From:
Sent:
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Heidi Siegfried
Tuesday, June 21, 2011 3:53 PM
Margi Trapani; Susan Dooha
FW: Where the Rubber Meets the Road - State Focused Health Care News - Wednesday,
June 15th
Mark H. subscribes to the Herndon thing and I got him to check 06/15. Our story got picked up in their state daily news clip
service. It is pretty far down in it.
Heidi Siegfried, Esq.
Director of Health Policy
New Yorkers for Accessible Health Coverage
Center for Independence of the Disabled of New York
841 Broadway, Room 301, New York, NY 10003
646-442-4147
212-254-5953 (fax)
hsiegfried@cidny.org
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Visit our website and join the conversation at CIDNY on the Issues
From: Metro New York Health Care for All Campaign [mailto:metrohealth@igc.org]
Sent: Tuesday, June 21, 2011 3:50 PM
To: Heidi Siegfried
Subject: FW: Where the Rubber Meets the Road - State Focused Health Care News - Wednesday, June 15th
From: Peter Van Vranken [mailto:pvan@gmavt.net]
Sent: Wednesday, June 15, 2011 10:14 AM
To: Peter Van Vranken
Subject: Where the Rubber Meets the Road - State Focused Health Care News - Wednesday, June 15th
 The Drive to Gut Medicaid – taking away care for seniors, people with disabilities and children:
o PULE - HAPPENING TODAY: HATCH ATTACKS - Sen. Orrin Hatch will continue his tough talk
about the Democrat's Medicaid reform strategies today during a speech at the Heritage Foundation and
criticize President Obama, suggesting the administration trashed innovations in the program when it
enacted the ACA. "Instead of reforming a bankrupt system, he decided to double down on it," Hatch will
say, according to excerpts of the speech obtained by PULSE. The Finance Committee's ranking
Republican intends to call out the ACA's provisions to expand the program as a "direct assault on our
Founding Fathers' Constitution of limited federal powers and reserved states' rights." Hatch also will
cite a letter from Republican governors that he received Monday and suggest the message from red
states is that they want more freedom to make the program "more patient-centered ... accountable and
transparent."
o Leavitt, Hatch targeting ObamaCare Salt Lake City Deseret News by Jamshid Ghazi Askar - Sen. Orrin
Hatch, ranking member of the Senate Finance Committee, will voice his vision for reforming Medicaid
in an address Wednesday to conservative think tank Heritage Foundation. Twenty-eight Republican
governors sent Hatch a letter Monday containing seven "guiding principles" for Medicaid reform.
Hatch's office released the letter to the media Tuesday with the understanding that the senator's
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remarks to Heritage Foundation will incorporate several of the governors' suggestions. States must
have greater flexibility in eligibility, financing and service delivery in order to provide long-term
services and support that keep pace with the people Medicaid serves," the governors wrote to Hatch.
"New federal requirements threaten to stifle state innovation and investment."
o Medicaid advocates say cuts would hurt kids The Hill's Healthwatch by Sam Baker - As they attempt to
fend off a range of proposed spending cuts, Medicaid advocates are emphasizing the program’s role in
covering children. Researchers at George Washington University released a report Monday that says
Medicaid and the Children’s Health Insurance Program effectively cover vulnerable patients at a
minimal cost. “Major cuts in Medicaid could seriously endanger the health and finances of millions of
children and other vulnerable beneficiaries, including the elderly and disabled,” the report states.
..First Focus President Bruce Lesley said. “Our nation has made enormous strides in improving access
to coverage for low-income children and other vulnerable populations.” The American Academy of
Pediatrics has also come out in strong opposition to proposed Medicaid cuts, particularly repealing the
“maintenance of effort” provisions in healthcare reform.
o The Importance Of Medicaid In Three Charts ThinkProgress by Igor Volsky - Congressional
Republicans are hoping to give states more discretion over their Medicaid programs and ideally push
beneficiaries into private sources of insurance coverage. They argue that the program’s costs are
growing at an unsustainable rate and that Medicaid’s structure and lower provider reimbursement rates
undermine patients’ access to quality care. The party has gone so far as to suggest that people are
better off uninsured than insured under Medicaid and has described the program as a “medical
ghetto.” But a new report from First Focus highlights the importance of Medicaid in providing cost
efficient coverage to lower income patients who “face elevated health risks.” Medicaid typically offers
“a broader range of services, including preventive care and special services needed by those with
disabilities or other chronic conditions” at access levels that are actually “comparable to access
provided under private health insurance and far better than access available to the uninsured.” Despite
the GOP’s claims, “almost all children covered by Medicaid or CHIP children have a usual source of
care” and “about nine out of ten publicly- and privately-insured adults had a usual source of care,
compared to less than half of uninsured adults”:
o COMMONWEALTH: MANAGED MEDICAID NOT AS GOOD - Commercial Medicaid managed
care plans may not be serving beneficiaries as well as plans that are not publically traded according a
report released today by the Commonwealth Fund. They have higher administrative costs and score
lower on quality and patient satisfaction measures
 Assessing the Financial Health of Medicaid Managed Care Plans and the Quality of Patient Care
They Provide CommonWealth Fund by Michael J. McCue, D.B.A., and Michael H. Bailit, M.M.
