Clip files / Local news from the states

This column features selected short items about state health care policy.

Nebraska may up newborn testing, restrict opt-outs

LINCOLN—Nebraska is poised to dramatically increase the number of diseases for which newborns are screened, all the while holding fast to a policy that forbids parents from opting out of the testing. The state Department of Health and Human Services is considering a proposal that would increase from eight to 26 the number of diseases for which newborns are tested. Currently, 41 states screen for more than 20 disorders. Nebraska is one of a handful of states that does not allow parents to decline newborn testing. Some parents object on religious grounds to the tests, which require five drops of blood drawn from a heel. Parents have recently pushed, to no avail, for lawmakers to give them the same choice to opt out that is offered in most other states. Over the last few years they have lost two court cases challenging the rule, and a bill before lawmakers last session fizzled. "The child's protection comes first, and the state has a right and obligation to protect the child," said Julie Miller, manager of the state's newborn screening and genetics program.

—Associated Press, 8/27/07

Kansas taps inspector to detect Medicaid fraud

Topeka, Kansas — When Kansas legislators earlier this year came up with a package of health care reforms, it included the creation of an inspector general to root out Medicaid waste and fraud. The Kansas Health Policy Authority Board has hired Robin J. Kempf as inspector general to audit, investigate, and conduct performance reviews for the Medicaid program, MediKan and the State Children's Health Insurance Program. "The health policy authority takes very seriously its role as good stewards of state resources. With Robin's experience and knowledge, she will make an excellent asset to our team as we work to improve health and health care in Kansas," said Marci Nielson, the authority's executive director. Kempf's position must be confirmed by the Senate after the legislature convenes in January. She has been associate general counsel for the Kansas Board of Regents since 2005, a role she also played from 2001 to 2003. Before Ms. Kempf's work with the board, she was a university professor in China and an auditor for the Kansas Legislative Division of Post Audit. The authority was set up in 2005 to review health care issues and oversees all health insurance purchasing plans for the state, including Medicaid, MediKan, and children's insurance. It also is drafting health reform options for the Legislature next year.

Medicaid, which provides insurance for people with low incomes, averages about 250,000 people a month. There are about 4,000 people enrolled in MediKan, which covers adults with disabilities who don't qualify for Medicaid but are eligible for services under the state general assistance program. It also provides limited medical benefits for those whose applications for federal disability are being reviewed.

The children's insurance program provides health coverage for youngsters who don't qualify for Medicaid and has about 35,000 participants. Medicaid covers children younger than 18 in homes where family income is up to 100% of the federal poverty level—$20,650 for a family of four. The insurance program covers up to 200% of the poverty level.

—Associated Press, 8/21/07

Will universal health coverage be a reality in New York State?

ALBANY — New York Gov. Eliot Spitzer's administration will hold five public hearings on providing universal health insurance coverage in New York, which has about 2.5 million residents without it and spends more per person on medical care than any other state. Spitzer announced in January that his administration would develop a plan for affordable health insurance for everyone. At the same time, the state is seeking a consultant to analyze proposals. A panel of experts will help the insurance and health commissioners, who are required to submit recommendations to the governor by May 31, 2008.

"We must ensure that we spend our health care dollars efficiently and effectively so that every New Yorker can afford health insurance and access the quality of care they need to live longer and healthier lives," Richard Daines, MD, health commissioner, said in a statement. But the key question will be how New York pays for it.

"Really the trick is going to be, as we all understand, is how we finance it," said William Van Slyke, a spokesman for the Healthcare Association of New York State, which supports the concept of universal coverage. "Everybody that's got a hand in this has got to be part of the solution," said Van Slyke, whose organization represents hospitals and health systems.

According to census data from 2006, 16.5 million New Yorkers have health insurance coverage and 9.3 million of them are in employer-sponsored plans. More than 7.2 million people are in government health care programs. About 400,000 people purchase insurance privately. The New York Health Plan Association, which represents managed health plans, thinks the state should reform requirements for products in the individual and small-group health insurance markets to make them more flexible and look at the use of taxes and surcharges to finance the system, said spokeswoman Leslie Moran.

United Hospital Fund president James Tallon, one of the experts, said capturing the 2.5 million uninsured people is urgent for the health care system, and few issues are more important in economic development than health care costs. The fund is a health care research and policy group. "Uninsured people are a huge structural flaw in the health care system because they generate costs without a source of paying for them," he said.

Other experts on the panel are Mark Scherzer, legislative counsel for New Yorkers for Accessible Health Coverage; Stan Lundine, former lieutenant governor under ex-Gov. Mario Cuomo, a Democrat; and attorney Elizabeth Moore, a partner with Nixon Peabody and former counsel for Cuomo. The web site for development of the plan is

Rochester Democrat and Chronicle, 8/15/07