Law Provides Health Insurance For All Oregon Children

Health insurance for nearly all of Oregon’s children is now a reality, thanks to House Bill 2116 signed into law by Gov. Ted Kulongoskii in Portland. The “Healthy Kids” legislation, along with the governor’s earlier approval of a companion bill, paves the way for providing affordable health insurance for 95 to 98 percent of Oregon’s children within the next two years. The less than 100-percent goal takes into account the reality that some children live with families that move too frequently or that avoid authorities.
According to an article appearing in the August 3 issue of The Oregonian, Gov. Kulongoski wants his commitment to provide health insurance to children to rub off on President Obama. “I would tell him, ‘Start with children.’ Make sure every child in this country has access to health care. It is not only a health issue. There is a great equality issue in this.”
The new health insurance legislation, which is slated to be phased into place by January 2010, expands state health insurance coverage to 80,000 uninsured children and 35,000 low-income adults. This measure essentially reduces the number of uninsured people in Oregon by one-third, and makes Oregon one of just eleven states committed to extending universal health care to children.
To pay for this additional coverage, a 1 percent tax is being added to health insurance premiums, as well as an increase in “provider taxes” on most Oregon hospitals.
The new health insurance program originally met some opposition from hospitals because of the proposed tax, although it is expected that the added cost will be completely offset by new federal Medicaid monies for Oregon associated with the increase in state health care spending. Although insurance companies did not support the plan, they agreed not to oppose it.
To handle the expected influx of applicants and the expansion of the health insurance program, the state Department of Human Services created the Office of Healthy Kids and has added about 100 new positions. Employees will begin by enrolling thousands of children who qualified for the Oregon Health Plan even before the new law was signed. Those children live in families with incomes up to 185 percent of the federal poverty level, which is $22,050 for a family of four.
In January, the state will begin to subsidize, on a sliding scale, private employer health insurance for children who live in families that earn between 201 and 300 percent of the federal poverty level. Children from families in that income range who do not have employer insurance can buy into the new state-sponsored insurance option, which will also be available to all Oregon children. The plan does not, however, cover children who are illegal immigrants.
By offering health insurance to more of Oregon’s children, Gov. Kulongoski and other proponents of the plan hope to see improvements in vaccination rates, early detection of autism, better asthma care, and other benefits. Oregon residents who want to learn more about the new health insurance program or enroll their children can visit www.oregonhealthykids.gov or call 877-314-5678.

Connecticut Details State Health Insurance Expansion Program

The Universal Health Care Foundation of Connecticut on Tuesday unveiled a proposal for a new state health care program intended to expand insurance coverage to the state's estimated 300,000 uninsured residents and cover up to 98% of all state residents by 2014, the Hartford Courant reports.
The SustiNet program, which would begin enrolling residents in 2011, would expand the state's employee health insurance pool to include residents who already are enrolled in the state's Medicaid and HUSKY health programs.
Under the program, the state employees' health plan would be made available to all uninsured individuals, not-for-profit groups, municipalities and small employers. The program would automatically enroll members unless they opt out. Large and mid-sized companies with payrolls exceeding $318,000 that do not provide employer-sponsored insurance or minimum health coverage for their workers would be required to share the costs of the program in order to participate in it (Levin Becker, Hartford Courant, 1/13).
The program also calls for increased use of electronic health records and an emphasis on preventive care, management of chronic conditions and better coordination of care between physicians and other care providers (Kaiser Daily Health Policy Report, 12/10/08). UHCF officials expect the program to save individuals and employers as much as $1.7 billion by 2014 because of the large size of the insurance pool. However, the state could be expected to spend an additional $950 million in 2014 when the program is projected to be fully implemented and operational, the Courant reports.
According to the Courant, UHCF's proposal is the first of many on the state and federal level that are expected to be released this year "in what many people say is the year for health reform." Connecticut lawmakers are expected to address health care reform in the current session, the Courant reports (Hartford Courant, 1/13).

GuidedCare improves much including cost of health insurance

GuidedCare, a program for older chronically ill patients, has been studied again; this time physician satisfaction with communications to patients and families was the focus. Physicians in this study reported an increase in overall general satisfaction levels after using the GuidedCare model. Physicians also showed greater satisfaction in understanding their patients’ clinical characteristics.
Other studies have shown that GuidedCare patients tend to spend less time hospitalized, in nursing homes, fewer emergency room visits and home health incidents as well. Patients feel they are receiving better care and the data supports that impression. Additionally, caregivers feel less strain when participating in GuidedCare programs. The even better news? The cost-savings. For every patient receiving GuidedCare, the estimated savings is about 11% ($1,365, after the cost of GuidedCare), or $75,000 per nurse.
With so many eyes on health insurance reform, the news continues to be good for the GuidedCare program. Patients want affordable health insurance coverage along with quality health care. Health insurance companies can now offer this model of health care and reduce their costs at the same time, resulting in more affordable health insurance coverage for a growing population of patients with chroni illnesses.
GuidedCare is a home-based program. The model consists of a team of individuals which include a registered nurse, multiple physicians, and other members of office staff who work together. The nurse visits the home and makes assessments, helps care planning, educates the patients and family members, conducts monthly monitoring visits, and coordinates with health care professionals, hospital, pharmacies, and other community agencies to ensure that all health-related needs are being met.
Medicare offers a program with similar functions for not just the aged, but also for anyone who is disabled and fits certain health criteria (necessity levels). States also have programs as well. If interested in enrolling in such a program, ask your doctor or contact your local Health Department for more information.