March 4 is an important date for anyone who cares about health policy. The Supreme Court justices will hear oral arguments in the case King v. Burwell, challenging tax subsidies for health insurance purchase in states that are not running their own health insurance exchanges.

The potential impact of the case is clear. Approximately 7.5 million Americans in 34 states receive subsidies to offset the cost of health insurance purchased through the federally-run exchange.

On Friday, Feb. 6, the Wyoming Senate voted 19 to 11 to reject a bill to expand Medicaid, WyoFile.com reported.

Majority Floor Leader Sen. Eli Bebout said, according to Wyo.File reporting, “Now is not the time. I think being cautious, and doing it the Wyoming way is the way we do things.”

The Senate Health Committee defeated Gov. Bill Haslam’s proposal to expand Medicaid in a 7-4 vote yesterday, according to the Times Free Press. Later in the day, both the House and Senate voted to adjourn the special session that had been called to consider the measure.

The poverty guidelines for 2015 are available and published here in the Federal Register. These guidelines -- often cited as 100 percent of the federal poverty line -- are used to determine eligibility for a number of stata and federal programs. Sometimes eligibility is greater than 100 percent; for instance, the Affordable Care Act allows states to expand Medicaid eligibility to 138 percent of federal poverty. 

Gov. Mike Pence announced today federal approval of his state’s Medicaid waiver to expand eligibility to all persons with incomes below 138 percent of the federal poverty level, according to the Indy Star newspaper.

Pence has lobbied hard for what he calls HIP 2.0, expanding a smaller consumer-driven health plan called Healthy Indiana Plan, rather than expand the traditional Medicaid program.

“The expanded and updated HIP 2.0 is based on a program that has been serving 60,000 low-income Hoosiers in our state for seven years,” said Governor Pence in a press release. “It is a proven model for Medicaid reform across the nation.”

Up to 350,000 people will be eligible according to the press release. The state will start taking applications today, Jan. 27, for coverage to begin on Feb. 1, 2015.

New Arkansas governor, Asa Hutchinson, will ask the legislature to continue to fund the private option Medicaid expansion through the end of 2016, according to the Arkansas Times. Then he intends to come up with a new plan for 2017 and beyond.

Gov. Hutchinson alluded to Section 1332 waivers, sometimes called waivers on steroids, that will be available to states in 2017 to implement wholesale reforms of Medicaid while releasing an approved state from many, if not all, of the requirements of the Affordable Care Act.

Top Five 2015 Health Issues: A Further Examination

A flurry of state governors - in the 24 states that have not yet expanded Medicaid - are talking about expanding Medicaid eligibility as allowed under the Affordable Care Act. Many of these governors are offering up solutions that they say are designed uniquely for their state, carefully differentiating the new proposals from “traditional” Medicaid. This activity is likely to continue throughout 2015. Outside ACA issues, states will consider a number of health delivery issues. These include how to match the workforce to the need for professionals and how to expand some service areas such as mental health and substance abuse.

CSG Director of Health Policy Debra Miller outlines the top five issues in health policy for 2015, including Medicaid expansion, growing the health workforce, integrating health and human services, long-term care, and mental health and substance abuse. 

Calling his proposal Insure Tennessee, Gov. Bill Haslam said yestereday he is requesting an amendment to the state’s TennCare demonstration project for a two year pilot project to cover as many as 200,000 low-income individuals under the Medicaid expansion available through the Affordable Care Act, according to numerous press reports.

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Breast milk contains important nutrients, immune-system antibodies and growth factors that all contribute to a baby’s health, particularly babies who are vulnerable because they are premature or underweight. But a number of circumstances — including maternal illness, death, surgery, use of drugs or medications, and certain chronic conditions — can prevent a mother from being able to breastfeed.

One potential alternative for some babies, then, is the use of human donor milk. Indiana, Iowa, Michigan and Ohio are among the states with nonprofit human-milk banks that have been certified by the Human Milk Banking Association of North America. (The association’s certification standards were established with input from the federal government and the blood and tissue industries.)

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