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A new healthcare reform bill in Pennsylvania has been approved by the state House of Representatives and is now headed to the state Senate for consideration.

The bill would create the Pennsylvania Access to Basic Care (ABC) program, which would allow any resident to purchase state-subsidized health insurance from the state. Residents would be able to buy coverage on a first-come, first-serve basis, wrote the Pittsburgh Tribune-Review.

Small business owners would also be able to provide their workers with health insurance through the ABC plan. But only businesses that have not offered insurance for six months or more qualify. The bill also provides tax credits to employers with private group coverage.

In its first year of operation, state estimates predict the ABC program will cost $501 million by the end of fiscal year 2009, which is at the end of September 2009. The program is also expected to cost $1.4 billion by 2018.

Funding for the ABC plan will come from current state programs, the state’s tobacco fund, and increased tobacco taxes.

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UPDATE: The Senate rejected the bill to include wind insurance coverage in a vote of 73 to 19.

In the beginning of this year, the National Flood Insurance Program was reauthorized by the U.S. Senate.

The flood program was created in 1968, and lets home and business owners buy flood coverage from the federal government if they are in areas with high flood risk.

Now, lawmakers are considering adding insurance coverage for wind damage as an amendment to the 40-year old flood program.

“Catastrophic coverage in the event of a hurricane should be seamless. Property owners shouldn’t have to go to court to fight over whether it was wind or water that destroyed their home or business,” said U.S. Senator Roger Wicker.

Private insurance companies voiced concerns that adding wind insurance would mean competition from the federal government. The chairman of the Senate Banking, Housing and Urban Affairs Committee, Senators Christopher Dodd and Richard Shelby agreed.

The White House has also indicated that the amendment would be vetoed.

But the amendment — already approved by the U.S. House of Representatives — is schedule to soon go the Senate floor for a vote.

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Even though California Governor Arnold Schwarzenegger’s previous plan for universal healthcare failed in a state Senate committee, he’s vowed to keep trying.

In an interview, Governor Schwarzenegger said that he had an obligation to bring universal coverage for California residents, and he’s currently working on another plan, reported the Associated Press and The San Jose Mercury News.

The governor’s second effort is partly being driven by a recent poll finding that almost 75 percent of residents in California support universal healthcare.

For the new plan, there won’t be any drastic changes.

“Now we’ll try again. We will continue on, keeping the stakeholders together, fine-tuning it and seeing if we can improve on it since we have the time now, then be back again,” said Governor Schwarzenegger.

State lawmakers previously blasted the plan for being too expensive, especially during the state’s budget deficits.

But nothing seems to be deterring the governor from trying again.

“One has the responsibility to use all your energy, and in my case all the other things I bring, to get it done. That’s my commitment I made to the people,” added Governor Schwarzenegger.

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Steve Poizner, California’s Insurance Commissioner, is proposing regulations that would require insurance companies to report premium trends over the previous six years, wrote the Los Angeles Times.

The proposal would change a current rule that requires carriers to report premiums in the last three years.

If implemented, the new rules would juggle the formulas that companies use to set insurance premiums — which would result in lower rates for policyholders, promises Poizner. The rules would affect homeowners and auto insurance.

Not everyone thinks the changes will help lower premiums. One consumer advocate contends that having more extensive premium trend reports could actually hurt policyholders. With more data, insurance companies could argue for premium increases.

The new rules don’t require approval from state Legislature — they only need to the go-ahead from California’s Office of Administrative Law.

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The Maryland General Assembly recently approved broad budget expansions for low-income children’s dental care.

Even in the midst of big spending cuts by the state, the Assembly decided to include millions of dollars in additional state funds to expand dental care, reported the Washington Post.

Part of the reason dental care access for low-income residents is limited is due to low reimbursements for Medicaid patients. Maryland has one of the lowest Medicaid reimbursement rates in the country. Many dentists refuse to accept anyone with Medicaid coverage.

To combat this problem, the budget expansion will incrementally increase dentists’ payments for patients with Medicaid. Along with federal funds, there will be a total of $42 million extra in the budget for Medicaid reimbursements.

Some of the state’s new budget will also help public health clinics provide dental care and create dental programs for students.

In addition to these spending increases, another bill will allow public health hygienists to administer preventive dental care — including cleanings, fluoride treatments, and sealants — without the approval of a dentist.

This will help increase the number of health care professionals that can provide routine dental care.

“It’s just a [better] time and cost-effective mechanism for getting treatment to kids who are underserved,” said Leigh Stevenson Cobb, the health policy director of the Advocates for Children and Youth.

The whole reform plan is in the works, and will soon be implemented.

“Everything we asked for, we got,” said Harry Goodman, from the Maryland state Department of Health and Mental Hygiene.

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Virginia lawmakers, Governor Timothy Kaine, and a charity healthcare organization are teaming up to offer low-income residents working in small businesses health insurance.

The program subsidize one-third of an employee’s health plan premiums. The employer and the worker will be responsible for the rest. The subsidies will be targeted at those working in small businesses who earn less than 200 percent of the federal poverty level.

“We are really excited about this. It’s targeted to help the working uninsured,” said Marilyn B. Tavenner, the state Secretary of Health and Human Resources.

