Capitol Comments

Building Blocks of Health Care Reform

By Mary Branham Dusenberry

Reforming the health care system won’t be easy, speakers at a workshop on the topic said Sunday.
But everybody knows change is coming as Congress considers options at the national level. In fact, some of those changes have been implemented as President Obama signed the Children’s Health Insurance Program Reauthorization Act Feb. 4.

The goal—getting more people insured—is admirable, Joan Gardner, executive director of State Services for Blue Cross Blue Shield, said. But plans for a national exchange, she said, could create problems. A government-run plan would create an uneven playing field between that plan and those provided in the private sector, she said.

But she acknowledged that changes need to be made.

Americans Sold on Electronic Medical Records, But Skeptical about Privacy and Cost

Three of four Americans say it is important to make the switch to electronic medical records, according to a public opinion poll released April 22 by the Kaiser Family Foundation, the Harvard School of Public Health and National Public Radio.

A majority of those polled said electronic medical records would improve the quality of medical care in general, as well as for themselves and their families. They also believe these records would prevent unnecessary care and medical errors.

The poll also revealed a healthy skepticism about the privacy of electronic medical records and implementation costs. Less than a quarter of the respondents believed electronic medical records would reduce health costs in general or for their families specifically. Nearly three in four were not confident that electronic medical records data would remain confidential.

The poll explores other questions about health care costs, care coordination and cost-effectiveness research.

Brian Russon, an industry strategist for the Health Solutions Group at Microsoft Corporation, will talk about health IT during the Technology Working Group session at the CSG Spring Meeting from 1 to 2:30 p.m. Saturday, May 16.  Also see the CSG Trends in America Special Report, Health Information Technology.

Going Where the Money Is ... Medicaid

Legislators are under the gun to balance state budgets and that means understanding the ins and outs of Medicaid, a major spending program in all states and territories.

The Council of State Governments has developed Medicaid 101: A Primer for State Legislators to help state legislators learn about Medicaid, the federal-state matching program that provides health insurance for one in four U.S. children, large numbers of elderly and people with disabilities and low-income parents.

Policy analysts at CSG with experience in administering state Medicaid programs provide the background and detail necessary for legislators to understand administrative testimony on Medicaid and to ask appropriate questions of state Medicaid officials. 

Stimulus Package to Help Medicaid Programs

The $825 billion economic recovery package presented by House Democrats includes $88 billion to increase the federal share of states’ Medicaid costs.

States would receive a bump of 4.9 percent in their federal matching rate for nine quarters, retroactive to October 2008. In addition, states could receive an additional increase in federal funds if they experience significant increases in unemployment rates.

In order to qualify for the increased Medicaid funds, states must not restrict Medicaid eligibility levels above those in place July 1, 2008. Restrictions prohibited include income eligibility or changes that make it more difficult for individuals to meet procedural requirements for enrollment or renewal.

The Center on Budget and Policy Priorities has released a preliminary analysis of the increases each state could expect in state fiscal years 2009, 2010 and 2011.  In addition, check out a comparison between House and Senate versions of the plan.

State, Federal Government Play Roles in Health Care Reform

By Crady deGolian

The recent presidential election will likely bring changes to the nation’s health care system. 

Though it is unclear at this point what those changes will be, it is certain that state governments will be at the forefront of implementing them. Catherine Hess, senior program director at the National Academy for State Health Policy, discussed the roles of federal and state governments in reforming health care during the Health Policy Task Force session during The Council of State Governments annual meeting Dec. 5.

Hess pointed out that while the U.S. ranks first among developed nations in dollars spent on health care, the country lags behind these same nations in innovations to improve the quality and efficiency of outcomes.  That means state governments will play an essential role in improving the nation’s health care system, she said.

Institute of Medicine Recommends State Policies on Smoking

By Ann Kelly, CSG associate director of health policy

A recent policy blueprint from the Institute of Medicine points to policies states can adopt to help people quit smoking and prevent youth from ever starting to smoke.  Without such aggressive policy action, the institute predicts the U.S. smoking rates will not decline further.

Helping people who are motivated to try and quit smoking is one of seven key policies included since safe and effective treatments, including medications, are available and insurance coverage for these treatments is increasing. While it is unlikely that an individual will quit smoking with one treatment, using effective cessation treatments population-wide can significantly reduce smoking rates and ultimately bring about savings in health care and other costs.

New help for people who want to quit smoking

By Ann Kelly, CSG associate director of health policy

Everyone knows someone who has tried to quit smoking and failed.  Consider:

• More than 44 percent of adult smokers and more than half of high school cigarette smokers try to quit each year. 

• 70 percent of smokers want to quit smoking, and most have tried to quit at least once on their own before seeking professional help.

• For most people it takes many attempts—up to five to seven tries—to successfully stop smoking. 

Securing Better Access to Health Care

Amidst the many challenges faced by rural America, access to quality health care is becoming a top concern.

The rapid retirement of baby-boomer medical professionals, coupled with waning graduation rates in many specialties, has left many parts of the nation without enough doctors, nurses and pharmacists.

California Forbids Trans Fats

California became the first state to ban trans fats in restaurants July 25 when Gov. Arnold Schwarzenegger signed Assembly Bill 97 into law. The new law will phase out trans fats from restaurants beginning in 2010 and from retail baked goods by 2011.

And California, although first in the nation for such a move, is going even further with the ban by fining those who break the law anywhere from $25 to $1,000, according to the Associated Press.

Talk about a stick approach to health.

New report examines health reform strategies in Midwest

State strategies to contain health care costs and reform health systems are the focus of a new Midwestern Legislative Conference report, released last week in conjunction with the nonpartisan association’s four-day meeting in Rapid City, S.D.

Using case studies from each of the 11 Midwestern states, the report examines several key health care issues and highlights innovative efforts being implemented or explored in the region.

“Our nation’s health care system is ripe for transformation, innovation and reform, and as the case studies in this report show, this region and its policymakers can help lead the way,” said South Dakota Senate Assistant Majority Leader Tom Dempster, chair of the MLC.