Capitol Comments

In recent weeks, a new word has emerged in the public discourse surrounding state’s fiscal difficulties: bankruptcy. States are facing colossal fiscal pressures, including mounting public pension obligations which now represent a trillion dollar unfunded gap, according to the Pew Center on the States.  

Grant opportunities will be available through 2015 as long as states meet certain benchmarks along the way, Joel Ario, the Department for Health and Human Services official in charge of implementing the health insurance exchange provisions of the Affordable Care Act, told attendees at a webinar powered by The Council of State Governments Knowledge Center. 

Secretary Sebelius told Arizona’s Gov. Brewer that when the state’s Medicaid waiver expires in September 2011, the state could indeed drop Medicaid coverage for some 250,000 low income adults. The question had been whether the state would violate the “maintenance of effort” requirements of the Affordable Care Act prohibiting states from implementing restrictions in eligibility requirements in place the day the federal bill passed.

Transportation figured prominently in President Obama’s 2012 budget proposal released this week. The proposal included the outlines of a $556 billion, six-year transportation plan. While some praised the plan for “bold vision,” others believe the lack of agreement on a revenue source to pay for it all and other factors will make it very difficult to achieve that vision.

State subscribers most often read these items in the January Health Policy e-monthly:

Click here to see the full newsletter issue and archives.

Newborns treated for drug addiction in Florida grew more than 173 percent for the 3 years ending 2009, and it’s not slowing down. Today, prescription drugs are largely the culprit, not cocaine as in years past. For the first half of 2010, over 600 Florida babies were tortured with this condition, exceeding the 2009 rate. The newborns experience extreme discomfort and are too difficult for many parents to manage, so hospitals are keeping some addicted babies for at least four weeks to gradually wean them off drugs. Florida has not implemented a prescription drug monitoring program, a policy solution adopted by 42 states to reduce the misuse of prescription drugs, and plans to institute a program in 2011 have now been waylaid. Another approach, cracking down on “pill mills”, has been discussed but is still not implemented, and the results are affecting other states like Kentucky. Like the neonatal nurse in the article above says, “Why isn't somebody doing something about this?"

Joel Ario, DHHS Director of the Office of Health Insurance Exchanges, will be available to take questions from state officials during CSG webinars scheduled this month. By January 1, 2014, all states must be operating health insurance exchanges under the Affordable Care Act. The exchanges will serve as marketplaces for small businesses and individuals to purchase insurance. States will be required to integrate the exchanges with Medicaid eligibility and application procedures.

The Department of Health and Human Services released new data yesterday showing that enrollment in the high risk insurance pools created by the federal health reform bill increased nearly 50 percent in the last three months, going from about 8,000 to 12,000 individuals.

When President Obama's 2012 budget is unveiled next week, it will include a surprise gift to states indebted to the federal government for unemployment insurance trust fund loans. Administration officials are reporting that the president's proposal will include a plan to give states a two year respite from automatic tax increases and interest payments on unemployment insurance loans. 

This week we learned about the President’s success in his struggle to quit smoking. One in five American adults either smoke or use some form of tobacco and although many try to quit, less than 10 percent are successful due to a lack of support. Tomorrow, ActionToQuit’s free webinar describes how hospitals can support smokers who want to quit, by screening all patients for tobacco use and providing treatment. ActiontoQuit urges all sectors – employers, insurers, health care providers, quitlines and policymakers – to work together to help tobacco users get access to all the treatments that can help them quit, and has produced a series of webinars and podcasts. See also: CSG’s Quitting Tobacco: Save Lives, Save Money in Medicaid and State Employee Plans

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