At the recently concluded National Leadership Conference held in La Quinta, California, the CSG Executive Committee approved eight policy resolutions on a wide range of topics, including export promotion, preventing Medicaid fraud, exploring a telehealth interstate compact, state sales taxation on e-commerce, and the Mercury and Air Toxics Standards rule.
 

NOW THEREFORE BE IT RESOLVED THAT, that The Council of State Governments establish a Telehealth Care Interstate Compact Working Group to explore the creation of a new interstate compact agreement designed to improve access to health care in rural areas by facilitating the interstate licensing of doctors and reforming the existing reimbursement system.  The working group will research the feasibility of such an arrangement and make specific recommendations to the CSG National Health Policy Task Force within one year.

Policymakers in the states and territories (“the states”) are facing two major health care dilemmas in 2012—Medicaid spending and implementation of the Affordable Care Act. Medicaid  enrollment continues to grow, federal stimulus funds have disappeared and in many states providers are pressing for increased reimbursement. States also must grapple with complying with mandates in the federal health care reform law. The U.S. Supreme Court is expected to rule on the constitutionality of the law sometime in 2012. In the meantime, states must decide how far to go in their own implementation.

Top-of-the-mind health care topics in states are Medicaid and implementation of the federal Affordable Care Act. Medicaid enrollment continues to grow, federal stimulus funds have disappeared, and in many states providers are pressuring for increased reimbursement. States also must grapple with complying with mandates in the federal Affordable Care Act. The U.S. Supreme Court is expected to rule on the constitutionality of the law sometime in 2012. In the meantime, states must decide how far to go in their own implementation.

What isn't new in the report on rural health care from UnitedHealth's Center for Health Reform and Modernization are findings that rural Americans are more likely to suffer from chronic health conditions and have greater difficulty accessing quality health care.

More helpful are the recommended solutions to rural health issues. Fully 30 pages are devoted to review of existing models of rural health care delivery, the promise of rural telemedicine, and new models for high-performing rural provider networks.

Rural households have worse health outcomes than urban households. Access to care is limited due to less insurance coverage, financial hardship and geographical access to care. Highlighted state policies address increasing the health care workforce in rural areas.

The Affordable Care Act mandates that states operate insurance exchanges to enable every citizen across the country to purchase or renew health insurance. The reform legislation provides federal support for “necessary” expenses so states can plan, establish and operate the exchanges for the first year of 2014. Although it specifies several conditions that insurance products offered through the exchange must meet, it allows the states great flexibility in determining how they will regulate and how much reform they will introduce for their state insurance market. Read about what health insurance exchanges can accomplish, how state Medicaid programs will be involved and what decisions states are facing in 2011 and 2012 related to health insurance exchanges.

All but two states maintained or improved eligibility rules for their Medicaid and Children’s Health Insurance Program, commonly known as CHIP, in 2010.These programs continued to be critical to providing insurance coverage for children and families that otherwise would be uninsured. The median state income limit for children’s coverage is now above 200 percent of the FPL, and pregnant women are eligible up to a median of 185% FPL. However, the median income limit for adult coverage is significantly below the higher eligibility level of 133% FPL that will be implemented under health reform in 2014.