- In many states, Medicaid programs have contracted out the delivery of health care services to
publicly traded health plans that are focused on managing the care of Medicaid members. Under
the health reform law, states will be expanding the enrollment of their Medicaid programs and
these publicly traded companies are expected to capitalize on this growing market. This study
examined how publicly traded health plans differ from non–publicly traded ones in terms of
administrative expenses, quality of care, and financial stability and found publicly traded plans
that focused primarily on Medicaid enrollees paid out the lowest percentage of their Medicaid
premium revenues in medical expenses and reported the highest percentage in administrative
expenses across different types of health plans. The publicly traded plans also received lower
scores for quality-of-care measures related to preventive care, treatment of chronic conditions,
members’ access to care, and customer service.
o GOP governors push back against Obama on federal Medicaid rules Washington Post by Michael A.
Fletcher - Faced with severe budget problems, Republican governors are escalating their fight against
federal rules requiring states to maintain current levels of health-care coverage for the poor and
disabled. The growing resistance to the federal government over the hugely expensive Medicaid
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program poses a critical test for President Obama, who has the power to relax the rules for states. If he
allows states to tighten eligibility requirements, it would outrage many of his core supporters while
undermining the central goal of his signature health-care law: expanding health insurance coverage.
But if the president turns his back on governors struggling to gain control of their finances by trimming
their most costly program, he risks intense criticism just as his administration is locked in a battle with
Republicans over the nation’s soaring debt. “There is a growing impatience among governors,” said
Mike Schrimpf, communications director for the Republican Governors Association. “As the Medicaid
portion of state budgets grows, the issue becomes even more pressing
o Connecticut Backs Away From Private Plans In Medicaid CQ HealthBeat by Reichard (subscription
requited) - Many in health policy say that paying fixed monthly fees per enrollee to private health plans
to deliver Medicaid benefits seems like a powerful tool to manage costs. But the state of Connecticut is
revamping its program to move away from such "managed care capitation." Instead, the state is relying
on more of the tools provided in the health care overhaul law, such as the use of medical homes to try
to deliver care more efficiently, a Connecticut state official told a Washington, D.C. health policy forum
Tuesday.
o (LA) Gov. Bobby Jindal's Medicaid privatization plan rejected by Louisiana House panel New Orleans
Times Picayune by Bill Barrow - The Louisiana Legislature is nearing a final vote on a bill that
eventually would give lawmakers the power to scrap Gov. Bobby Jindal's planned privatization of the
state's Medicaid insurance program for the indigent and working poor. Senate Bill 207 by Sen. Willie
Mount, D-Lake Charles, faces a likely veto from Jindal, who is certain to protect one of his signature
health-care policy initiatives. But the proposal, which cleared the House Health and Welfare Committee
on a series of divided votes Tuesday, nonetheless represents legislative displeasure at the governor's
seeking of an overhaul of the multibillion-dollar enterprise without lawmakers' input. Mount is
chairwoman of the Senate Health and Welfare Committee. The Jindal plan would convert the traditional
Medicaid fee-for-service model into a system of coordinated-care networks run by private insurance
firms or provider networks that are awarded state contracts. Individuals with Medicaid would then be
members of a given network, much like the health management organization system used in the private
insurance market.
 The Competitive Health Insurance Marketplace (formally known as the “Exchange)
o (VA) Panel hears update on insurance exchange plan Virginian Pilot by Julian Walker - Virginia officials
are planning for the creation of a state health insurance exchange to comply with the federal health
care act, even as Gov. Bob McDonnell supports a state legal challenge that could overturn the law. A
meeting Tuesday of the Joint Commission on Health Care included an update on the process of setting
up an exchange. The panel also heard from a think tank scholar who spoke against that approach.
Health insurance exchanges are marketplaces through which individuals without insurance and small
businesses without group insurance plans can buy coverage. Those who meet income eligibility
guidelines could receive subsidies. Dr. Bill Hazel Jr., Virginia's secretary of Health and Human
Resources, said it's prudent to be prepared, given the uncertain outcome of the lawsuits over the Patient
Protection and Affordable Care Act, a signature policy initiative of President Barack Obama. …
o Maryland hiring leaders for health insurance exchange Baltimore Business Journal by Scott Dance Maryland health officials are in search of a few professionals to help lead the creation of the state’s
first health insurance exchange. The Board of Trustees for the Maryland Health Benefit Exchange are
hiring an executive director, director of policy and director of information systems. The exchange is
slated to become a marketplace where health insurers will compete to provide care for small businesses
and individuals who don’t receive health care plans from employers, as mandated by the federal
Affordable Care Act.
