Utah Health Matters E-Newsletter
February 9, 2007
With 2 weeks & 4 days remaining in the Session, NOW is the time to make
our case for all worthy health priorities.
Reasonable funding for Medicaid (including dental & vision) and CHIP
seems more possible than last week, but it will take persistent and
respectful efforts. Based on recent experience working with Ogden community leaders, we
cannot over-emphasize the need to engage community leaders from the districts
of leadership, in this suggested order: Utah County (Pres.
Valentine, Sen. Bramble, Rep Lockhart), St. George
(Rep. D. Clark), Logan & Bear River (Sen. Knudson & Hillyard), Sandy (Speaker Curtis). While
new to leadership, Sen. Killpack is also critical,
because Republican leadership is deferring to his judgment on the merits of HHS
The week ahead…
Where We Stand on Funding for Health & Human Needs: Making Room for Medicaid & CHIP
Bill Tracker for Week 5
3. Federal FRONT:
What’s Next for SCHIP Reauthorization?
4. Updates &
Next Steps for Consolidation under Dept of Workforce Services
5. Coverage for the Utah’s Uninsured: Blind
Spot of Utah Health Policy?
6. Civic Engagement Resources
1. Where we
stand on Funding for Health Needs: Making
Room for Medicaid & CHIP
Last Wednesday, the Health & Human Services Subcommittee
Co-Chairs presented the HHS priorities and
recommendations to Executive Appropriations Committee, the leadership of the
Legislature. We were pleased to hear
the co-chairs represent the sub-committee’s request to allocate 8% of the
available surplus to HHS priorities. However,
the chairs also recalled the main recommendations of the Medicaid Interim
Committee: to limit Medicaid cost growth to 5%.
The chairs pointed that if the $19 million from the Federal cost
shifting of targeted case management were not subtracted from HHS’ funding allotment
(but taken instead from the larger General Fund), then the committee could limit cost growth to 5% (The
main recommendation from the Medicaid Interim Committee was to limit Medicaid
cost growth to 5%). What’s curious
about this is that the original 5% target was aimed at Medicaid—not at all HHS expenses.
With our one-on-one meetings with leadership the following are
important points to make: either HHS should have 8% of the
available surplus OR the $19 million should not be ‘parked’ in the HHS area. Either scenario
makes it possible to drill down the HHS combined priority
list to levels that will fund the most critical priorities.
If you’ve been holding back in your advocacy, now’s the time to
pull out all the stops. These 2-3 days
are the ‘calm before the storm.’ If leadership is to be persuaded to allocate
8% to HHS (or take the $19 million from the general
fund), they must hear from YOU NOW about why the
following priorities should be funded.
-Medicaid vision & dental services (ranked 20 & 21)
-full CHIP funding (and the program should be re-opened in
March, not July)
-mental health funding.
For talking points, visit http://www.healthpolicyproject.org/LegActionCenter/fact_sheets.htm
Please take a few minute
to call, visit, or email members of leadership (It is fine to call them at
(Leadership), House Members
Appropriations (Leadership), Senate Members
Please send thank you notes to our Co-Chairs for representing
the committee’s wishes well and for their service to the most challenging and
heart rending committee of the Legislature:
Sen. Allen Christensen, Co Chair firstname.lastname@example.org
Fax: 326-1475 Home: 801-782-5600
Rep. Merlynn T. Newbold,
Co Chair email@example.com
NOTE: Since leadership’s recommendations impact the entire state,
you don’t have to live in a member’s district to call—though it helps if you
do. If you call Friday or Monday, leave a message with the Capitol
switchboard (Senate: (801) 538-1035, House: (801) 538-1029). Ask the legislator to call you back
sometime that day, if at all possible. If you call them at home or on their
cell, ask if they can spare a few minutes.
