Gov. Rick Perry might have rejected the opportunity to run a state health insurance exchange outlined in the federal healthcare law, but that doesn't mean state agencies won't work closely with Washington regulators to offer Texans a way to buy insurance. Texas Health and Human Services Commission officials are waiting to hear from the U.S. Department of Health and Human Services about many of the details on how to proceed ahead of the planned rollout of the exchange in 2014, Goodman said. The Texas Department of Insurance is also expected to play a role but was characteristically tight-lipped about its involvement with the federal government.
A battle is brewing here in Florida, where Gov. Rick Scott took to national television soon after the ruling to announce that he would reject the expansion. Mr. Scott describes Medicaid as a dysfunctional program, saying the portion of the state budget devoted to it is growing at more than three and a half times the rate of general revenues. Hospital associations around the country have already signed off on cuts to reimbursement rates under the healthcare law on the assumption that the new paying customers they would gain, partly through the Medicaid expansion, would more than cover their losses.
Many doctors now refuse to accept Medi-Cal patients or sharply limit the number they see because of what they describe as extremely low reimbursement rates. As California gears up for a major expansion of Medi-Cal under national health reform, such compensation is leading to a critical concern: Will enough physicians be willing to see the influx of new patients? Now covering 7.7 million Californians, Medi-Cal is the state's version of the federal Medicaid program. It is expected to grow by 900,000 children with the state's recent elimination of the Healthy Families program. The state will enroll an additional 1.5 million or more adults when national health reforms take effect in 2014.
For several years now, doctors and patients have been struggling to reimagine the future of health care. Policy makers, health care experts and pundits have been eager to help, churning out well-meaning op-eds and essays and cobbling together exhaustive blogs and books. In a mere 175 pages, and with an impressive roster of references and well-placed graphics, “The Health Care Handbook” illuminates the maddeningly opaque terms, acronyms, organizations, personages and policies that abound in health care. The authors do so not by expounding on the minutiae, but by jettisoning the jargon and gobbledygook and presenting only the core ideas.
All 49 birth facilities in the state have voluntarily eliminated the formula giveaways as of the beginning of July, making Massachusetts the second state to do so. Rhode Island hospitals ended the practice last November. Back in 2005, Massachusetts tried to end the free formula practice with a statewide ban instituted by the Public Health Council, but that decision was overturned several months later. More than a dozen studies have shown that breast-feeding mothers who received free formula samples after they left the hospital were less likely to be breast-feeding by the time their infant was one month old.
For now, the basement of OSF Healthcare's corporate headquarters is home to the newest technology in intensive care units, not just for OSF Saint Francis Medical Center, but for OSF Healthcare hospitals in four other cities. The eICU program is more than technological bells and whistles, say OSF Healthcare officials who announced the new program Wednesday at corporate offices. The high-tech ICU could lead to reduced mortality rates and better outcomes across OSF Healthcare's system. Mortality rates could decline by 20 percent, said Dr. William Tillis, OSF eICU medical director.