Medicaid Plus | Anna Loengard | Bills to watch

Reform is on again, off again in Washington DC. But with a month to go, lots of initiatives are still at play in the legislature. We track some of those this month – but we also launch our State of Reform podcast in this month’s edition. So, here are “5 Things We’re Watching” in Hawaii’s health care system for April.

1.  Medicaid Plus program up to 250% of FPL

Language is alive in legislation (HB552, HD1, SD1) that would create a “Medicaid Plus program.” This program would cover folks above Medicaid eligibility (138% FPL) up to 250% of the federal poverty level, or $70,725 per year for a family of four.

This program is a long way from being funded and implemented. But the idea is to provide a safety net if Congress repeals the ACA and middle class families lose the subsidies there.  This program could backfill disruption in the individual market as well.  One observer tells me it would be comparable to the old QUEST-Net program run by the state.

2. Launching our podcast

State of Reform tries to bridge the gap between the world of health care and that of health policy.  We do this in part by providing a platform for the voices of senior executives and health policy leaders.  Last month, we added an occasional podcast to our other channels: video, email, web, social, and book publishing.

In our first podcast episode, we talked to people in the Lone Star State, perhaps the staunchest state-opponent to the Affordable Care Act.  We wondered: Is a Trump presidency good news for Texas health care?

Our second podcast took a look at housing, which included a review of how Hawaii’s effort to integrate housing into the Medicaid benefit compares with states like Washington and California.

3.  Health fares well in Senate budget

The Senate may take up the operating budget later today after a 48-hour delay following approval by the Ways and Means Committee (WAM).  WAM reduced spending compared to the governor’s introduced budget – appropriate given the mid-session revenue shortfall. However, it also added some funding for health.

About $9.6m was added for housing and homelessness programs for each FY following the defeat of SB 7 in the House. Almost $145m over two years was added to support the Hawaii Health Systems Corporation, along with a $20m capital improvement allocation. Close to $3m was added for child and adolescent mental health. $13m was added to address chronic disease and about $10m went to re-base provider rates for Development Disabilities.

4. Video:  Anna Loengard

Anna Loengard joins this month’s edition of “What They’re Watching,” a series of short commentaries from Hawaii health leaders on topics and issues they are following in market and policy circles.

“I think there’s a lot of anxiety in the marketplace, in general there’s so much going on all at once.” Loengard says that the change and lack of predictability in the market today is a challenge, both in Washington DC and in the state.  I think HMSA is doing an increasingly good job at communicating what their real goals are, which I think are going to be really positive for primary care over the next several years.”

5.  Key bills to watch in the last month

Friends in the capitol tell us there may still be momentum around housing even if SB 7 died in the House. A Senate resolution asks providers and plans to start using ICD-10 codes to track homelessness in an attempt to get more and better direct information related to the chronically homeless population.

SB 397 funds a “Hospital Sustainability Program,” a bill with “strong support” from Queen’s. A bill related to opioid treatment is being taken up in SB505. The bill has had some vocal opposition but has now passed both chambers, albeit in different forms. SCR 80 creates a checklist process for employers wishing to offer high deductible health plans. It’s modest in initial scope but anything can change up until Sine Die on May 4th.