Kaiser Daily Health Policy Report Highlights Health Care Proposals in Six States

Summaries of news about efforts to restructure health coverage in Louisiana, Maryland, Pennsylvania, Utah, West Virginia and Wisconsin appear below.

• Louisiana: The Louisiana Chapter of the American Academy of Pediatricians and the Louisiana Hospital Association recently filed public records requests to obtain details about Gov. Bobby Jindal's (R) plan to restructure the state's health care system, the Baton Rouge Advocate reports. The requests included all documents concerning Jindal's plans for Medicaid. The proposal would test "coordinated care organizations" in four areas of the state. The plan aims to improve patients' health and reduce costs with better care management. The government also would pay Medicaid premiums for state residents. Last week the Louisiana Medical Society said that the plan lacked transparency. Roger Smith, head of the medical society, said, "This lack of transparency is an obstacle to evaluating the feasibility of the proposed plan." State Department of Health and Hospitals Secretary Alan Levine said, "Everybody is concerned with what they have not read yet," adding, "It is only fair for me to have the opportunity to craft my proposal before people start picking away even before I finish" (Shuler, Baton Rouge Advocate, 11/12).
  
  
• Maryland: A coalition of health care advocates on Wednesday presented Maryland state lawmakers with a $15.5 billion universal health care proposal, the Baltimore Sun reports. The Maryland Citizens' Health Initiative, which includes policy experts from the University of Maryland and Johns Hopkins University, proposes the creation of a health insurance pool for coverage of individuals and employees of small businesses, reinsurance for high-cost care, an expansion of Medicaid eligibility and subsidized premiums for those who qualify. The plan would cost $15.5 billion over five years and would be partially funded by a 2% employer payroll tax on wages and increases in tobacco and alcohol taxes. Delegate James Hubbard (D) said he would introduce the proposal as legislation in January 2009. However, the Sun reports "such a proposal faces an uphill battle" as state lawmakers look to address budget shortfalls and consider rolling back earlier health care expansions (Smitherman, Baltimore Sun, 11/12).
  
  
• Pennsylvania: Gov. Ed Rendell (D) on Monday asked the state Senate to act on his health coverage expansion proposal in a lame-duck session, but Republicans, who control the chamber, refused the request, the Philadelphia Inquirer reports. The Democratic-controlled House has approved Rendell's proposal, which the governor says would extend health coverage to 176,000 state residents by 2012. That number includes 47,000 people who already have "adult basic" coverage through the state, as well as the 129,000 on the waiting list. Rendell's proposal would add coverage for prescriptions drugs and some behavioral-health services. According to Rendell, the $1.9 billion program could be funded using money already held in a tobacco sales-tax account set aside for health care purposes, as well as federal matching funds. Senate Majority Leader Dominic Pileggi (R) said, "We continue to be ready and willing to work on health care issues, which remain a priority for Senate Republicans," but in the "current economic downturn ... our top priority must be to ensure that we can continue to provide existing services under these difficult conditions." According to Pileggi, Senate Republicans will wait to see what President-elect Barack Obama proposes on health care next year, to ensure any state action is "fully compatible with federal laws." Rendell also reiterated that he would not continue to extend state funds for a medical malpractice insurance subsidy program for doctors until a health coverage bill is approved (Worden, Philadelphia Inquirer, 11/11).
  
  
• Utah: The Utah Legislature's Health System Reform Task Force on Tuesday presented a blueprint for prospective legislation to be drafted and debated, the Salt Lake Tribune reports. The panel, which will hold its final meeting Dec. 16, suggested that lawmakers focus on ways to preserve the private insurance industry while creating more affordable plans; remove barriers -- such as coverage mandates -- to affordable policies; allow businesses to let employees shop for their own plans; increase transparency of brokers' compensation and create standards for the exchange of electronic health records; simplify administrative processes; require that state-contracted firms provide coverage for workers; and implement medical malpractice reforms that would protect doctors (Rosetta, Salt Lake Tribune, 11/12). Some changes suggested by the panel could be made into legislation and proposed in January 2009, but most probably will not come until 2010, according to the Salt Lake City Deseret News (Thalman, Salt Lake City Deseret News, 11/10).
  
  
• West Virginia: Gov. Joe Manchin (D), who was re-elected last week, last Thursday said he is "committed" to providing health coverage for every uninsured working state resident, possibly by expanding the main benefits program for state workers, the AP/Charleston Daily Mail reports. Manchin said he may propose expanding the state Public Employees Insurance Agency to provide insurance for small businesses. Additionally, Manchin suggested allowing Medicaid beneficiaries to retain their coverage for 10 years after their income increases beyond the maximum amount for eligibility. Extending this grace period, currently set at five years, would require a federal waiver, according to Manchin spokesperson Lara Ramsburg. PEIA covers about 197,000 state workers, retirees and their families, and Medicaid covers about 281,000 West Virginia residents. Their combined cost was about $1.2 billion last year. Ramsburg said that because of the economy and other factors, Manchin could be forced to delay action on health care until after 2009 (AP/Charleston Daily Mail, 11/7).
  
  
• Wisconsin: Some state Senate Democrats say they will try again to pass the Healthy Wisconsin universal health care proposal now that the party holds the majority in the Assembly, but Gov. Jim Doyle (D) and others are opposed to the plan, the Milwaukee Journal Sentinel reports. Doyle said the state should wait for the administration of President-elect Barack Obama and congressional leaders to take action on a national health system overhaul. Supporters of Healthy Wisconsin said it would lower costs for firms and employees by eliminating private health care plans, but opponents say it would double state taxes (Walters/Marley, Milwaukee Journal Sentinel, 11/12).