News in brief - June 6, 2005

HHS commission to study Medicaid - Bill would invest in enrolling kids in Medicaid, SCHIP - Americans having a harder time affording drugs - Lawmakers reject plan to raid Wis. injured patients fund - Maryland legal opinion allows liability premium relief before July 1

HHS commission to study Medicaid

Dept. of Health and Human Services Secretary Mike Leavitt has established a Medicaid reform commission tasked with producing two reports. The first, due Sept. 1, will provide the department with recommendations on how to achieve $10 billion in program savings over the next five years, as dictated by the current budget proposal moving through Congress. The second report, due Dec. 31, 2006, would offer suggestions on how to provide coverage for more individuals while containing cost growth.

Bill would invest in enrolling kids in Medicaid, SCHIP

Legislation that would provide $100 million in funding for outreach efforts to enroll children in Medicaid and the State Children's Health Insurance Program was recently introduced by Senate Majority Leader Bill Frist, MD (R, Tenn.), and Sen. Jeff Bingaman (D, N.M.).

In 2002, the most recent year for which data are available, there were 8.5 million uninsured children in the country, nearly 5 million of whom were eligible for coverage through SCHIP or Medicaid, according to the Robert Wood Johnson Foundation.

"Covering children is not only the right thing to do, but by ensuring that children have access to preventive care, it is also one of the best ways of reducing long-term strain on America's health care system," Dr. Frist said in a statement.

In a letter of support for the legislation, AMA Executive Vice President Michael Maves, MD, wrote that the AMA has "long-standing policy urging states to undertake, and physicians to participate in, educational and outreach activities aimed at Medicaid-eligible and SCHIP-eligible children."

Americans having a harder time affording drugs

The number of Americans going without prescription medications is rising, says a study by the Center for Studying Health System Change. The trend hits patients with chronic diseases especially hard. More than 14 million of them could not afford all their prescriptions in 2003.

"Adults with chronic conditions were twice as likely as other adults to have problems affording prescription drugs," said the center's president, Paul Ginsburg, PhD.

In 2003, 18.3% of Americans with a chronic condition had difficulty accessing medications, compared with 16.5% in 2001. Among all adults, 12.8% had trouble filling prescriptions in 2003 versus 12% in 2001. The trend is likely due to an increase in the number of prescriptions and a rise in cost sharing, the authors concluded.

Lawmakers reject plan to raid Wis. injured patients fund

Wisconsin's Joint Finance Committee last month rejected a proposal by Gov. Jim Doyle to take $180 million from the state's Injured Patients and Families Compensation Fund to help shore up the Medicaid program.

The panel voted 14-2 against the measure, which physicians said would have disrupted the relatively stable liability insurance climate the state has enjoyed for several years. The compensation fund helps keep insurance premiums low, which in turn helps to assure access to care for patients in the state, physicians said.

State lawmakers are wrestling with ways to address financial shortfalls in the Medicaid program, which faces a budget gap of more than $650 million by 2007, according to some estimates.

"Legislative leaders did the right thing today, even though it makes their job of balancing the budget more difficult," said Susan Turney, MD, executive vice president and CEO of the Wisconsin Medical Society. "But they realize that the money in this fund doesn't belong to the government and it doesn't belong to doctors, either. It belongs only to those who are injured because of medical negligence."

Maryland legal opinion allows liability premium relief before July 1

The Attorney General's office in Maryland issued an opinion last month that clears the way for physicians in the state to receive financial relief on their liability insurance premiums before July 1.

The issue for physicians is now one of timing, said T. Michael Preston, executive director of MedChi, the Maryland State Medical Society. If the subsidy is funded soon enough, doctors could see the relief amount they're entitled to fully accounted for in their third-quarter premium statements, he said. If uncertainty remains as insurance companies are preparing their third-quarter bills, the relief would likely be split between the third and fourth quarters, he said.

The state's General Assembly had approved a measure in December 2004 to help physicians pay their liability insurance premiums in the wake of substantial premium increases by insurance companies. Relief had not yet been granted, however, because there was some confusion in the way the law was written.