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CCH® BENEFITS — 08/12/10

State Health Care Reform Update

from Spencer’s Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. With the passage of federal health care reform, states will have increasing responsibilities in regard to employer-provided health insurance benefits. Spencer’s Benefits Reports continues to provide regular updates about state health care reform.

California. The California Public Employee’s Retirement System (CalPERS) has approved an average increase of more than 9% in health premiums next year for state and local government workers. CalPERS blamed the rate increase on rising costs for hospital care, doctor visits, and prescriptions. The increase will mean higher premiums for public agencies and their 1.3 million employees, dependents, and retirees. For more information, visit http://www.calpers.ca.gov/.

Connecticut. A provision in the Patient Protection and Affordable Care Act allows states to start covering low-income, childless adults in Medicaid right away and to start receiving federal funds. Connecticut was the first state to move 45,000 low-income adults from a state-funded program to Medicaid, saving the state an estimated $53 million through July 2011 with federal dollars. For more information, visit http://www.ct.gov/dss/site/default.asp.

District of Columbia. The District of Columbia has enacted a new temporary measure on extended dependent coverage. The law continues provisions previously enacted in April on an emergency basis, which were set to expire on July 28, 2010. The previously enacted provisions require that group health plans, individual health plans, and health insurers offering health insurance for dependent children make that coverage available to an insured’s child who is younger than 26 years of age, is unmarried, has no dependents of his own, is a resident or full-time college student, and is not eligible for coverage under another group or individual plan (or Medicare/Medicaid) at the time coverage begins. Coverage for dependent children must be the same as that available to other covered dependents, and at the same rate or premium. For more information, visit http://www.dccouncil.washington.dc.us/.

Kansas. A new nonprofit corporation will oversee the exchange of electronic health information in the state, and it will be governed by a 17-member board of directors. The American Recovery and Reinvestment Act (ARRA) included $34 billion in incentives for medical providers to maintain and use electronic health records for their patients. ARRA also called for the creation of state or regional health information exchanges so the records can be transferred easily from one provider or treatment location to the next. For more information, visit http://www.kslegislature.org.

Louisiana. While the number of individuals enrolling in the state’s Medicaid program is still increasing, the program will have $280 million less in this year’s budget to cover the cost of care for patients. The Medicaid budget for this fiscal year is $6.5 billion, down from $6.78 billion for the last fiscal year. The budget reduction will require reduced payments to physicians, hospitals, and other providers of health care for the 1.28 million residents enrolled in Medicaid. Rate reductions went into effect on August 1. For more information, visit http://www.lamedicaid.com/provweb1/default.htm.

Maine. State law requires the governor to issue a health plan every two years, and Gov. John. E. Baldacci recently released the 2010-12 State Health Plan. This year’s plan proposes to reduce health care costs by strengthening public health and prevention, supporting strategies that reduce avoidable hospitalizations and emergency department use, and restructures how the state pays for health care in order to reward efficiency and prevention. For more information, visit http://www.maine.gov/gohpf.

Massachusetts. The state house has passed a bill that would require insurance companies to cover a broad range of services for children with autism. The bill contains mandated coverage for services known as “applied behavioral analysis,” which include training children with autism and related disorders in social, verbal, and motor skills. Some believe the bill will increase health care costs, and a coalition of business groups, insurers, and the Group Insurance Commission, which provides health care coverage to more than 300,000 state and municipal employees, opposes the bill. For more information, visit http://www.mass.gov/legis/.

New York. State lawmakers have passed legislation that requires health insurers to cover autism-related screenings, diagnoses, and treatments. New York is the 22nd state to require insurers to cover autism-related treatments. For more information, visit http://assembly.state.ny.us/.

Ohio. On July 1, Ohio’s new dependent law, which allows young adults to stay on their parents’ health insurance until they turn 28, went into effect. The law makes Ohio one of the few states to exceed the extension to age 26 mandated by the Affordable Care Act. Experts predict that 20,000 young adults between 26 and 28 years old will be able to sign up for health insurance due to this law. However, the new law does not affect employers with self-insured health plans, and advocates for the uninsured estimate that approximately 3 million state residents have insurance coverage from employers who self-insure. For more information, visit http://www.legislature.state.oh.us/.

Utah. The state has released the Utah’s All-Payer Database, which contains information on all medical and pharmacy insurance claims filed statewide. The database will provide doctors and consumers with a large source of information about state residents’ health, the cost of care, and the best treatments. For more information, visit http://health.utah.gov/hda/.

Wisconsin. The state has released its next ten-year health plan that calls for creating laws, policies, and education guidelines to build disease and injury prevention. The plan, Healthiest Wisconsin 2020: Everyone Living Better, Longer, emphasizes two goals: eliminating persistent disparities in health outcomes based on race, ethnicity, socioeconomic factors, sexual or gender orientation, and disability; and focusing on quality of life for individuals throughout life both by increasing prevention efforts and providing good care for people with chronic disease and disabilities. For more information, visit http://www.dhs.wisconsin.gov/hw2020/report2010.htm.

For more information on this and related topics, consult the CCH Pension Plan Guide, CCH Employee Benefits Management, and Spencer's Benefits Reports.

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