2012 State Legislative Tracking Database—Coming Soon!
NCSL is launching the 2012 Federal Health Reform: State Legislative Tracking Database on Jan. 17, 2012. In 2011, the database had over 900 bills.
Topics in the database include: Medicaid, Health Insurance Exchanges, Health Insurance Reform, Health Information Technology, Prevention and Wellness, Providers and Workforce, and Challenges and Alternatives. The last category contains bills that oppose, opt out of, or differ from elements of the federal provisions.
States are expected to address health insurance exchanges, build and upgrade health information technology systems, determine essential health benefit packages, and prepare for Medicaid expansions this legislative session. In 2011, 10 states created health benefit exchanges through legislation, and 42 states passed insurance reform laws to comply with or address requirements in the Affordable Care Act (ACA). The database will include 2011 and 2012 pending, enacted and failed bills and resolutions. Bills can be searched by state, year, topic, keyword, status or primary sponsor. This 2012 legislative database will be online and free to all web users.
High Risk Pools: State Growth and Spending
When Health and Human Services (HHS) created the Pre-Existing Condition Insurance Program to cover patients who had been denied standard health insurance, $5 billion in federal funds was earmarked to cover the costs of establishing the program in all 50 states.
For the first 17 months of operation (July 2010 to November2011), only 44,800 people enrolled nationwide, which was much less than the national projections, resulting in expenditures of less than $445 million (as of September 2011). Because of this, in some states premiums were reduced in 2011 by as much as 40 percent, and other states increased public advertising. [figures updated 1/17/12]
A recent upsurge in enrollments, an increase in severely ill patients, and other state-specific situations, however, are leading to financial challenges in several states.
Enrollment, which has varied widely across states, almost doubled nationwide from April through October 2011. As of Jan. 8, 2012, nine states that chose to run the program themselves have asked the federal government for more money to ensure their new high-risk pools do not run dry before 2014.
Two of the states so far have been granted additional federal funds.
- California was given $118 million more to add to the $761 million allocated in July 2010. State officials reported that per-member, per-month costs were more than three times the original estimates by actuaries.
- New Hampshire initially was given $30 million and expects to receive another $20 million. The New Hampshire Health Plan organization indicated that more funds were needed because the people who enrolled were sicker than anticipated.
Alaska, Colorado, Montana, New Mexico, Oregon, South Dakota and Utah have requests pending with the Center for Consumer Information and Insurance Oversight at HHS.
The Pre-Existing Condition Insurance Program was designed to end in January 2014, when all health insurers will no longer be allowed to deny people coverage for pre-existing health conditions. Another 220,000 people are currently enrolled in 35 traditional, state-run high-risk pools, which do not receive federal funds.
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