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CCH® BENEFITS — 11/19/08

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. Because of the potential impact of this ongoing activity on employer-provided health insurance benefits, Spencer's Benefits Reports provides regular updates about state health care reform.

Autism. Arizona, Florida, Louisiana, Pennsylvania, and South Carolina all have passed laws requiring insurance companies to provide coverage for treatment associated with autism. In addition, California, New Jersey, New York, Michigan, Ohio, and Virginia are considering such legislation in 2009. An estimated 1 in 150 children in America have been diagnosed with autism. For more information, visit http://www.autismspeaks.org.

Arizona. Although the official count is not completed, backers of the state’s Proposition 101, which would have barred an Arizona universal health system, have conceded that the proposition will fail. Proposition 101 would have amended the state’s constitution to prohibit laws that mandate people to obtain health coverage, or that restrict an individual’s choice of private health care systems or private health plans. The measure also would have prohibited laws that interfere with an individual’s right to “pay directly for lawful medical services” or that impose a penalty or fine on an individual who chooses not to obtain coverage. The primary purpose of the measure was to preclude lawmakers or voters from setting up a health care system such as that established in Massachusetts. For more information on the Arizona Department of Health Services, which would implement any statewide health initiative, visit http://www.azdhs.gov/.

Illinois. Beginning on Jan. 1, 2009, Illinois parents will be able to keep their unmarried children on their health insurance plans until they reach age 26, or age 30 if they are military veterans. Gov. Rod Blagojevich used his amendatory veto power to add the expanded coverage provision to HB 5285. The state estimates that this might allow up to 300,000 young adults to stay on their parents’ plans. Approximately 30% of Americans age 19 to 29 do not have health care coverage. Illinois joins 24 states in defining the dependent age limits to include older children. For more information, visit http://www.hfs.illinois.gov/.

Indiana. Beginning October 1, Indiana raised the income eligibility for its SCHIP program, Hoosier Healthwise, from 200% of the federal poverty level (FPL) to 250% of the FPL. Indiana estimates that with this increase, approximately 10,000 children age 19 and younger have become newly eligible. Families now eligible for Hoosier Healthwise must contribute to premiums. Those earning between 200% and 225% of the FPL must pay $42 per month for one child and $53 for two or more children. Families earning 226% to 250% of the FPL must pay $53 per month for one child and $70 for two or more children. The program also now allows for year-round eligibility, regardless of changes in a family’s income and coverage of telemedicine as a benefit. For more information, visit http://www.healthcareforhoosiers.com/index.html.

Milwaukee. Despite opposition from the city’s mayor and its business community, 68% of Milwaukee voters approved a measure requiring private employers to pay for sick days for all workers. The law will require employers within the city to provide each employee up to nine days of paid sick leave per year—or one hour of sick leave for every 30 hours worked. Companies with nine or fewer employees can cap the maximum paid sick leave at five days per year. The measure becomes effective within ten days of the election, and employers have another 90 days to comply. The Metropolitan Milwaukee Association of Commerce, a business group opposed to the mandate, said that it intended to fight the outcome of the referendum in court. San Francisco and Washington, D.C., both have passed and implemented similar laws. For more information, visit http://www.ci.mil.wi.us/.

Montana. On November 4, 70% of Montana voters said yes to ballot initiative I-155, which will cover an estimated 30,000 uninsured children through expanded eligibility for the State Children’s Health Insurance Program (SCHIP) and Medicaid coverage. The initiative also will provide premium assistance to families who have access to one or more employer-sponsored comprehensive group health insurance plans. The premium assistance will not exceed the cost of coverage for that child under the plan. Finally, the Montana initiative will provide assistance to employers that establish an IRC Sec. 125 premium-only health care benefits plan in order to allow those with dependent coverage to pay for coverage pretax. For more information, visit http://healthymontanakids.org.

New Jersey. Beginning in July 2009, all children in New Jersey up to age 19 will be required to have health insurance under the “Kids First” mandate. Currently, the mandate does not assess penalties for noncompliance, but does provide many opportunities to obtain affordable coverage. One key feature of the reform is an expansion of NJ FamilyCare to parents with incomes from 133% to 200% of the FPL; the expansion began September 1, and New Jersey officials expect that an additional 17,500 parents and 10,000 children will enroll by the end of 2009. For more information, visit http://www.njfamilycare.org/.

South Carolina. Voters in South Carolina rejected two constitutional amendments that would have allowed state and local governments to invest in the stock market to fund retiree health care benefits. More than 55% of voters rejected the measure, even though state officials warned citizens that rejecting the amendments could lead to higher taxes. For more information, visit http://www.sc.gov.

Utah. Insurance companies in Utah have introduced NetCare, which is an insurance product prototype designed to provide overage to state residents between jobs and which costs less than COBRA, reports the Salt Lake Tribune. NetCare would offer individual or group coverage for up to 12 months for employees transitioning off of their employer’s insurance plan. After the 12-month period is up, members would have to reapply as an individual and be evaluated. NetCare is, in part, a result of a health reform bill signed into law in Utah in March. Among other initiatives, HB133, Health System Reform, directed the state legislature to help develop one or more insurance products to aid in health reform. For more information, visit http://www.healthpolicyproject.org/FAQ.html.

Washington, D.C. The Healthy D.C. bill, which recently was proposed, will be delayed for at least one year to allow the district to create a $20 million cash reserve amid the recent economic downturn, the Washington Post reports. The bill would have provided coverage for about 25,000 uninsured D.C. residents who were ineligible for Medicaid and the D.C. HealthCare Alliance. Under the program, residents with incomes less than 200% of the FPL would have received subsidies, paying monthly premiums between $20 and $100, based on income. For more information, visit http://www.washingtonpost.com/wp-dyn/content/article/2008/10/28/AR2008102801678.html.

Wisconsin. More than 410,000 Wisconsin voters approved a nonbinding health care advisory referendum on the ballot. This referendum does not specify to the Wisconsin legislature what health care plan to adopt. Instead, it specifies that the legislature should guarantee affordable health care to everyone in Wisconsin, and that this coverage should be at least as good as the coverage state legislators receive. The referendum also set the legislature’s deadline for the end of 2009.

Wisconsin also reported that it will be expanding its BadgerCarePlus program to provide basic health care coverage for low-income childless adults who are not eligible for other state health programs. The BadgerCarePlus program previously was limited to children, families with children, and people with disabilities. The program will cost the state approximately $40 million annually. For more information, visit http://dhs.wisconsin.gov/badgercareplus/.

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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