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It’s time now to focus on Arizona’s health-care system

admin — Mon, 18 Jan 2010 08:06:27 +0000

Since last spring, the noisy and sometime rancorous health-care-reform debate has kept all eyes and ears on Washington. It now appears the probability is high that a health-care-reform bill will be signed by President Obama. Given what our state is contemplating with respect to the next round of budget cuts, I think some sharp focus on health care in Arizona is needed – now. Gov. Jan Brewer has rightfully placed all options on the table in her difficult and, at times, bruising work with other state leaders to address what is approaching a $2 billion shortfall in our state budget. This includes a request by the governor to all state agencies asking for plans that will cut each agency’s budget by 15 percent. A significant part of these reductions will come from the Arizona Health Care Cost Containment System (AHCCCS) and other state health programs. AHCCCS is Arizona’s Medicaid program. At first blush, a 15 percent AHCCCS reduction may seem like a necessary although painful action that we must take. However, the math behind a 15 percent cut at AHCCCS isn’t so straightforward. It is critical that our state’s leaders and the general public appreciate the fact that every dollar spent in AHCCCS is matched by $3 from the federal government. The real formula that would quickly emerge from a 15 percent reduction by AHCCCS is cut one dollar and lose three more. The elimination of Arizona’s KidsCare program also is being contemplated. If this insurance is eliminated for 47,000 children in Arizona, we will not save a dime for the people of this state. Once uninsured, many of these children will need health care, but they will become at-risk for delayed care due to the cost of that care. Routine health care matters. Illness or injury left untreated can quickly evolve into serious or even catastrophic health-care issues. As a result, many of these children eventually will get their care in the most expensive health-care settings – ERs and hospital rooms. A great deal of the costs for this care will then be shifted to Arizona’s insured consumers. If we assume that national health-care reform will significantly cover more people, we also should assume it will take many years for this coverage to be implemented. In my view, retaining KidsCare until another plan becomes available makes good sense for Arizona. Another cut being proposed is a 30 percent reduction in the state’s contribution to Graduate Medical Education. This cut ultimately could reduce the number of physicians in the state. Hard decisions must be made to address the state’s climbing budget shortfall, and all of us must be part of the solution. Our governor and Legislature deserve that support. However, decisions that look good on paper or even on a budget spreadsheet in the short term, can prove highly damaging to the state’s fiscal health and people’s physical health in the long term.

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La. can?t afford health-care bill

admin — Wed, 13 Jan 2010 14:33:24 +0000

The United States Senate seems headed for a vote on a nearly $1 trillion health-care overhaul. We all recognize the need to change the current system of delivering and financing health care — in order to ensure quality and to make coverage more affordable. The problem is that there is no evidence that the current proposals in Congress will make those needed improvements for Louisianians. In fact, studies by respected organizations have shown that current congressional proposals would result in the people of our state paying significantly more for their health coverage. The Senate proposal would create an expensive new bureaucracy, levy more taxes on the backs of working citizens and make cuts to Medicare that would mean higher costs borne by our state’s seniors. If the current proposals are signed into law, health-care costs will rise at an even faster rate. This simply is not the kind of solution Louisiana can afford. Louisiana’s health plans support health reform and have pledged changes to their business model to make health care more affordable and accessible for everyone. Some time ago we committed to Congress that we would help adopt pro-consumer rules and sweeping protections that would remove restrictions on pre-existing conditions, end the practice of basing premiums on health status or gender, and help achieve universal coverage. Health plans cannot support, however, proposed changes that would harm individuals and families already enrolled, and small businesses that have acted responsively in offering coverage to their employees. It appears that U. S. Sen. Mary Landrieu, D-La. , and U. S. Sen. David Vitter, R-La. , will soon have the opportunity to vote on whether: 1) to approve health-care changes some political leaders consider their legacy, but that the majority of citizens of our state do not want and cannot afford; or 2) to ask their congressional colleagues to take the time to develop true health-care reform that addresses affordability and quality. The choice each one makes will speak loudly here at home. Our country and state need health-care reform that will make health insurance more affordable and that will expand access to the uninsured. Unfortunately, Congress’ current version of health-reform fails to get the job done. Let’s take a step back and consider health-care reform that will work.

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King will continue to fight health-care bill

