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Keep an eye on
Maine on this issue. The sticking
point from what I’ve read is when it is to go into effect. Dirigo, the state motto, is latin for “I
lead”. Maine has a long history of
leadership, from Ed Muskie, Margaret Chase Smith, George Mitchell and current Senators
Snowe and Collins. This
legislation is similar to that in California, Minnesota, Rhode Island and
Vermont, home of two other independents, Jeffries and Dean. Some real progress will be made this
year, I suspect, and some will fall into the Campaign 2004 rhetoric. - KWC Maine Health Plan Falls
Short of Approval
By THE ASSOCIATED PRESS, June 13, 2003, Filed
at 12:47 p.m. ET @ http://www.nytimes.com/aponline/national/AP-Maine-Health.html AUGUSTA, Maine (AP) -- Maine lawmakers came just shy of
immediately enacting one of the nation's most far-reaching health insurance
plans, but the universal health care proposal still had strong support Friday.
For lawmakers, it was less a matter of it would go into effect than when. The Senate voted 20-14 Friday, falling short of the
two-thirds majority needed for the legislation to go into effect without delay.
The House voted 95-46 Thursday, also short of the two-thirds vote. However, both votes showed strong
support for the plan. Lawmakers
could try to vote again. They also have the option of altering the legislation
to require only a simple majority vote for the plan to pass. If that happens
and the plan wins approval, it would go into effect 90 days after lawmakers
adjourn. First-year Democratic
Gov. John Baldacci has already endorsed the plan, which would create a
quasi-public agency to help people secure medical coverage through private
insurers. Under
it, all 180,000 people in Maine who cannot otherwise afford health care
coverage would have access to it by the year 2009. Participants
would be charged subsidized
premiums
that would vary according to their ability to pay and the amount of coverage
purchased. Funding would come from a patchwork of
sources,
including a tax on insurance companies and $80 million the state expects to
save each year by eliminating
unreimbursed medical costs run up by uninsured people. Although the proposal enjoyed bipartisan support, critics
portrayed the program as untried and doomed to failure. ``This bill is illusion and promise not
fulfilled,'' Assistant House Minority Leader David Bowles, a Republican. ``This
bill is not the right thing.'' Arthur
Levin, director of the New York-based Center for Medical Consumers, said Maine
was ahead of other states in its efforts to reform health care. ``In the absence of the feds not moving
in the right direction, it falls to the states to pick up the pieces,'' he
said. Maine's
move toward universal coverage is unusual in a year when most states are simply trying to
hold onto the coverage they have, said Donna Folkemer of the National
Conference of State Legislatures.
The
legislation aims to hold down the runaway costs of medical care with voluntary
price caps for providers, hospitals and insurers, and a limit on non-hospital
outpatient procedures. Maine
also has a program called Maine Rx to use its buying power to force drug companies to offer
bulk discounts on prescription drugs for the elderly, the working poor and
others who have trouble paying for their medicine. Maine Rx was upheld by the U.S. Supreme Court last
month. The U.S. Senate has scheduled debate next week on
legislation providing prescription drug coverage for millions of Medicare
recipients, and House Republicans have proposed a similar bill. If approved,
the changes would be the most far-reaching to the program since it was created
in 1965. Governors' Effort to Revise
Medicaid Stalls By Ceci Connolly, Washington Post
Staff Writer, Friday, June 13, 2003; Page A04 Five Republican
governors working with their Democratic counterparts on a plan to revamp Medicaid
conceded yesterday the bipartisan effort has failed and said they instead hope
to strike a deal with the Bush administration. Just 10 days ago,
governors and their aides optimistically declared they were on the verge of an
agreement to refashion the health insurance program for 44 million low-income
Americans. The compromise unraveled, both sides say, after aggressive lobbying
by Democratic senators who oppose the changes. The breakdown could
complicate efforts by the administration to rein in Medicaid spending -- by
moving recipients into managed-care programs, charging higher co-payments and
putting a cap on federal payments. Administration officials had hoped that if
governors of both parties crafted the legislation, Congress would be more
inclined to adopt it. Thomas A. Scully,
who oversees the Medicaid and Medicare programs for the administration, said
bipartisan support from the governors was critical. "If they don't want to
do it," he said recently, "it's not going to happen." Now it appears that any Medicaid bill
is destined for sharp partisan debate -- or indefinite postponement. Hours after the GOP
governors sent a three-and-a-half page letter to Health and Human Services
Secretary Tommy G. Thompson outlining their principles, Democrats countered
with their own statement. Both documents, cloaked in the diplomacy of
legislative language, nevertheless revealed the bitter frustration on both
sides. "It is unfortunate that with
health coverage for millions at risk -- with virtually every state making
wholesale cuts in Medicaid benefits and populations -- that some would choose
to forfeit an opportunity to protect health care for our neediest populations," the Republicans wrote. "We offered to
continue working with our Republican colleagues," the five Democrats said.
"Unfortunately, their higher priority was to write to" Thompson "recommending enactment of a
one-size-fits-all federal block grant." Medicaid, the nation's
largest public insurance program, is run jointly by states and the federal
government. Rising health care costs, coupled with the sluggish economy, have
made it increasingly difficult for states to cover their share of the bill. The
two sides split over whether the Medicaid financing system should be changed
from the current entitlement program, which guarantees money to cover everyone
eligible for care, to a block grant approach that would limit the federal
payments. Republicans, led by Florida Gov. Jeb Bush, told Thompson they support the administration's desire to
switch to a block grant, which the White House has dubbed an
"allotment." Democrats, led by Sen. Edward M. Kennedy
(Mass.),
waged an attack on the
White House approach and persuaded Iowa
Gov. Tom Vilsack (D) to
back away from the negotiations. At a meeting last week, Kennedy urged
colleagues to telephone their governors to oppose a block grant; he called a
half-dozen himself, his spokesman Jim Manley confirmed. In an interview,
Vilsack said Democrats quit the talks when it became clear Republican governors
"could not deliver a promise from Congress or the administration"
that the federal government would pick up the costs of caring for individuals
who are eligible for both Medicaid and Medicare. Ron Pollack, executive
director of Families
USA, a liberal
consumer group that opposes the GOP plan, predicted Medicaid legislation will
not progress this year.
"This is a huge
victory that prevents the largest Medicaid cutback in history, offering a
welcome reprieve" for millions of low-income people, he said. HHS spokesman Bill
Pierce, however, said Thompson
is not ready to give up. "With the actions many states are taking, include cutting
spending on Medicaid, this is just more evidence of why we need to continue try
to come to agreement," he said. http://www.washingtonpost.com/wp-dyn/articles/A52415-2003Jun12.html |
