Clip files / Local news from the states
July 1, 1999 6 minutes read
Clip files / Local news from the states
This column features selected short items about state health care policy digested from publications from around the country.
Enrollment in Colorado CHIP disappoints program officials, prompts cut in fees, administrative simplification
DENVER—Colorado’s Children’s Health Insurance Program in its first year will enroll about one-third fewer children than projected, the victim of intimidating forms, a cumbersome bureaucracy, and monthly fees.
"People thought it would move much more quickly," said state Rep. Diana DeGette, D-Denver.
State officials are responding with a cut in fees, simplification of enrollment forms, and the establishment of enrollment centers.
"It always takes time to get the wrinkles out," said Barbara O’Brien, executive director of the Children’s Campaign. "I’m completely confident that over the course of the next year or two, we’ll get this straightened out."
Colorado’s Child Health Plan Plus offers coverage through six health maintenance organizations to families earning up to 185% of the poverty level, $30,850 for a family of four. State projections called for 22,000 to 25,000 children to be enrolled by June 30, but by the end of May, only 16,000 were enrolled.
"It’s beginning to pick up, but it was slow going for awhile," said Dean Woodward, deputy director of the state Department of Health Care Policy and Financing.
The 16,000 enrolled are only about one-fifth of the estimated 76,000 uninsured children in the state, said Bonnie Sherman, executive director of Child Health Advocates, which administers the program for Colorado.
—Denver Rocky Mountain News, May 31
Houston’s two-year-old county-supported Medicaid HMO in poor financial shape, say consultants
HOUSTON—A poor financial report card for Community Health Choice (CHC) is prompting some officials to call for the Harris County Hospital District to sever its ties with its tax-supported health maintenance organization.
Responding to a Milliman & Robertson report concluding the hospital district needs to boost CHC reserves by as much as $10.8 million and increase medical expenses as much as $4.2 million a year, CHC president and chief executive officer Glen Johnson, MD, called for the district to cut CHC loose to pursue other affiliations.
Hospital district officials are facing the options of doing nothing and risking the possibility of the state Department of Insurance declaring CHC insolvent; pumping millions of dollars into an HMO it has repeatedly criticized for losing money; or disassociating from the HMO. No decisions have been made, though district officials and CHC appear to be leaning toward independent affiliation.
The hospital district started CHC about two years ago, after the state ordered the shifting of approximately 165,000 Harris County Medicaid patients to managed care plans. But CHC quickly fell behind the handful of other plans in membership recruitment, and it has been scrambling unsuccessfully ever since to meet Medicaid revenue projections.
—Houston Chronicle, May 21
Welfare reform takes health coverage from two-thirds of a million people, says Families USA
WASHINGTON, DC—The first year of welfare reform took health insurance from about 675,000 people, mostly children, says a new report by nonprofit advocacy group Families USA.
Moreover, the number of low-income uninsured is likely to grow as time limits imposed by 1996 welfare reform legislation take effect in the years following 1997, says the report, titled Losing Health Insurance - The Unintended Consequences of Welfare Reform.
Most of the children losing coverage likely were still eligible for Medicaid, the report says. The impact of welfare reform hits minority children disproportionately: When minority children lost Medicaid, about 58% became uninsured, while 41% of white children became uninsured when they lost Medicaid, the report says.
A full copy of the report is available at http://www. familiesusa.org/uninten.htm.
Robert Wood Johnson Foundation offers grant funds for survey data research
WASHINGTON, DC—Grant funds for research projects that use existing physician and household survey data are available from the Robert Wood Johnson Foundation through its Changes in Health Care Financing and Organization Program.
The foundation is seeking projects that will inform public and private health policy leaders about key issues in health care policy and market developments; encourage the use of the rich health tracking survey data to answer new and innovative questions; and, for a small proportion of projects, advance the methodological underpinnings of research using survey data.
