States are increasingly turning to community paramedicine to help fill the gap in the health care workforce. States have been experimenting with community paramedicine programs for the last five years or more. Expanding the role of licensed or certified emergency medical technicians—or EMTs—and paramedics to provide non-emergency preventive health care services directly to patients in their communities can be cost-effective and make up for health care work force shortages. 

Voters in Colorado will face a choice on the ballot this November regarding medical aid in dying for the terminally ill. The “Colorado End of Life Options Act,” or Initiative 145, is a proposal that would allow physicians to prescribe life-ending medications to adult Colorado residents who have a terminal illness with a prognosis of six months to live or less.

On August 16, the insurance giant Aetna announced that it will be withdrawing from insurance exchanges in 11 states beginning in 2017.  This move comes on the heels of the decision by Humana and United Healthcare to substantially reduce the number of states in which they offer coverage.

Maybe, but not as soon as Gov. Bentley had hoped.

On Tuesday, Aug. 23, the Alabama House failed to allow a committee meeting to move forward in time to get the lottery proposal, as a constitutional amendment, on the Nov. 8 general election ballot, according to media coverage by AL.com.

On July 5, 2016, Hawaii became the third state to require all public and private health insurance providers to cover 12 months’ worth of contraceptives at one time. Other states introduced similar legislation in 2016. Research has shown that this change could have enormous effects.

Kaiser Family Foundation has posted an excellent web panel discussion on drug pricing. Representatives from Pfizer, a large international pharmaceutical company; Express Scripts, and Aetna, a major health insurance carrier, talk with Larry Levitt, a Kaiser senior vice president.

A comparison of U.S. Census data for 2013 and 2014, released in early 2016, shows that a greater portion of Americans in each state had health insurance in the more recent year. Nearly 8.5 million individuals gained health insurance coverage between 2013 and 2014. In 2014, all the provisions of the Affordable Care Act designed to increase access to affordable insurance were in place for states. Some states, however, decided not to expand income eligibility for Medicaid to 138 percent of the federal poverty level as the Supreme Court ruled in 2012 was the prerogative of the states, not Congress. The states that showed the greatest increase in coverage between 2013 and 2014 were states that expanded Medicaid income eligibility.

The Small Business Health Care Relief Act of 2016 (H.R.5447) was proposed by Congressman Charles Boustany (R-LA-3) to expand employer healthcare options for small businesses. Cosponsored by 22 Democrats and 37 Republicans, the legislation recently passed the House and was referred to the Senate Calendar as General Order 526.

CSG Midwest
Minnesota was an early adopter of the use of health care homes, and a five-year study of their impact shows promising results for any state looking to reduce health costs and improve patient outcomes.
“Given how much is spent for Medicaid, Medicare and dually eligible enrollees, you can create large savings and bend the cost curve,” says Douglas Wholey, a professor of health policy at the University of Minnesota and the study’s lead evaluator.

Gov. Matt Bevin, elected in November 2015 and who had pledged during his campaign to eliminate Medicaid expansion which brought health coverage to 400,000 previously uninsured individuals, announced yesterday his plan to transform Kentucky’s Medicaid system through an 1115 waiver. The new waiver will cover almost all the Medicaid enrollees eligible under the pre-expansion rules as well as all the newly eligible under the expansion rules.

Bevin said his plan is an opportunity “to come up with what is going to be truly a transformative and sustainable and fantastic program,” according The Courier-Journal coverage of the press conference. He pledged to both save money—$2.2 billion in combined state and federal funding over the next five years—and reduce the number of Medicaid enrollees—86,000 people by 2021 by moving them to private insurance.  

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