Get Ready for Feb. 15
This Thursday, Feb. 15 the new revenue projections will be
announced and we expect they will be positive (leaving more surplus or wiggle
room in the budget for funding priorities). The Utah Medicaid Policy
Partnership may hold a press conference that day or the next (or the UHPP may
do a ‘virtual’ press conference featuring comments from community leaders in
key legislative districts). Please weigh in how you want to handle this. It
is our understanding that the Family Investment Coalition wants to hold a
press conference on Feb. 19.
Bill Tracker for Week 5
the latest updates on most health-related bills. Click on Health
Bill Tracker for 2-9-2007.
Victory on the PDL (SB42 Preferred Drug List)!
SB42 passed both the House and Senate, which means Utah is on the path to better
management of Medicaid cost growth. The UMPP’s
argument to re-invest the savings in Medicaid (in this case, provider rates)
is also making headway. Over the next year our challenge will be to implement
additional cost management tools and to make sure the PDL is fully engaged to
improve quality and safety in prescribing, to limit costs, and to educate
consumers and providers about the prudent use of pharmaceuticals. It’s not as
easy as it sounds!
FRONT: Next Steps for SCHIP Reauthorization
President Bush released his
proposed 2008 federal budget this week and it is bad news for America’s families. The
president’s budget slashes Medicaid spending and fails to adequately fund the
State Children’s Health Insurance Program (SCHIP). The president’s plan will put health
coverage increasingly out of reach for millions of America’s families.
The president’s proposed funding for SCHIP is inadequate to
retain enrollment for the children who currently participate in the program.
Not only will states be unable to enroll more children, but they will be
forced to terminate coverage for hundreds of thousands of children, thereby
consigning them to the ranks of the uninsured. The administration also proposes limiting
the federal government’s share of costs in SCHIP to children with incomes
below 200 percent of the federal poverty level—the equivalent of $2,862 a
month in total earnings for a family of three—further curtailing access to
children who desperately need health insurance.
At the same time the president’s budget limits
access to children’s health coverage, it asks Congress to cut Medicaid
spending by more than $25 billion over the next five years. These unwise Medicaid cuts would come on
the heels of $6.9 billion (over five years) in gross Medicaid savings the
Bush administration attained under the Deficit Reduction Act of 2005.
Action Steps for this week
1. Help us find families who have been helped by CHIP (or who
have uninsured kids). Call (801) 433-2299 or send an email to firstname.lastname@example.org
to share your story and help with CHIP advocacy at the state and Federal
2. It is not too soon to make appointments with Utah’s congressional delegation for the recess
period, starting with Sen. Hatch. Please note: Sen. Hatch has had surgery
(he’ll be fine!), but he will need more medical care during the Feb. recess.
Please book your appointments for the April recess (1st week)
through Reed Ryan: email@example.com. Use our Talking
Points for Federal SCHIP Re-authorization if you need them.
4. Updates & Next Steps for Eligibility Consolidation
under Dept of Workforce Services
Somewhat like the advocacy and provider community, the HHS Appropriations
Subcommittee is split on whether the consolidation of eligibility services
under DWS is a good idea. The reasons for ambivalence are varied, but all
point to the need for further study and planning. A few days ago Bill Walsh
& Shirley Weathers shared a thought provoking letter about the
consolidation proposal. Please take a look—we
have posted it here. Bill &
Shirley’s concerns could be addressed in the proposed ad hoc advisory
committee (see wish list item #1).
Thanks to so many of you for helping to compile the Wish List.
Here is the latest...
Wish List for a Seamless Consolidation of Eligibility
- To ensure a
smooth transition, DWS and DOH should form an ad hoc advisory committee
comprised of Medicaid stakeholders (consumers, advocates, providers,
- DWS’ mission
statement should be revised to accommodate the added focus on
eligibility for persons who are not oriented to workforce integration.