The average size of the grant award is expected to be between $50,000 and $100. The solicitation will make available $1 million for between 10 and 20 projects over a two-year period.
Applications are due July 23 at the Alpha Center in Washington, DC. Additional information is available from the Alpha Center at (202) 296-1818 or at the Robert Wood Johnson Foundation Web site: http://www. rwjf.org/new/jwnew.htm.
Massachusetts hospitals sue state over $5 million in unpaid Medicaid claims
BOSTON—Two state court lawsuits brought by 25 Massachusetts hospitals say the state improperly denied more than $5 million in legitimate Medicaid claims over a five-year period.
The hospitals allege the state’s Division of Medical Assistance (DMA) violated federal law by refusing to pay for patients who were admitted to the hospital but had no medical complications. In one case, a 20-month-old infant was admitted overnight after eye surgery because her doctor wanted to put her in a special crib that would prevent her from moving her head and damaging her eye. Because the overnight stay was not the result of any complications of the surgery, DMA denied the claim, saying the hospital should have billed the visit as outpatient, even though the infant stayed overnight. In February, the state’s Supreme Judicial Court backed a legal challenge to the rule brought by the Massachusetts Eye and Ear Infirmary, saying the DMA justification was "meaningless’’ and "tautological.’’
In October, DMA had revised its policy, but the hospitals claim in their lawsuits that the revision also violates federal laws requiring explicit definitions be used in determining how DMA pays hospitals.
—The Boston Globe, May 21
With 28% of population uninsured, Arizona residents consider expansion of Medicaid
PRESCOTT, AZ—The portion of Arizonans who don’t have medical insurance has grown to 28%, ranking Arizona worst in the nation for uninsured residents.
"We thought it was bad when 15% to 17% of Arizonans were uninsured," said Scott Gorman, MD, of Phoenix, interim executive director of Mayo Health Plan Arizona. "We can only hope it is now finally on the radar screen."
While many participants at the 74th Arizona Town Hall said immigration contributed to the problem, many others said unaffordable health care was the core of the issue.
Andy Groseta of Cottonwood, a third-generation cattle rancher and chairman of the board of Northern Arizona Health Care, said most of the workers in managerial positions at large ranches and farms had insurance 10 to 15 years ago.
Among other recommendations being discussed was allowing more people to participate in Arizona’s Medicaid program, Arizona Health Care Cost Containment System (AHCCCS). Raising the eligibility level for AHCCCS to 200% of the poverty rate would allow more working poor to be covered by health insurance, according to some town hall participants.
—The Arizona Republic, May 19
New Texas law requires parental notification for unmarried minors seeking abortion services
DALLAS—Gov. George W. Bush in early June signed into law a bill requiring that notification be given to parents whose unmarried, minor daughters seek abortions.
"This law both respects families and protects life," Mr. Bush said, during a public signing ceremony at a Dallas hotel.
The law, which will go into effect Sept. 1, includes a judicial bypass provision.
Thirty-seven other states have parental notification laws, said Sen. Florence Shapiro, one of the bill’s authors.
—AP/Austin Statesman-American, June 8
Religious hospitals won’t have to provide access to reproductive services, say California legislators
SACRAMENTO—The defeat of a proposal to require religious hospitals to facilitate access to reproductive services will make it harder for poor women to get birth control or abortions, its supporters say.
"I think that we have seen a significant increase in the number of hospitals in California that have through merger and acquisition indicated they would follow Catholic guidelines on reproductive health," Catholics for a Free Choice president Frances Kissling said.
Bill author Assemblywoman Sheila Kuehl, D-Santa Monica, wants to require hospitals owned by religious groups to make sure female patients can get services such as birth control, abortions, and fertility treatment. The hospitals would have had to prove they provided the access before the state would give them construction money or approve their mergers. The hospitals would not have been required to provide the services directly, but could contract with an outside clinic or refer patients to one.
—AP/San Diego Union-Tribune, June 5
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