Capitol Comments

Last month, the U.S. House Transportation and Infrastructure Committee hosted a series of field hearings and listening sessions around the country to gather input on policies for a new long term authorization of federal transportation programs. Among the common themes heard at the events: the need for stability and predictability in federal transportation funding, the desire to explore more public-private partnerships and innovative finance mechanisms amidst a realization that they may not be applicable in all states or for all projects, the impact of environmental review processes on project delivery and the desire for greater flexibility for states and localities in spending federal transportation dollars. Here’s a roundup of some of what was heard at the sessions, based on written testimony and various media and blogger accounts.

Gov. Quinn is proposing drastic cuts in human services in his state of Illinois. Both prevention and treatment services for drug and alcohol abuse are on the chopping block.

News comes today that all prevention services aimed at youth to prevent the use of alcohol and drugs could be eliminated. One Illinois newspaper quotes the Illinois Alcoholism and Drug Dependence Association CEO, “we are looking at 32,000 youth that may not receive prevention services, which increases the risk that use will occur."

Perhaps lost somewhere this week between news of President Obama’s budget and transportation plan and Florida Gov. Rick Scott’s rejection of high-speed rail in his state is the fact that today, February 17th, marks the two-year anniversary of the American Recovery and Reinvestment Act. The act, which provided $48.1 billion for transportation infrastructure projects around the country, has received plenty of criticism for not doing enough to revive the economy but also won praise from state governments who saw the infrastructure funds as a godsend during what was otherwise a period of slashed transportation budgets. And, as I reported in a CSG National Report last year, some states themselves won a fair amount of praise for their efforts to meet deadlines, select worthy projects and report on their activities. While the one year anniversary of ARRA in 2010 produced a flood of reports looking at the legislation’s impact, I could find only a handful commemorating this anniversary.

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.