SCHIP News

The Senate has passed an expansion of the State Children’s Health Insurance Program for another 4 ½ years on January 29th. Since the House voted and passed their version of an expansion, they now go to a conference committee. The plans are nearly identical, with most of the funding coming from tobacco tax increases as well as expanding eligibility to children and pregnant women who are legal immigrants, but without a five-year waiting period.

Region 8 legislative report

The Region 8 Legislative Report has been received and with it some items of interest come with it. The following affects not only those agents with licenses in those states, but possibly every agent or broker in the health field. Since most legislative sessions are just starting, there isn’t much activity yet as the states are concerned with budget issues. Some of the activity:

1) California—New bill to reform and improve CA’s broker safety net health plan for uninsurable. State funding will be needed. Sixty to seventy healthcare reform bills are expected to be introduced before 2/27deadline. Expected to be funded by new costs and rules for health insurance industry.
2) Oregon—HB2009 introduced by Rep. Greenlick would establish Health Insurance Exchange and Health Authority.

NAHU is monitoring the situation.

Chamber calls for PEBP changes

On January 26th, a week before the start of the 2009 Legislative session, the Las Vegas Chamber of Commerce held a press conference, whereby they called for reform of the Public Employees’ Benefit Program (or PEBP). While also addressing other issues, the applicable healthcare provisions were as follows:

1) Eliminate the PEBP retiree health care subsidy for all new employees.
2) Reduce the PEBP retiree health care cost for all current employees.
3) Eliminate PEBP retiree health care subsidy for all current employees when they become eligible for Medicare.

The Chamber’s call for reform follow a series of fiscal analysis reports performed by Jeremy Aguero of Applied Analysis and Guy Hobbs of Hobbs, Ong & Associates, whose purpose according to the Chamber was to “provide a factual foundation from which the Chamber can make informed public policy recommendations.”

House Moves Forward with Stimulus Bill

The House Ways and Means Commerce Committee voted 24-13 on Jan. 22 to approve its part of the stimulus package to provide tax, health and unemployment relief to families while also urging businesses to create new jobs. Three areas are of great interest to NAHU.

1) COBRA subsidization and expansion: The bill provides for $30.3 billion to subsidize COBRA premiums. Additionally, workers aged 55 or older who have at least 10 years employment with their last employer would be allowed to keep their COBRA until Medicare eligibility or until they get other coverage.

2) Medicaid expansion: The bill also provides $8.6 billion so states could receive 100 percent federal matching funds to provide optional state Medicaid coverage, through 2010, for certain individuals who are involuntarily unemployed.

3) Health information technology incentives: The House proposal also includes $20 billion in spending to encourage the adoption of health information technology, with payments to doctors of $40,000 to $65,000 who can demonstrate that they are meaningfully using electronic data, such as through the reporting of quality measures.

NAHU's Position: Nahu has serious concerns regarding the proposed extension of COBRA eligibility and the potential Medicaid expansion with no subsidies for any other coverage option except for COBRA. However, the proposed means to administer the subsidy through the employer (or their administrative designate) for COBRA administration is exactly as NAHU recommended.

Senate Democrats are working on their own version of a stimulus package with the overall goal of having a bill finalized for President Obama’s signature by mid-February. NAHU is working with key Senate offices on the COBRA provisions of concern as well as the Health IT privacy enforcement issues.

Senate passes SCHIP legislation

By a 12-7 vote, the Senate Finance Committee on Thursday approved SCHIP reauthorization and expansion legislation that could add four million children to the program, the AP/Boston Globe reports (AP/Boston Globe, 1/16). The bill, introduced by committee Chair Max Baucus (D-Mont.), would expand the program by $31.5 billion over four-and-one-half years. The House passed a similar bill (HR 2) on Wednesday. The bill now goes to the floor, where Senate leaders are expected to amend Baucus' language into the House-passed bill and send it to conference to resolve any differences.

Health Opportunity Accounts

The Deficit Reduction Act allows 10 state Medicaid programs to set up five-year demonstration projects to provide Medicaid recipients with Health Opportunity Accounts (HOAs), similar to Health Savings Accounts (HSAs) used in the private sector.168 Proponents hope these accounts will create an awareness of health care costs and inject an element of consumerism into the purchase of medical services. The states that choose to participate will receive federal matching funds to contribute up to $1,000 per child and $2,500 per adult into the HOAs. HOAs can be used to purchase a variety of medical goods and services, and unused funds will be available for future use by participants. Moreover, if patients become ineligible for Medicaid, they have up to three years to use up to 75 percent of their HOA balances to purchase private health insurance.169 South Carolina, which had already applied for a HIFA waiver to restructure its Medicaid program, has applied to become one of the 10 states.

House votes Yes on SCHIP Expansion

The U.S. House of Representatives passed bill HR 2 today which expands the State Children's Health Insurance Program, which was slated to expire March 31rst. The bill calls for funding, primarily through cigarette taxes, through September 2013. A Senate version of the bill is scheduled for mark up by the Senate Finance Committee on Thursday. President-elect Obama has stated he will sign new legislation into law once he takes office.