May 2010      

From the Director's Desk
Federal Health Reform Highlights from Health Policy Director Debra Miller 
In This Issue
State Reform and Medicaid
Federal Health Reform
Preventing STDs and HIV
Injury Prevention
Preventing Tobacco Use
Mental Health & Substance Abuse
Other Trends
Obesity & Adolescent Health
CSG Resources
 
State Health Reform and Medicaid
Actions:
Georgia, Tennessee
hospitals' fees will fund Medicaid program and draw federal matching funds. Oklahoma considers tax on health insurers to support Medicaid. About half of all states' budgets assume still-anticipated Congressional action to extend the enhanced Medicaid match rates adopted in the stimulus, adding Jan. 1, 2011 through June 30, 2011. Virginia, Kansas and Arizona face painful Medicaid cuts as legislatures adopt lean budgets. 
 
Connecticut and Washington, D.C. have moved to immediately cover childless adults under Medicaid provisions of reform. Florida legislature delays transition of Medicaid to managed care, pending results of five-year pilot creating medical homes. New Hampshire develops a new trust for retired state employee health costs.  
 
Colorado enacts Senate Bill 76, preventing health insurance companies from incentivizing their employees to reject benefit claims, and House Bill 1252 requiring health insurers to cover mammograms.
 
Trends:
State and local budgets for public health have declined and positions cut resulting in a $20 billion annual shortfall in local, state and federal public health activities.  Uninsured are not more likely to visit emergency rooms for non-urgent care than those who have private insurance or Medicaid coverage. Key factors are whether the patients have chronic illnesses or referral by primary care physician, and how quickly patient wants to be seen by a physician.
 
Resource: Evidence-based programs to improve Medicaid quality and cut costs: "Medicaid Best Buys"
Federal Health Reform
Actions:
Nearly 20 states, including Mississippi, have decided not to run 'high-risk' insurance pools. Georgia has joined 19 other states suing the federal government over the individual coverage mandate. 
 
Trends:
More than 200,000 individuals already enrolled in high-cost state pools will be excluded from the new federal program available this summer. States will set up health care exchanges by 2014. Also beginning in 2014, Americans with incomes between 133 and 400 percent of the federal poverty level will be eligible for federal subsidies to make premiums affordable. 

Resources:
  • National High Risk Pool CSG Midwest brief and Department of Health and Human Services Fact Sheet       
  • FAQ on state health insurance exchanges
  • FAQ on new health insurance subsidies
  • Young Adult Coverage Fact Sheet on continuing coverage on parents' health plan up to age 26
  • Medicare changes mailed to all enrollees, in English and Spanish        
  • Medicare Primer updated to include health reform changes        
  • Early retiree health insurance Fact Sheet        
  • Community Living Assistance Services and Supports, or CLASS, brief, describing a new voluntary insurance program to cover community long-term care services and supports
 Preventing STDs and HIV
Actions:
Wisconsin
enacted Senate Bill 460 allowing expedited partner therapy for sexually transmitted infections. Wisconsin also joined 42 other states and enacted an opt-out consent law for HIV testing.
 
Trends:
Ten states now have waiting lists for the AIDS drug assistance program, and more than 1,000 people who need AIDS treatment are unable to obtain medications. June 27 is National HIV Testing Day and events are planned throughout the country. Mobile units are being used to distribute clean syringes to prevent HIV, hepatitis and other infections among injection drug users
 
Resources:
Injury Prevention
Actions:
Wisconsin and Utah enacted legislation to control prescription drug abuse. 
 
Trends:
Texting while driving is prohibited by 23 states' laws, but law enforcement may find it difficult to obtain desired results. 
 
Resource: CSG Brief on prescription drug monitoring programs and developing interstate compact
Preventing Tobacco Use
Actions:
Massachusetts public health requires retailers to post graphic warnings about smoking effects.  

Trends:
Partnership for Prevention urges U.S. Health and Human Services Secretary Kathleen Sebelius to use funding available in federal health reform programs to support evidence-based programs to reduce tobacco use. New rules for tobacco advertising require warnings to be bold and fill 20 percent of advertising space. 
 
Resources:
Mental Health and Substance Abuse
Action:
Wisconsin enacts Senate Bill 362 requiring health insurance to cover mental health, alcoholism and drug treatment at the same level as other treatment.
 
Trend:
More people in jails than hospitals have mental illness.
 
Resource: Legislative Tool Kit on mental health
 Other Trends 
 
Health impacts of the Gulf Coast oil spill are largely unknown.
 
Hospital-acquired infections are now tracked in 27 states but still cause about 100,000 deaths annually with a cost of more than $35 billion.
 
Returning veterans in trauma care units are inadequately treated.
Obesity and adolescent health
Actions:
Pennsylvania
considers increasing school physical activity and nutrition requirements. Santa Clara County, California, board of supervisors votes to ban toys with unhealthful fast food
 
Trends:
Participants in an Alabama weight loss competition lose nearly 150,000 pounds. Public and private organizations launch a National Physical Activity Plan.  

Resources: 
CSG Health Resources
 
NEW: State-by-state profiles on STD, HIV & Teen Pregnancy Prevention
Alzheimer's Disease Talking Points  
Oral Health BriefPreventing Tooth Decay Talking Points
Making HIV Testing Routine Brief

50-State Trends Facts and Figures:
HIV/AIDS
 
More than 100 Talking Points, Briefs and Tool Kits on state health policies and legislation at Healthy States - Publications
 
Request printed copies from healthpolicy@csg.org
Please send any comments to healthpolicy@csg.org!