Tuesday, May 6, 2008

Ohio Considering Individual Mandate 

Expanding Medicaid, introducing guaranteed issue also on the table

By Marc Kilmer

Categories:  Individual Mandates, Massachusetts, Ohio

As the Gongwer News Service($) reports:

A group of health care stakeholders appointed by Gov. Ted Strickland has generally agreed that the state should require Ohioans purchase health insurance and subsidize low-income individuals who can't afford it...

However, for an individual mandate to be feasible, members generally believe there should also be a guaranteed issuance of coverage, [Department of Insurance Chief Policy Officer Doug Anderson] said....

These are probably going to be the recommendations of a 42-member stakeholder group convened by Ohio's governor. This includes insurers, employers, and others who you would think would see the flaws in this approach.

Essentially Ohio is trying to replicate Massachusetts even though the Massachusetts Plan is far from living up to expectations, either on its fiscal side or its coverage side.

This push for health care reform is motivated by the number of Ohio's uninsured. But this effort will merely make insurance more unaffordable for some and increase its cost for the rest. Ohio should be considering market-based reforms, but it seems that perspective has been left off the Governor's task force.

• posted by Marc Kilmer
• 12:17 pm
• 1 comment

Thursday, May 1, 2008

Cancer Trial Insurance Mandate Advances in Ohio 

By Marc Kilmer

Categories:  Insurance Regulation, Ohio

According to the Columbus Dispatch:

A bill requiring insurance companies to cover routine costs associated with experimental cancer trials got unanimous support from the Ohio House yesterday....

Senate Bill 186 essentially says that if a health- insurance plan covers visits to the doctor, X-rays and hospital stays for cancer patients undergoing typical treatment, it cannot exclude coverage for the same costs just because a patient is in a clinical trial.

As with most mandates, this one is pretty seductive. After all, who can be against providing routine coverage during cancer trials? The incremental march of these mandates raises insurance costs, though, and prices people out of the market. Ohio is not as bad as many states with its insurance mandates, but it has added a couple over the past year or so. Unfortunately, once these mandates are put in place, it's unlikely that they will be repealed.

• posted by Marc Kilmer
• 9:56 am
• 0 comment

Friday, April 11, 2008

Medicaid Exceeding Budget in Ohio 

State still pressing an expansion

By Marc Kilmer

Categories:  Medicaid, Ohio

Sometimes state fiscal irresponsibility is pretty glaring. Take the case of Ohio's Medicaid program as reported by the Gongwer News Service($):

Underspending on the managed care side of Ohio's $12 billion-plus annual Medicaid program has offset some fiscal pressures caused by high caseload, but officials still project the entitlement to be $400 million over budget by the end of the biennium, lawmakers were told Thursday.

So what to do when spending is exceeding the budgeted amount? Seek to expand the program's eligibility, of course!

Since the federal government rejected Ohio's plans to cover children at 200-300% poverty through the Medicaid/State Children's Health Insurance Program, the state has submitted two additional proposals to cover children in families up to 250% and expects to hear back by May 15, Mr. Corlett said.

I discussed the foolishness of this approach back in February.

• posted by Marc Kilmer
• 2:03 pm
• 0 comment

Thursday, March 27, 2008

Insurance Connector Being Discussed in Ohio 

By Marc Kilmer

Categories:  Individual Mandates, Insurance Regulation, Ohio

According to the Gongwer news service($):

Health care providers, insurers, employers, and state officials are inching closer to finalizing ideas for reforming Ohio's health care system, with discussion focusing on creating a public/private partnership to help cover the uninsured.

The 42-member Healthcare Coverage Initiative Advisory Group, which Gov. Ted Strickland appointed last year, met Tuesday to hash out concerns with the so-called "connector model," where the state would generally help subsidize costs for the uninsured to purchase private insurance.

The committee discussed a proposal to create a connector within state government that would determine both eligibility and subsidy amounts for low-income Ohioans. Moreover, it would contract with carriers through a bid process that would include negotiating with insurers on rates.

There is also discussion about imposing a health insurance mandate. Governor Strickland opposed such a mandate during the election, but it's difficult to predict if he'd accept one now.

Given the well-documented troubles with the Massachusetts helath care plan, it's amazing that other states are seeking to go down the same road.