admin — Sun, 10 Jan 2010 23:04:47 +0000

U. S. Rep. Steve King, R-Iowa, said Democrats are working to create a “dependency class” in America in an effort to expand their political base and stay in power. “That’s part of the motive,” King said when discussing federal health-care reform efforts with reporters after a Tuesday taping of Iowa Public Television’s “Iowa Press. ”King, who represents Iowa’s 5th District, said he will do what he can to try stop a health-care bill from heading to President Barack Obama’s desk, and he urged others who opposed the bill to join him. He said Democrats are moving toward nation health care, whether a public insurance option is included in the final bill or not. “That’s the goal; that’s the endeavor,” King said. “They’ll regulate everything, and when they do that, we will lose the liberty we have today to buy health insurance policies. ”He predicted that if Congress passes health-care reform, Democrats will pay a price at the ballot box in 2010. “I’ve never seen this kind of energy in America, this kind of uprising, especially from the heart of the heartland of America,” King said. King said he is worried about the “mindset” drifting into America that doesn’t seem to understand the free-enterprise system. “We’re descendants in this part of the country from people who came across America in covered wagons,” King said. “I mean, they came here to live free or die on the prairie. They didn’t ask for a government handout. ” Norm Sterzenbach, executive director of the Iowa Democratic Party, called King’s comments hypocritical. “Before he rails against Democrats for working to help seniors pay for prescriptions and help students afford college, he should consider giving up his government salary, as other members of Congress have,” Sterzenbach said. King, a four-term congressman, said he plans to seek another term in 2010. Iowa is expected to lose one of its congressional seats, and King said he probably still will seek re-election in 2012 even if redistricting places him in the same district with another member of Congress. As Iowa Republicans look to unseat Gov. Chet Culver next year, King said he did not know whether he would endorse one of the candidates in the GOP primary. “I’d like to see them fight this out, because it tests their vigor, and it tests their ability, and it also shapes the policy for Republicans that will be matched up against the policy that’s been set by Gov. Culver,” King said. The “Iowa Press” featuring King is scheduled to air at 7:30 p. m. Friday and noon Sunday on Iowa Public Television.

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Health-Care Reform to Dump Poor Kids?

admin — Tue, 05 Jan 2010 00:36:24 +0000

Oleta Fitzgerald, director of the Children’s Defense Fund’s Southern Regional Office, says she is concerned over the welfare of Mississippi children if either of the two health-care reform packages considered by the U. S. House and Senate ever make it into law. The House passed H. R. 3962 earlier this month, and Senate Democrats managed to beat back the threat of a Republican filibuster a few weeks ago, allowing the Senate to move forward with debate on the Patient Protection and Affordable Care Act, H. R. 3590. Both bills promise big reforms in the health-care and health-insurance industries. The Association for American Medical Colleges states that nearly 15 million people will be newly eligible for Medicaid and the Children’s Health Insurance Program under H. R. 3590, at an estimated cost of $374 billion over 10 years. Fitzgerald says both bills contain huge holes regarding CHIP coverage for Mississippi children: “Right now, the fight over health-care reform in the House and Senate is all about abortion and the public option, but the children are getting lost in this discussion,” Fitzgerald said. The issue, she said, centers on Mississippi’s unconventional requirement for CHIP eligibility. Many states recently expanded their Medicaid program requirements to accept people who are a little further from the federal standard for poverty. Eleven states recently extended CHIP-eligible families’ income levels up to 200 percent of the federal poverty level, or higher. ($20,800 for an individual or $35,200 for a family of three). But instead of expanding Medicaid, Mississippi set up a new health insurance program that contracts with private insurance companies. The states that expanded Medicaid will continue to receive federal support for those programs under both the bills under discussion in the House and Senate. But in Mississippi, all children and their families over 150 percent of the federal poverty level ($16,245 a year for an individual and $27,465 a year for a family of three) would go into an insurance exchange created by the House and Senate bills. The Senate bill plans to put CHIP-eligible kids in an exchange by the year 2019, while the House bill has them transferred by 2013. Insurance exchanges do not promise the reliability of a government health program, Fitzgerald warns. “Going into the exchange could require co-pays and premiums, the children would get lumped in with adults, and it’s not clear what requirements the insurance companies would have for their benefit packages,” she said. There is also the question of permanence. Exchanges like the ones proposed by the House and Senate bills have not always been long-lasting. Texas, Florida, North Carolina and California all attempted—and failed—to create enduring insurance exchanges, primarily because private insurers tampered with the market. A July report issued by the California HealthCare Foundation tried to pinpoint some of the factors that killed the California insurance exchange, which closed its doors in 2006. According to the report, the California exchange became too expensive when the clients it served became too costly. An exchange requires a certain number of healthy individuals to complement the more sickly participants of the exchange’s customer base; otherwise the cost of participation becomes too high for all participants. But insurance companies in California lured healthy customers with lower premiums and steered the more sickly individuals into the exchange, creating a disproportionately expensive customer base. “People involved in operations of the California exchange agreed that when there is competition for the same customers within and outside the exchange, the exchange is in ‘extreme peril’ of becoming a victim of adverse selection,” the report states. “If an exchange attracts a disproportionate share of higher risk individuals and groups as the California exchange did at various times, it cannot succeed. “Fitzgerald said Mississippi’s eagerness to boot CHIP-eligible children from the program to keep down state costs is another factor complicating the new bills. “Another problem is enrollment. We need enrollment in the exchanges to be simplified, because enrolling in state health programs have a history of being anything but simple in Mississippi,” Fitzgerald said, referencing a Medicaid policy championed by Republican Gov. Haley Barbour, which requires Medicaid recipients to meet Medicaid personnel “face-to-face” to be considered for program renewal. CDF is working with its national office in trying to insert an amendment in the Senate bill though Democratic Sens. Robert Casey and Jay Rockefeller, which would keep all children up to 300 percent of the federal poverty level in the CHIP program until the new insurance exchange is thoroughly vetted.

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