a family of four (AP/Chicago Sun-Times, 12/29/05).
  
  
• Louisiana: Louisiana on Jan. 1 began reducing by 10% all Medicaid reimbursements to doctors, hospitals, nursing homes and other health care providers because of increased costs and smaller revenues caused by Hurricanes Katrina and Rita, the Baton Rouge Advocate reports. Fred Cerise, secretary of the state Department of Health and Hospitals, said the $200 million in cuts were necessary after Congress failed to vote on a federal aid package that would give $2 billion in Medicaid assistance to Louisiana, Mississippi and Alabama. Cerise said he hopes the House will pass a version of the legislation already approved in the Senate when it returns from recess on Jan. 31. Barring federal assistance, Louisiana also will have to reduce the number amount of no-cost prescriptions for Medicaid beneficiaries from eight to five per month, he added (Ballard, Baton Rouge Advocate, 12/28/05).
  
  
• Maine: The Maine Association of Health Plans, a trade group representing four major health insurers in the state, has filed a second lawsuit in less than a month to overturn a $43.7 million fee for DirigoChoice that the companies are required to pay, the Portland Press Herald reports. The state's Dirigo Health Agency has assessed the fee to pay for an expansion of the DirigoChoice health insurance program. The state "contends that the fee, calculated as 2.4% of private insurers' paid claims, effectively costs the companies nothing because it equals what private insurers save because of Dirigo Health initiatives," the Press Herald reports. In MAHP's lawsuit filed in Cumberland County Superior Court, the trade group says the fee is "arbitrary and capricious." The trade group represents Aetna, Anthem Blue Cross and Blue Shield, CIGNA HealthCare and Harvard Pilgrim Health Care. MAHP Executive Director Katherine Pelletreau said that if the trade group loses the lawsuit, insurers will have to pass the cost of the fee on to consumers. Trish Riley, a spokesperson for the Governor's Office of Health Policy and Finance, said the insurance companies participated in determining the fee last month, so they should not have objections. She also said that passing the fee's cost to consumers would break an agreement reached between the insurers and the state in 2003 (Harkness, Portland Press Herald, 12/21/05).
  
  
• Maryland: Attorneys for 13 documented immigrant children on Dec. 21, 2005, said that Gov. Robert Ehrlich's (R) decision to cut Medicaid coverage for several thousand documented immigrants was discriminatory, the Washington Post reports. The attorneys, who appeared before Montgomery County Circuit Court, are seeking an injunction that would require the state to restore coverage. Joel Tornari, an assistant state attorney general, said the cuts, which amounted to $7 million, were not discriminatory because their program was paid solely by the state. The broader Medicaid program is funded by state and federal dollars. The judge said he will reach a decision by early January (Washington Post, 12/22/05).
  
  
• Pennsylvania: The state is offering coverage through its adultBasic program to about 30,000 low-income residents who have been on a waiting list for up to 18 months, the Pittsburgh Post- Gazette reports. AdultBasic provides insurance for individuals who have incomes that exceed Medicaid requirements but cannot afford private health insurance. The program currently covers 36,000 people, who pay a $32 monthly premium and receive coverage for hospital visits, hospitalization and maternity care. The program's current waiting list totals more than 114,000 families. AdultBasic is funded mostly with the state's share of the national tobacco settlement, but money provided by Highmark and three Blue Cross insurers in Pennsylvania enabled the program to accept more families in December 2005 in addition to the 20,000 it accepted in October 2005. After being criticized for having large cash reserves despite their not-for-profit status, the insurers in February 2005 agreed to give $1 billion over six years to various community health programs, including adultBasic (Snowbeck, Pittsburgh Post-Gazette, 12/30/05).
  
  
• New York: The New York Times on Dec. 23, 2005, examined how a number of counties in New York state have "been driven to financial desperation by the rapidly rising cost of Medicaid." New York is the only state that requires local governments to pay a large share of Medicaid costs. In recent years, "the Medicaid rolls upstate and around New York [City] have swelled sharply, as the state expanded eligibility and the number of jobs offering health insurance shrank," the Times reports. The problem "is most serious in counties upstate, which lack a broad tax base but have a growing Medicaid population," the Times reports. Counties have taken a number of steps to counter the financial problems caused by Medicaid, including raising taxes, reducing services and laying off workers (Perez-Pena/Luo, New York Times, 12/23/05).
  
  
• Tennessee: A committee created to examine "the range and effectiveness" of safety net programs created to assist 191,000 adults who lost TennCare eligibility this year will hold its first meeting on Jan. 4, less than one week before its report is due to the state General Assembly, the AP/Tennessean reports. As a result, the committee will miss its deadline, according to the Tennessean. State Sen. David Fowler (R), who introduced the amendment to establish the committee and has resigned because of the slow start, said, "To do this job well is going to require hours and hours and days and days." Andrea White, a TennCare safety-net spokesperson, said, "It's unfortunate that obviously the committee will not be able to give a formal report by Jan. 10. The good news is now that we have a (safety-net) program built and extended, they can have a much more hearty and meaningful conversation" (AP/Tennessean, 12/27/05).
  
  
• Virginia: A Virginia law that took effect Jan. 1 restricts undocumented immigrants from receiving state-funded benefits, including Medicaid coverage, the AP/Washington Times reports. According to supporters, the law will save the state millions of dollars. But opponents say the new law is similar to already existing federal and state statutes that prohibit undocumented immigrants from receiving certain benefits. In addition, they say that the new law could confuse documented immigrants and prevent them from applying for benefits for which they are eligible (Walker, AP/Washington Times, 12/31/05).
  
  
• Washington: About 13,000 immigrant children are on a waiting list for the Children's Health Program, a state alternative to Medicaid that was funded this year by the Legislature for the first time since 2002, the AP/Seattle Times reports. A state computer system next month will draw 4,300 names at random to receive coverage, and about 3,000 additional children could be added in July. The Legislature has agreed to spend $13.7 million for the first group in the program, which once provided coverage to more than 22,000 kids (Woodward, AP/Seattle Times, 12/27/05).