Roundup: States Face New Revenue Downturn; Calif. County Has Disparities In Life Expectancy

News outlets report on a variety of state health policy issues.

Reuters: States' Revenue Surge Ebbs At End Of 2011: Report
Revenues in most U.S. states increased in the fourth quarter of 2011, but their recent surge is tapering off, as they grew just 2.7 percent from the final quarter of 2010, according to a report released on Monday. "This is a noticeable slowdown from the 11.1 (percent) and 6.1 percent year-over-year growth reported in the second and third quarters of 2011, respectively," the Rockefeller Institute, a think tank that closely watches states' revenues, said in the report. ... As revenue slows, "states' education and healthcare obligations continue to grow," the Center on Budget and Policy Priorities found (Lambert, 3/19).

California Healthline: Report Shows Health Disparities In Valley ZIP Codes
A recent report on health inequities in the San Joaquin Valley gives new meaning to the real estate mantra: location, location, location. The report by the Joint Center for Political and Economic Studies and Fresno State's Central Valley Health Policy Institute found that location plays a very real role in health -- so real in fact that life expectancy rates can vary by as much as 21 years in the valley, depending on the ZIP code. There are generally much smaller gaps in life expectancy rates, even between developing countries and industrialized nations (Daniel, 3/19). 

California Healthline: Hearing Focuses On Children's Dental Care
A recent report revealed that only 30% of Medi-Cal children saw a dentist in fiscal 2010-2011 in Sacramento County. In other recent years, the utilization rate was even worse. Statewide, closer to 50% of Medi-Cal children saw a dentist last year. The difference in Sacramento is attributed in part to the county's payment model of geographic managed care in which dentists get a capitated rate for caring for a population in a certain area. Critics say there is little incentive for dentists to see more children since they get paid the same amount whether they see more patients or not (Gorn, 3/20). 

Arizona Republic: Sponsor Working To Amend Birth-Control Bill
The sponsor of a bill that would allow employers to deny contraceptive coverage on religious grounds said she is working on amendments to clarify the measure. Rep. Debbie Lesko, R-Glendale, said her bill has been widely misunderstood and misinterpreted, particularly an exception that would allow female employees to still be covered if they need the contraceptives for health reasons, such as controlling endometriosis (Pitzl, 3/19).

The Associated Press/Washington Post: Birth Control Bill Stalls In Arizona Senate But Supporters Plan Changes To Address Concerns
A bill that would let more Arizona employers drop coverage for birth control drugs stalled Monday in the state Senate because of increasing opposition from women who feared they would have to reveal private health information to employers (3/19).

Arizona Republic: Obama Campaign Memo Slams 'Romney-Arizona Tea Party Agenda' On Women's Issues
In another sign of how much traction the Arizona Legislature's contraception bill is getting at the national level, President Barack Obama's re-election campaign is tethering the controversial legislation to Republican frontrunner Mitt Romney. In a memorandum dated Monday, Mahen Gunaratna, Obama's Arizona campaign press secretary, charges that Romney, a former Massachusetts governor, and conservative "tea party" GOP legislators in Arizona "are set on limiting women's access to health care and seek to insert themselves in decisions that should be made between Arizona women and their doctors (Nowicki, 3/19).

Arizona Republic: Democrats, GOP Clash Over Bills Vs. Feds
House Democrats lambasted Republicans Monday for introducing "extreme" and "ideologically driven" legislation targeting the federal government. In recent years, state lawmakers have been working to challenge or supersede existing federal law on issues ranging from health care to immigration and land management. Many of the proposed laws are an attempt to make a statement to Washington, D.C. (Sanchez, 3/19).

Kaiser Health News/NPR: A Tale Of Two Health Insurance Extremes
The U.S. spent $2.6 trillion on health care in 2010 — more than the entire economy of France or Britain. But the amount spent and how it's used varies from state to state. And, at the opposite ends of the spectrum: Texas and Massachusetts. At 25 percent, Texas has the highest rate of uninsured people in the nation. Massachusetts, where a 2006 law made coverage mandatory, has the lowest rate — less than 2 percent of people are uninsured. Here's a look at two Americans who are living the reality of that difference (Cohen, Feibel and Bebinger, 3/19).

Boston Globe: Group: Localities Saved $80 Million After Curbing Benefits
A taxpayer group said Monday that Massachusetts cities and towns have saved $80 million on health care since the state enacted a controversial law last year that forced teachers, firefighters, and other municipal employees to give up some of their collective bargaining rights. The Massachusetts Taxpayers Foundation, a business-funded watchdog that advocated for the law, said in its report that the overhaul was likely to save more than the $100 million annually that had initially been projected by the group (Bierman, 3/19).

