This week Gov. Jerry Brown signed into law SB 277 which removes the personal belief exemption parents could use to exempt their children from vaccination requirements tied to public school attendance.  When the law becomes effective in 2016, California will become the third state, after Mississippi and West Virginia, to allow vaccination exemption for medical reasons only.  

State legislators attending the fourth annual CSG Medicaid Policy Academy June 17-19, in Washington, D.C., learned how critical Medicaid funding can be to services for vulnerable persons. Dr. Jeffery Brenner, a 2013 winner of a MacArthur Foundation genius award, challenged the group to rationalize the health care system. He described how his project in Camden, N.J. has reduced costs and improved care for patients suffering from a complex set of chronic diseases. Health care workers visit patients in their residences and seek to evaluate not just medical needs but social and emotional needs as well. 

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Last summer, lawmakers in the Illinois House declared a “heroin emergency” in the state. This year, the legislature overwhelmingly approved a comprehensive plan (HB 1) to deal with it. According to The State Journal-Register (Springfield), the state's new fight against drug abuse will cost between $25 million and $58 million.

Sixteen states have passed laws explicitly authorizing needle exchange programs, and there are a number of states with statutes that either decrease barriers to the distribution of clean needles or altogether remove syringes from the list of drug paraphernalia. Additionally, a recent HIV outbreak in the small town of Austin, Ind., has led more states to consider authorizing such programs.

Sixteen states have passed laws explicitly authorizing needle exchange programs, and there are a number of states with statutes that either decrease barriers to the distribution of clean needles or altogether remove syringes from the list of drug paraphernalia. Additionally, a recent HIV outbreak in the small town of Austin, Ind., has led more states to consider authorizing such programs.

Long-term care and supports were the focus of the 2015 CSG Medicaid Policy Academy, held in Washington, D.C., June 17-19, 2015. The 30 registered CSG members came from 19 states. Home states are marked in purple in the map below. Over the four years CSG has convened the Medicaid Policy Academy, legislators from 42 states have participated. 

The program concluded with a plenary session featuring Dr. Jeffrey Brenner, medical director of the Urban Health Institute at the Cooper University Healthcare as well as the founder and executive director of Camden (N.J.)  Coalition of Healthcare Providers. In 2013, Dr. Brenner was named a MacArthur Fellow for his work on addressing the health care needs of the chronically ill in impoverished neighborhoods. 

In 6-3 decision the Supreme Court ruled today that health insurance tax credits are available on the 34 Federal Exchanges. The Court’s opinion focused largely on the consequences of ruling to the contrary:  the destruction of health insurance markets.

Chief Justice Roberts, writing for the majority, began his opinion by pointing out that the Affordable Care Act relies on three reforms:  making sure health insurance is available to everyone regardless of their heath and not charging higher premiums depending on health, requiring everyone to be insured, and offering tax credits to those with low-income so they can afford insurance. If only the first reforms were implemented a well-documented economic “death spiral” occurs, where health insurance premiums skyrocket, because only the sick buy insurance.

Forty-eight rural hospitals have closed their doors since 2010, according to data recorded by the North Carolina Rural Health Research Program at the University of North Carolina, Chapel Hill. The typical rural hospital has 25 to 50 beds. It is more dependent on Medicare and Medicaid, which generally pay less than other insurers, and it has lower patient volume than urban hospitals. “The implication of lower volume is that the hospital is spreading fixed costs over less people and there is less certainty about the numbers of services that will be provided on any given day,” said Mark Holmes, director of the North Carolina Rural Health Research Program. “This uncertainty makes it hard to staff the hospital and hard to plan.”

As states across the country continue to transform health care, achieving the balance between cost containment and high quality care remains a primary focus. CSG is pleased to present a FREE eCademy webcast featuring national health care expert Dr. Jeffrey Brenner, who explores strategies to improve the quality of health care delivery while minimizing costs. Brenner is the medical director of the Urban Health Institute at the Cooper University Healthcare as well as the founder and executive director of Camden (N.J.) Coalition of Healthcare Providers. He was named a MacArthur Fellow in 2013 for his work on addressing the health care needs of the chronically ill in impoverished communities in the U.S. This presentation was broadcast as part of CSG’s 2015 Medicaid Policy Academy in Washington, D.C.

Last week Pennsylvania and Delaware moved toward a Plan B in case the Supreme Court rules against the Obama administration in the pending King v. Burwell lawsuit that questions whether tax subsidies can be provided in those states that did not opt to operate their own state health exchanges.

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