Clip files / Local news from the states

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

Oregon’s governor considers voluntary, all-payer formulary

PORTLAND, OR—Faced with 10% to 20% increases in health insurance costs in his state, Oregon Gov. John Kitzhaber has proposed the state develop a voluntary statewide formulary. From its bully pulpit, the state would exhort not only the Oregon Health Plan, the state’s Medicaid program, but also state employees, medical groups, health maintenance organizations, and other health insurance companies to help control costs by adhering to the formulary.

"If you’re going to make a difference, you need to look at all 3 million of us, vs. 350,000 in the Oregon Health Plan," said Lynn Read, deputy director of the Office of Medical Assistance. "To date, states have not had success controlling costs. We’re hopeful this process will yield results."

The state overall saw a 4% to 5% increase in prescription drug costs last year, a representative from the governor’s office said. The Oregon Health Plan, however, spent $116 million on prescription drugs last year, a 33% leap from 1997, according to a report by the Office of Medical Assistance Programs. A combination of factors contributed to the increase, from volume increases to new medications coming on line.

Business Journal of Portland, Jan. 31

NASHP takes retrospective look at impact of state-level initiatives

PORTLAND, ME—Without a quarter century of state initiatives, the current level of uninsured in the country would be greater by several millions of people, says a report from the National Academy for State Health Policy.

The report, "Access for the Uninsured: Lessons from 25 Years of State Initiatives," describes how state actions have not only insured millions of Americans, but provided a testing ground for large-scale federal efforts. For more information on the report or to order a copy, contact the National Academy for State Health Policy, 50 Monument Square, Suite 502, Portland, ME 04101. Telephone: (207) 874-6524. The report costs $30 for government and nonprofit agencies and $50 for all others.

Welfare reform is given a major role’ in declining health coverage for women

WASHINGTON, DC—Welfare reform is likely to have played a "major role" in the drop in health insurance coverage among women of reproductive age during the 1990s, says a special analysis from the Alan Guttmacher Institute. The proportion of American women of reproductive age enrolled in Medicaid fell by 21% between 1994 and 1998, and nearly one in five American women of reproductive age lacked insurance of any kind by 1998, says the report in the December 1999 issue of The Guttmacher Report on Public Policy. Author Rachel Benson Gold describes the variety of responses to this "spillover effect" of welfare reform, particularly those involving transitional Medicaid, outreach, and special initiatives for immigrant women. The full report is available at gr020606.html.

Decline in tobacco consumption will lower tobacco settlement payments

HOUSTON—Declining consumption will cut tobacco settlement payments to states by 11%, says Philip Morris attorney Meyer Koplow. His remarks came as Texas hospital districts learned that they will receive $60 million less than expected this year as a result of a drop in the domestic shipment of tobacco products. Payments are tied to both the level of tobacco shipped and to inflation. A 14% overall decline in shipments was offset by a 3% inflation adjustment.

Houston Chronicle, Jan. 31

Health plans in New York kick off anti-fraud campaign

NEW YORK—Hospitals in New York are enlisting the help of consumers in a campaign to fight health insurance fraud and abuse.

"It is estimated that fraud and abuse are costing all of us as much as $100 billion each year," said a statement from William Mahon, executive director of the National Health Care Anti-Fraud Association. The association has joined with the New York Health Plan Association in developing a print and Internet campaign to raise awareness about health care fraud and how to combat it.

—New York Health Plan Association release, Jan. 21

Kaiser Commission suggests ways to get kids enrolled in Medicaid

WASHINGTON, DC—The reasons parents don’t enroll their eligible children in Medicaid are not inherent in the program but rather are "problems with practical, feasible solutions all states can implement," says a new report from the Kaiser Commission on Medicaid and the Uninsured. "Medicaid and Children: Overcoming Barriers to Enrollment," is a summary of a national survey of parents and an analysis of ways to boost participation in Medicaid.

A copy of the report is available through the Kaiser Web site, or by calling (800) 656-4533.