Advocates have suggestions that could be discussed in the ad hoc
- Together and
in consultation with ad hoc advisory committee, DWS and DOH should
develop a marketing and outreach plan for
targeting under-enrolled groups and helping them apply for medical
assistance. As the policy and financing lead on Medicaid, the DOH should
arrange for the state (DWS) to receive the 50-50 Medicaid ‘admin’ match
for these functions.
- DWS should
systematically document the administrative and cost impacts of the new
citizenship documentation requirement established under the 2006 Deficit
Reduction Act. These impacts should be analyzed and shared with Utah’s congressional delegation. Note: other states have demonstrated
adverse impacts of the new requirement on eligibility (details at http://www.cbpp.org/2-2-07health.htm).
- DWS should
work with DOH staff (Anita Hall) to enter into data brokering
arrangements with other states so that applicants not born in Utah can obtain all needed documentation for proof of
- DWS should
work with DOH staff to ensure that all new and current Medicaid
applicants establish a medical
home (an ongoing relationship with a primary care provider). To this
end, DWS should work with the DOH to track and regularly report which
providers are accepting new Medicaid patients.
5. Coverage for the Utah’s Uninsured: Vanishing Point on Utah Health Policy Horizon?
Last year showed an increase in Utah’s uninsured rate that
was 7 times the national rate of growth, yet no viable solutions are in play
in the current Session—but why? If we
look at states that are undertaking
bold solutions (Maine, Massachusetts, California, Illinois), we see that their initiatives were many years in the
making. Furthermore, these states are
keen on spending millions (really, billions) more taxpayer dollars on health
care. However, because they do little
to address the underlying causes of rising health care costs, the UHPP has
strong doubts about the viability of these initiatives.
Our starting point at the UHPP is the
recognition that we are already spending enough money (though not in Medicaid
or CHIP) to cover everyone with high-quality care: it’s just that we’re not
spending our dollars in an efficient or sustainable manner. Thus when it comes to health policy for
the uninsured we are, like most Utah policymakers, fiscal conservatives. If there is a place where we can ‘get it
right the first time’, from which we might leap toward fiscally sustainable
solutions, we think Utah is the place. The downside, of course, is that it will take
longer to turn the wheel toward viable solutions for Utah.
We have developed two pieces of
legislation to move us in the right direction:
HB152: Small Business Health Plan Task
Force (Rep. Mascaro)
SCR 6, 1st
Subst (Sen. Bell) Resolution Urging Congress to
Sponsor the Health Partnership Act or Creative Federalism
On the road to sustainable solutions,
we will be faced with temptation or led astray. In discussions on bills such as HB141 (Health
Insurance and Health Care Payment Amendments (Rep. Daw)
we hear how easy it is to blame (or
criminalize) the uninsured themselves for their plight. Others are tempted to
blame the so-called 800 pound gorilla (Intermountain Healthcare) for Utah’s
health care woes (SB107,
1st Subst. Notice
of Available Charity Care (Sen. Waddoups) as if
sheer size implied culpability. www.le.state.ut.us/~2007/status/sbillsta/sb0107.htm , when in fact Intermountain Health Care is one of the major
reasons why health care costs are lower in Utah than in any other state.
the ‘free market’ continues to distort plain facts about what’s causing
double digit inflation in health care costs.
We look forward to working with all of
you (and the Governor’s Office of Economic Development) through the Session and beyond to create affordable,
comprehensive, quality coverage for all Utahns.
6. Civic Engagement
REMEMBER: You can get a message to your senator by calling the Capitol
switchboard at (801) 538-1035 for the Senate and (801) 538-1029 for the House. Or, you can look up his or her home or work
phone number on our legislator contact list, available to download on our
website: http://www.healthpolicyproject.org/2007%20Legislators.xls Don’t know who your legislators are? Look it up here: http://capwiz.com/utahchildren/state/main/?state=UT&view=myofficials#00
Take a look at the advocacy toolkit on our website: http://www.healthpolicyproject.org/LegActionCenter/toolkit.htm You can also call our office at 801-433-2299 to schedule a
training and strategy session of your own.