o Opinion: Texas 'going full speed ahead' on implementing health care reform Daily Kos by Jed Lewison So Rick Perry has gone from being full-throated defender of Texas' right to secede to this: Meanwhile,
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despite Mr. Perry’s stated opposition to a federally-mandated health insurance exchange and the state’s
participation in lawsuits aimed at overturning federal health reform, officials at the Texas Department
of Insurance acknowledge that since last fall, with the help of a $1 million grant from the United States
Department of Health and Human Services, they have been working quietly to plan for a health
insurance exchange. “We’ve been going full speed ahead on implementation, doing the due diligence so
that we can be on time with what the law says,” said John Greeley, a spokesman for the agency. Lucy
Nashed, a spokeswoman for Mr. Perry, said the governor is aware of the grant, which she said is
exploratory and does not require Texas to set up an exchange. While Mr. Perry prefers local solutions
to Texas’ health care problems, Ms. Nashed said the governor remains hopeful the courts will overturn
the federal health law. “The governor’s firm belief that Texans should be in charge of our health care
programs is unchanged,” she said. To be fair to Perry, it's not like he's suddenly become an advocate
for health care reform—he still supports denying insurance to tens of millions of Americans while
offering overly-expensive coverage to everybody else. So this isn't so much a flip-flop as it is an
example of trying to have it both ways. It'll be interesting to see how this plays out if the reports that
Perry will become a 2012er prove to be accurate.
o (NY) Time Running Short for NY Health Insurance Exchange Plan Public News Service - Gov. Andrew
Cuomo has introduced his version of New York's Health Insurance Exchange plan this week, and
lawmakers are working against a Monday deadline if they want to enact it. The health exchange would
provide much-needed, one-stop shopping for more than 1 million New Yorkers who don't get insurance
through their employers, says Heidi Siegfried, director of health policy at New Yorkers for Accessible
Health Coverage. For many, she says, it can be confusing to both find and keep affordable, quality
health insurance. "If you lose your job, if you have a disability and you're not sure you can work
anymore, or you are trying to get coverage for your child, it can be tough. That could really change in
2014, if New York passes legislation this session." Opponents prefer to call the plan "ObamaCare" and
Republican governors in several states have gone to court in an effort to declare it unconstitutional.
Cuomo proposes having the state set up its own exchange. That means, Siegfried says, that the state can
call the shots but can still access tens of millions of dollars in federal funding for affordable health care
- if the legislation passes. Much of the debate in Albany has centered on what role insurance companies
should play in the new health exchange. The Senate's plan allows them to help run the exchange, which
Siegfried believes could hurt consumers. "Providers and insurers can be on the advisory committee; but
we don't want to see them actually involved with the governance of the exchange. We think that there
needs to be stronger conflict-of-interest provisions."
 Other Stories of Interest:
o PULSE - CALIFORNIA EARLY MEDICAID EXPANSION STARTS SLOW - The state began the
early expansion of its Medicaid program this month and is running into some frustrations over how
many of the new enrollees are ending up in the default program, rather than making the selection
themselves. Of the 35,000 new enrollees reached by phone, just 273 (about 0.5 percent) elected into a
specific program. "No one is particularly happy with that number," Peter Harbage, a health consultant
working on California's reform efforts, said at the Medicaid Congress conference yesterday. "Those are
numbers the state really does want to improve on." Harbage's presentation http://bit.ly/lAaG6s
o (MA) Red tape cited in health gap for young Boston Globe by Kay Lazar - Complex rules keep children
unenrolled - Many children are going without health insurance, despite the state’s universal insurance
law, because of confusing rules about how to sign up and when to renew the government-subsidized
coverage, according to findings to be released today by consumer advocates. A month long campaign to
search out and enroll many of the estimated 3,300 remaining uninsured children has resulted in new
coverage for 1,479 youngsters, according to Health Care for All, a Boston-based consumer group that
is leading the initiative. But advocates say the campaign has also highlighted burdensome paperwork
requirements that often result inchildren being booted off of Medicaid, the state and federal program for
low-income people, though they are still eligible. …
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o States Battle Over Medicaid Eligibility And Access To Care- Fox News by Angle - Would you work for
one third of what you're usually paid because the government demanded it? That's what doctors are
asked to do in Medicaid, the joint state/federal health care program for the poor. "One of the
challenges for Medicaid is that the reimbursement levels for doctors are lower than they are for
Medicare, that's true across the country," says Neera Tanden of the Center for American Progress, a
liberal-leaning think tank. And Medicare pays some 20 percent less than private insurance. With
Medicaid reimbursement so far below Medicare, access to care is endangered. Virginia's Republican
Governor Robert McDonnell says, "You don't want to undermine the quality of care for Medicaid
patients because you have a shrinking number of doctors and hospitals that accept Medicaid,
o States Balance Budgets With Cuts, Not Taxes Stateline by Prah - Two areas of state spending came in
especially hard for cuts this year, if only because they account for so much of state budgets. Medicaid,
the health insurance program for the poor, accounts for 22 percent of state spending and K-12
education accounts for 21 percent. For many states, it would have been almost impossible to close
budget gaps this year without scaling back these programs significantly.
o Oregon Senate Votes To Expand Health Coverage For Low-Income Women With Breast, Cervical
Cancer The Oregonian by Harr - Even with a lean state budget, the Oregon Senate unanimously agreed
today to expand the number of low-income women eligible for breast cancer or cervical cancer
treatment. Senate Bill 433 now moves to the House.
END
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