Gov. Daniels Asks Feds Not to Trash State Health Program; Will they Listen?

Gov. Mitch Daniels recently sent a formal request to Health and Human Services Secretary Kathleen Sebelius asking federal officials not to terminate the state’s Healthy Indiana Plan, which has many satisfied participants and 99% planning to renew their coverage, according to the state of Indiana.

The state has sent several letters to Health and Human Services representatives requesting answers to questions about utilizing HIP as the program to serve Indiana’s newly-eligible Medicaid recipients beginning 2014. So far, there has been no guidance.

Here is a link to the governor’s letter: http://www.in.gov/gov/files/Press/011411letter.pdf

Previous correspondence may be found at this link: http://www.in.gov/aca/2330.htm

Executive Order authorizes establishment of state healthcare exchange

The governor also has signed an executive order authorizing the Family and Social Services Administration to work with other state agencies to conditionally establish and operate a state-based healthcare benefit exchange. The steps taken will be preparatory only and do not connote a decision to put a state-run exchange in place.

According to Affordable Care Act (ACA), states are required to establish a health benefit exchange by January 1, 2014. The federal government will establish exchanges for states that have not made adequate progress by January 1, 2013.

The governor said it is in Hoosiers’ best interest to begin to put a framework in place. There has been little information or guidance from the White House about how a federally-based exchange would operate.

“The nation will be best served by the repeal of this expensive and unworkable law, or by its judicial overturn. But for now, there seems no alternative but to prepare for the possibility that Indiana will try to operate an exchange of some kind,” said Daniels.

Individuals and small businesses will use health exchanges to find, compare and enroll in health insurance plans and to obtain federal tax credits for premium expenses. It is estimated that at least 1.4 million Hoosiers will use the exchange; however, the numbers are likely to increase as businesses and individuals drop their existing health insurance to receive tax credits.

Overhauling Medical Malpractice Laws the Right Thing to Do

Malpractice changes have been ignored, for the most part, in the health care reform discussion – now there are numbers to back why this needs to be a part of the solution.

The Congressional Budget Office (CBO) recently released data estimating government spending on programs such as Medicare, Medicaid and the Children’s Health Insurance Program would decrease by $41 billion over a 10-year period with proper reforms. The reason:  Physicians would no longer overuse tests as a way to protect themselves from lawsuits.

Changes in the malpractice system would also cut national health care spending by 0.5% a year ($11 billion in 2009). No, that doesn’t solve all the problems, but trying to fix the lawsuit-happy world we are living in is a step in the right direction.

CongressDaily reports the CBO’s analysis is based on a few reform factors such as capping noneconomic damages at $250,000 and punitive damages at $500,000. It also calculated the numbers based on a one-year statute of limitation for adults and three years for children from the time the injury is discovered.

A few senators rightly shared their support for reform (and dismay for dawdling Democrats), CongressDaily shares:

"This is an important step in the right direction, and these numbers show that this problem deserves more than lip service from policymakers," said Sen. Orrin Hatch, R-Utah. "Unfortunately, up to now, that has been all the president and his Democratic allies in Congress have been willing to provide on these issues." Hatch had requested the updated analysis from CBO.

Senate Finance ranking member Charles Grassley and National Republican Senatorial Committee Chairman John Cornyn of Texas also expressed disappointment that Democrats have not cracked down on medical liability issues. Cornyn urged senators to "take account of the CBO’s objective numbers and the experience of Texas and other states where healthcare access and affordability have been improved by setting reasonable limits on lawsuits against doctors."

Democrats are reluctant to cap payouts from medical liability lawsuits. But President Obama recently directed HHS Secretary Sebelius to look at ways to make changes to the system that will bring down spending.

CBO’s analysis makes a clear argument that malpractice reform should be part of health care reform discussions. Still, supporters have their work cut out for them based on this outlandish comment:

The findings "reiterate what we’ve always known: that medical malpractice claims have almost no effect on overall healthcare spending," said American Association of Justice President Anthony Tarricone. "The vast majority of empirical evidence suggests that there are only minuscule savings to be found in reforming our nation’s civil justice system."