• posted by Marc Kilmer
• 1:10 pm
• 1 comment

Wednesday, January 30, 2008

Ohio Health Care Reform Proposed 

Lamaker unveils proposal after statewide hearings

By Marc Kilmer

Categories:  Insurance Regulation, Ohio

Ohio state Representative Jim Raussen unveiled a health care reform blueprint yesterday. His plan was developed after statewide hearings last year that heard from a variety of interest groups on how the health care system should be changed.Here are the key parts of the plan, as listed by the Dayton Business Journal:

There doesn't seem to be anything too innovative, but nothing too harmful, either. Yes, the trans-fat ban is silly, but at least he didn't push for a statewide ban on trans-fat for businesses. I don't like the mandate that parents' insurance continue to cover "children" up to age 29, but that seems to be a popular idea to cover those darn irresponsible kids.

The idea to have the state issue re-insurance so people with chronic conditions can obtain private insurance is something that intrigues me. While I don't necessarily like the idea of the government getting involved in this area, it seems it may be the best way to correct what certainly appears to be a market failure. I haven't looked into this issue too much, but does anyone know of any good research on states that have tried this approach?

• posted by Marc Kilmer
• 6:30 pm
• 1 comment

Monday, January 7, 2008

Ohio Hospitals Concerned About Uninsured 

Surprise! Liberals want Medicaid expanded

By Marc Kilmer

Categories:  Medicaid, Ohio

Hospitals in Ohio are concerned about the rising number of uninsured patients who are using their emergency rooms. As John Graham's post below discusses, there are many aspects of this type of story that the media miss.

What I find most interesting is the implicit call by the Universal Health Care Action Network of Ohio to expand Medicaid to deal with this "crisis." As the chart accompanying the Columbus Dispatch article discussing this issue illustrates, Medicaid recipients use the emergency room quite a lot, too. Something that Medicaid proponents don't like to acknowledge is the fact that hospitals actually receive more in payment from the average uninsured patient than they do for the average Medicaid recipient.

More Medicaid isn't the answer to the "crisis" of the uninsured in the emergency room.

• posted by Marc Kilmer
• 3:46 pm
• 1 comment

Wednesday, December 26, 2007

Ohio Medicaid Too Expensive -- Governor Wants it Expanded 

Strickland cuts services while blasting feds for not allowing expansion

By Marc Kilmer

Categories:  Medicaid, Ohio

It was a tough end to the year for Ohio Gov. Ted Strickland. With Medicaid spending increasing faster than anticipated, the state was facing an unanticipated $207 million more in spending on this program. In response, the state delayed implementing a Medicaid dental benefit and an increase in reimbursement rates for providers.

At the same time, however, the governor is attacking the Bush Administration for its decision to reject Ohio's plan to expand Medicaid to cover children in families up to 300% of the federal poverty level. Since the state doesn't have enough money to pay for its current Medicaid program, it seems unwise to make the program even more expensive. Governor Strickland doesn't seem to understand this, though.

• posted by Marc Kilmer
• 3:49 pm
• 2 comments

Monday, November 26, 2007

Health Care Squeezing Ohio Pension System 

By Marc Kilmer

Categories:  Ohio

Ohio's pension system for retired school employees is feeling the pinch of higher health care costs. Per-person health care costs have risen by almost 20% since 1998, putting the fund on course for bankruptcy in 2014.

With Ohio having a fairly generous health care package for retirees, this fiscal mess was inevitable. There are some proposals to shore it up, but there is opposition to making retirees shoulder more of the financial costs. With the Baby Boomers beginning to retire, I'm sure we'll see more of these stories in other states.

• posted by Marc Kilmer
• 2:46 pm
• 1 comment

Monday, November 26, 2007

FMLA Expansion in Ohio 

By John LaPlante

Categories:  Ohio

Among the legacies of Bush 41 presidency is the Federal Medical Leave Act, which further interjected government into the workplace.

The State of Ohio is threatening to go the FMLA one better, according to the Cleveland Plain Dealer, by decreasing the threshold on the requirement for maternity leave from companies with at least 50 employees to those with as few as four.

• posted by John LaPlante
• 11:12 am
• 0 comment

Wednesday, November 14, 2007

AARP, Unions Form "Consumer" Health Group in Ohio 

By Marc Kilmer

Categories:  Ohio

Yesterday representatives from the AARP, SEIU, the Universal Health Care Action Network, and other liberal advocacy organizations announced the formation of Ohio Consumers for Health Care Coverage. These groups are, in the words of the Columbus Dispatch, "coming together to keep an eye out for consumers."

If I were a health care consumer in Ohio, I'd be very concerned about these groups saying they represent me. Somehow I think they will be pushing for more government involvement in Ohio health care, which will be detrimental to consumers' welfare. Then again, maybe I'm wrong and these groups have seen the light and now support market-based health care reform that will truly help consumers. Anyone want to place bets on which is more likely?

• posted by Marc Kilmer
• 2:36 pm
• 0 comment