Georgia Health News: Why Free Clinics Help More Than Just Their Patients (Video)
(Tiffany Miller has) been to the ER "countless times" for sudden fainting spells due to an unidentified central nervous system condition that has plagued her for the last four years. ... Visiting the ER has become "pointless," Miller said. "I just lay there, sometimes in a hallway, until I've regained full mobility and can leave." But to stay out of the ER, Miller would need to see a primary care doctor monthly and take five different medications daily. Uninsured and unable to work for the past two years, Miller couldn't afford any of those preventive measures until she turned to Gainesville’s Good News Clinics (Abree, 3/19). 

The Associated Press: Expert Says Idaho Prison Care 'Cruel'
Medical care is so poor at an Idaho state prison that it amounts to neglect and cruel and unusual punishment, according to a report that was unsealed Monday. Correctional health care expert Dr. Marc Stern said there have been some improvements at the Idaho State Correctional Institution south of Boise. But terminal and long-term inmates sometimes went unfed, nursing mistakes or failure likely resulted in some deaths, and one inmate wasn't told for seven months that he likely had cancer, he said (Boone, 3/19).

Milwaukee Journal Sentinel: Walker Signs Family Care Expansion Amid Criticism
Gov. Scott Walker signed legislation on Monday that expands access to a long-term assistance program known as Family Care, but no sooner had he signed it than Walker was derided by Democrats for having his hand forced by the federal government. Walker signed several bills at Independence First in Milwaukee, including lifting the enrollment cap on the long-term care program for the elderly and disabled (Bergquist, 3/19).

Kansas Health Institute News: KanCare Bidders Heavily Courting Medicaid Providers
"I feel like I'm the pretty girl in high school and it's two weeks before prom," said Krista Postai, who runs the Community Health Center of Southeast Kansas, a multisite safety-net clinic headquartered in Pittsburg. "I have lots of offers." Postai and other Medicaid providers – a group that includes doctors, hospitals, pharmacies, home health agencies, nursing homes, mental health centers and community-based programs for the developmentally disabled – are being wooed by the five companies that have submitted bids to manage the state's $2.8 billion Medicaid program (Ranney, 3/19). 

Health Policy Solutions (a Colorado news service): Consumers Want Live Help With Online Exchange
Surveys of nearly 700 Coloradans found they support the state’s new health insurance exchange, but found they want hands-on help to make sense of the online market slated to go into effect in 2014. "A navigator system is critical," said Danny Katz, director of the Colorado Public Interest Research Group Foundation, CoPIRG, one of the groups that conducted focus group meetings in October and November at 53 sites across Colorado (Kerwin McCrimmon, 3/19).

The Lund Report (an Oregon news service): Health Plans Shift Pharmacy Costs Onto Vulnerable Patients
Industry insiders and patients are raising alarm about what they’re calling an insidious trend in the price of life-saving pharmaceuticals by insurance companies, which began shifting, they say, an unprecedented burden of drug costs onto people with chronic diseases. More people are having to pay upwards of 30 to 50 percent for medications that can cost $600 a month, compared to $35 copayments last year, said Shelley Bailey, owner of Central Pharmacy in downtown Portland (Rendleman, 3/19).

The Lund Report (an Oregon news service): A Tight Timeline for CCO Development Worries Policy Board Members, Advocates
The Oregon Health Authority is racing against the clock in order to have coordinated care organizations (CCOs) certified and providing care to Oregon Health Plan patients by August 1st amid growing concern that the tight timeline doesn't leave enough time for a thorough vetting public process. ... These CCOs will replace the state's managed care organizations, and integrate the physical, mental and dental healthcare for the 650,000 patients on the Oregon Health Plan (Waldroupe, 3/19).

HealthyCal: "It Takes a Village"
The rapidly-spreading Village Movement is helping older adults age gracefully by offering the best of two colliding worlds: “aging in place” to avoid institutional living while creating tight community bonds to foster better health and social connections. But these villages are not retirement communities with fixed geographic boundaries. They are collections of individuals living in their own homes across traditional neighborhoods, communities, even entire cities or regions, with the members of each community connected by a network that offers them essential services allowing them to remain independent (Perry, 3/19).

HealthyCal: LAO: Brown's Plan For In-Home Care Might Not Work
Gov. Jerry Brown’s proposed cuts to the budget for In-Home Supportive Services would probably face legal challenges and, even if they survived the courts, would be difficult to implement, according to a new report from the Legislative Analyst (3/19).

St. Louis Beacon: Missouri Pioneers Community-Based Mental And Medical Health Services
For years, poor people suffering from a combination of mental and physical health conditions have had few options beyond walking through the door at an emergency room or finding a bed in a nursing home until the crisis eases. Now come unique services through Hopewell and People's Health Centers. Both are among Missouri pioneers in integrating mental and physical health services to help people remain in the community rather than in institutions (Joiner, 3/20).

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