04/2001: State Legislative Update
According to an opinion issued by Arizona Attorney General Janet Napolitano, the state’s tobacco settlement money must be used for health care programs included in the Proposition 204 initiative passed by voters— not to supplant funding for existing programs. The opinion also states any settlement money must first go to providing health insurance coverage for an estimated 200,000 working poor. Any remaining settlement funds should be used for six current, and unspecified future, health care programs.
Health insurance reform tops the legislative wish list of state officials this year . . . but small business owners wish lawmakers would just lay off for awhile.
In a February 26 interview with the Orlando Business Journal, Bill Herrle, state director of the National Federation of Independent Business in Tallahassee, summed up the business owners’ concerns. “Frankly,” he said, “we’re just seeking stability in policy this year.”
Last year, several health insurance laws were passed to help small businesses get coverage at affordable rates. This year, business owners want legislators to avoid making any changes so insurance companies will be encouraged to re-enter the Florida market.
Herrle did not comment specifically on one of the more positive legislative efforts under discussion in Tallahassee: restructuring and reopening the state’s high-risk insurance pool for people with uninsurable health conditions.
A bill to expand a state program that helps low-income senior citizens pay for prescription drugs led to a partisan dogfight in the Illinois House Revenue Committee.
House Minority Leader Lee Daniels (R-Elmhurst) is sponsoring H.B. 5, which would expand Illinois’ “circuit breaker” program to cover prescription drugs that treat osteoporosis and other diseases. Daniels’ bill would also raise the income threshold so more people would qualify for the program.
According to Democrats, Daniels’ proposal didn’t go far enough. Rep. Joe Lyons (D-Chicago) amended the bill to cover all prescription drugs and remove the age barrier to qualify. That amendment could cost the state between $2 billion and $4 billion annually, Daniels contented.
State Senate Finance Committee Chairman Thomas L. Bromwell (D-Baltimore County) expects his committee to vote on a bill to spend up to $20 million to help 100,000 Maryland residents who lack adequate prescription drug coverage.
In the House of Delegates, Economic Matters Committee Chairman Michael E. Bush (D-Anne Arundel) said leaders there have decided to devote an extra $13 to $16 million to prescriptions drug programs, with the goal of assisting 30,000 to 40,000 people.
Governor Parris Glendening (D) is on record as being strongly opposed to using state funds to address the prescription drug problem, which he considers a federal responsibility. Glendening did not include money for such a program in his 2002 budget.
Representative Mark Jansen (R-Kent County) sponsored H.B. 4829, a bill that would allow HMOs and other health insurance contracts to provide coverage for elective abortions as an optional rider only. The bill has been heard in the House Committee on Insurance and Financial Services.
First-term Democratic Governor Bob Holden took it on the chin when the Missouri House of Representatives rejected his plan to use tobacco settlement money to cover a state budget crunch and shortfall in the prescription drug program.
The House passed a measure designed to make managed care companies pay claims within 45 days. In opposition, Catherine Edwards, spokeswoman for the Missouri Association of Health Plans, says surveys indicate her group members already pay 95 percent of claims within 45 days. So if they’re already meeting the mandate, why does MAHP oppose the measure? Among other reasons, the bill slips also mandates unlimited, direct access to OB-GYNs. Current law allows one visit per year without a referral.
The governor has named Scott Lakin, a former state representative (D-Kansas City) and former insurance agent, to head the Department of Insurance, replacing Jay Angoff, who moved to the Health Care Financing Administration last year. Lakin was a vocal leader on the House health care subcommittee in 1994, which promoted an effort to create a state-run single-payer health care system. The proposal did not pass.
The Committee on Legislative Council filed M.D. 265, which would amend the state’s Children’s Health Insurance Program (CHIP) by increasing the eligibility cap to 200 percent of the federal poverty level.
Senators in two legislative committees unanimously approved a plan that allocates the state’s $50 million-a-year tobacco settlement money for spending on a variety of health care-related programs. Sen. Roger Wherbein, chairman of the Appropriations Committee, said he is “optimistic” the plan will hold together during debate by the full legislature.
Sen. Mike Foley introduced a legislative mandate that would require insurance companies to cover certain reproductive health procedures. After being criticized for vague language, the bill was amended to read in part: “Refusal to cover basic reproductive health-care procedures is discriminatory. And, medical insurance claims may not be denied on the basis of fertility or infertility.”
Legislation (A.B. 2791) in the pipeline would create a new form of health plan to be offered in the individual and small group market. The plan would include coverage for hospitalization expenses, diagnostic testing, wellness benefits, mental health and substance abuse benefits, and physicians’ services. It would be sold on a guaranteed-issue basis, community-rated, and guaranteed renewable.
On a slightly more positive note, S.B. 18 passed the Senate Health Committee. This legislation, introduced by Sen. C. Louis Bassano (R-Union City), would allow insurance carriers to petition state approval agencies in order to sell health insurance directly to consumers by electronic methods. The legislation sets standards for sales and would establish that electronic signatures are as valid as paper signatures.
The nursing shortage has hit Texas hard, and legislators have a $53 million solution to address it.
The Nursing Shortage Reduction Act (S.B. 572), crafted by Sen. Mike Moncrief (D-Fort Worth), would double the number of nursing graduates in the state to 10,000 by year 2007. The plan would increase the capacity of nursing programs by adding new faculty and would also provide incentives for nurses with advanced education interested in teaching.
Sources: The Council for Affordable Health Insurance (CAHI) and its member companies provided information for this State Legislative Update. Contact CAHI at firstname.lastname@example.org. Additional material was provided by the National Association of Health Underwriters, <http://nahu.org/government, http://bizjournals.com, and http://stateline.org.