AcademyHealth Stateside - 02/16/2005 (Plain Text Version)In this issue: Medicaid Reform and Health Care Cost Lead Discussions at the SCI Winter Meeting
On February 3-4, State Coverage Initiatives (SCI) hosted its national meeting for state officials in Washington, D.C. More than 100 state officials from 37 states and the District of Columbia gathered to learn about recent cost drivers in the health system, the future of entitlements and public insurance, and possible federal reforms. The conference was held immediately following the National Health Policy Conference (NHPC), co-hosted by AcademyHealth and Health Affairs. The potential for federal reforms to Medicaid and the State Children’s Health Insurance Program (SCHIP) was a major focus of the meeting. With Medicaid such a critical component of the safety net, states and other proponents of the program have expressed concern over proposals to cap federal expenditures or transform Medicaid into a block grant program for states. In the session “Rethinking Public Insurance,” Alan Weil of the National Academy for State Health Policy and Debbie Chang of the Nemours Foundation suggested that both Medicaid and SCHIP play a vital role in providing coverage but both can be improved. Adding a state prospective, Alan Levine, executive director of the Agency for Health Care Quality in Florida, laid out Governor Bush’s proposed Medicaid reforms. States officials continued their dialogue about overall health system cost. Private coverage has slowly eroded, leaving public insurance absorbing the rising number of uninsured citizens at a considerable cost to states. As reported in State of the States: Finding Alternative Routes, 2004 saw Medicaid surpass elementary and secondary education as the largest component of total state spending (21.9 percent). “Today’s cost trends continue to make insurance less affordable and strain public finances,” said Paul Ginsburg of the Center for Studying Health System Change, who presented new data on health care cost drivers. State officials from Maine and Indiana also discussed their efforts to understand and address rising costs in their states. The meeting highlighted various purchasing strategies. Richard Curtis from the Institute for Health Policy Solutions and John Grgurina from the Pacific Business Group on Health put to rest myths that purchasing pools alone will improve health insurance coverage. David Haugen also presented on Minnesota’s new “Smart Buy” purchasing alliance, a voluntary program of health care purchasers representing approximately 3.5 million Minnesotans that uses its purchasing power to drive value reform. The pending changes in state pharmacy programs and cost containment efforts received much attention. Vernon Smith from Health Management Associates laid out the impact of Medicare Part D on Medicaid programs. Kim Fox from the Rutgers Center for State Health Policy provided lessons for State Pharmacy Assistance Programs (SPAPs) based on the experiences of states with the Medicare Discount Card. Finally, Jack Hoadley from Georgetown University's Health Policy Institute spoke about recent state cost-containment strategies and the impact of Part D on these efforts. Delivering the keynote address, “Eras of Health Reform,” AcademyHealth President and CEO David Helms looked back at health planning and reform efforts over the past 40 years. He provided policymakers with a historical context to reflect on the current health care debate, including the many reasons why we have failed to expand coverage in the past, and lessons on how to make progress now. To view presentations and access additional information on this meeting, please visit www.statecoverage.net/0205agenda.htm. |