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CCH® BENEFITS — 10/29/10

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. Beginning in the fall of 2011, seventh through twelfth grade students in the state will be required to get a whooping cough booster shot before starting school, under a new state law. Before Gov. Arnold Schwarzenegger signed the bill into law at the beginning of October, California had been one of only 11 states that did not require middle school students to get a booster shot against whooping cough, or pertussis. Health officials have said teens who have not been immunized have been a factor in the spread of the disease, which has infected at least 5,272 people in California so far this year. California also is the the first state to create a health insurance exchange. For more information, visit http://www.leginfo.ca.gov/.

Arizona. Beginning October 1, the Arizona Health Care Cost Containment System, the state’s Medicaid program, has cut coverage for basic health services such as physicals, most dental care, podiatry, some organ transplants, and other programs. The state also has cut benefits for medical equipment such as insulin pumps, hearing aids, cochlear implants, computer-controlled lower limbs and joints, and other equipment. State officials say the cuts were necessary to deal with the state’s budget crisis and an increase in the number of enrollees due to the bad economy. The benefits cuts are projected to save an estimated $20 million through the end of June. More than 1.3 million state residents were enrolled in this program as of September 1. For more information, visit http://www.azahcccs.gov/.

Florida. According to state officials, the number of insurance carriers offering Cover Florida program plans has been decreasing. The Cover Florida program was created to provide options to uninsured residents seeking health care coverage at an affordable price. In September, United HealthCare stopped selling new Cover Florida policies, at least temporarily. United HealthCare spokesperson Tracey Lempner said the company stopped selling new plans amid concerns that the low-cost health insurance program conflicts with the insurance reforms contained in the Patient Protection and Affordable Care Act (ACA). For more information, visit http://www.coverfloridahealthcare.com/.

Montana. Healthy Montana Kids, the state’s government-financed health insurance program for children in low- and moderate-income families, will soon be open to kids of state and university-system employees, under new rules that took effect on October 8. The new rules also increased the program’s coverage for dental care and ambulance services. State employees have been prohibited from using portions of the Healthy Montana Kids program, which is funded in part by the federal government. However, the ACA removed those bans. For more information, visit http://www.healthymontanakids.org/.

Pennsylvania. A bill that would create a state office of health insurance consumer advocacy, representing consumers’ interests in insurance matters before the courts or any state department or agency, has been introduced in the Pennsylvania house in hopes of passage before the end of the 2009-10 legislative session. The bill will help consumers navigate the requirements of the ACA. For more information, visit http://www.legis.state.pa.us/.

Texas. According to state officials, the Texas HIV Medication Program, which supplies medication to individuals with HIV or AIDS who cannot afford them, will run out of money in the next two years and be forced to cut off enrollment, tighten eligibility, or stop covering some drugs unless the state provides an additional $23 million. Enrollment has increased to record levels in recent months because more individuals are without jobs and private health coverage, the state screens more people for HIV, and the drugs are highly successful at prolonging lives, said program manager Dwayne Haught of the Texas Department of State Health Services. For more information, visit http://www.dshs.state.tx.us/hivstd/meds/default.shtm.

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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