This new program will be funded by the state and the healthcare charity, the Riverside Foundation.

Governor Kaine has allotted $500,000 over two years for the program and the Riverside Foundation kicked in $1 million, reported the Newport News Daily Press.

“It looks like it could be a win-win situation, where we actually expand public-private partnerships and we provide incentives, so that maybe some small businesses can provide health-insurance coverage to people who are currently uninsured,” said state Delegate Phil Hamilton.

The program is scheduled to start in July.

“I wholeheartedly endorse the project,” added Delegate Hamilton.

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Florida Governor Charlie Crist is traveling around the state to promote his new healthcare plan. His proposal, which he introduced in February, would get rid of state mandates requiring insurance companies to cover certain healthcare services, reported Miami Herald.

Mandates drive premiums up, and Governor Crist’s proposal would help make certain plans much more affordable. The cheaper plans would be directed at employers and employees in small businesses, but anyone might be able to get more affordable coverage under Crist’s proposal.

Crist warns the new plans won’t provide the most comprehensive coverage. These plans would instead offer more basic benefits — including coverage for doctor’s office visits, inpatient and outpatient care, and emergency care.

“That’s not a Cadillac-type of plan. But at least it’s a plan that covers a lot of different types of concerns that cause worry,” explained Governor Crist.

The state Senate is expected to approve Crist’s proposal later this week.

In the state House of Representatives, they’re pushing their own healthcare bill to set up a public/private corporation which will offer non-mandated coverage for small business workers.

The House bill also allows children to stay on their parents’ plan until age 30, and makes it easier for low-income residents to become eligible for some state healthcare programs.

Governor Crist is strongly promoting these new healthcare bills, and expect them it to be passed within a month.

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Maine Governor John Baldacci is considering his options to revive the DirigoChoice healthcare program to provide coverage for uninsured residents. The program is in financial despair after unexpectedly high costs.

To ward off costs, Governor Baldacci is considering two separate kinds of tax increases to provide more funding for DirigoChoice.

The first would increase cigarette taxes by 50 cents statewide and a tax increase on other tobacco products. The other would up taxes for medical claims paid by private health insurance companies, reported the Bangor Daily News.

Democratic lawmakers are backing the idea of increasing funding for the health care program.

Critics of the DirigoChoice argue the program was flawed from the start and should be dismantled. State Senate Minority Leader Carol Weston pointed out DirigoChoice had five years to prove itself, but didn’t succeed.

Senator Weston also was opposed to raising taxes with a sluggish economy and state budget shortfalls.

“This is a bad time for any legislator to be talking about raising taxes,” said Senator Weston.

But advocates of the program still want to try to revive the health care program for low-income residents — and most Democratic lawmakers in Maine are in support.

“This is a fight worth having, for a program that is making a difference in people’s lives,” said Governor Baldacci.

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Four U.S. Senators recently introduced a bipartisan bill that would provide health insurance tax relief for small businesses and the self-employed.

Senators Dick Durbin, Olympia Snowe, Norm Coleman, and Blanche Lincoln all worked together to create the legislation.

The bill would give small businesses a $1,000 tax credit per employee if they pay for at least 60 percent of premiums. If an employee has family coverage, employers get $2,000.

Some states have small business health insurance pools, where private insurance companies are required to provide coverage.

The measure prohibits insurers from excluding pre-existing conditions, denying coverage, refusing coverage renewal, and considering health status in these pools, wrote a New York Times blog.

People who are self-employed also would get tax relief — $1,800 in tax credits if enrolled in an individual plan and $3,600 if they have a family plan. Self-employed workers would also be able to purchase health insurance from a small business pool.

The bill now has to work its way through the U.S. Senate. But because of higher priorities, the measure isn’t expected to come to a final vote until the end of the year.

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Three new bills from Colorado lawmakers were recently introduced all in an effort to put stricter regulations on health insurance companies.

The first bill, proposed by state House Speaker Andrew Romanoff and Senate Majority Leader Ken Gordon, would require insurers to pay claims without hassle, reported the Denver Post.

Speaker Romanoff argued that insurance companies force some policyholders through a difficult process to get claims paid.

Critics of Romanoff’s bill contend there are already such laws in place.

“It seems to me we’ve got some pretty robust protections in law already, both for providers and for consumers,” said Michael Huotari, executive director of the Colorado Association of Health Plans.

A second bill recently passed in the state House would give the state’s insurance commissioner the authority to more strictly punish insurance companies for dishonest business practices. This measure was designed by Senator Gordon and state Representative Gwyn Green.

The third and most controversial bill was introduced by state Representative Morgan Carroll. This measure would give the state power to reject increases in premiums by insurers.

Representative Carroll supported her bill arguing premiums have gone up 60 percent over a span of five years — when wages only went up 13 percent.

But some healthcare experts point out that health insurance costs are driven by health care costs. Insurance rates, they contend, would decrease if costs of care were controlled.

“It’s the right problem but the wrong solution. Insurance premiums are high, and they have been increasing because healthcare costs are high and increasing,” said Huotari.

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Florida legislators are considering a bill that would increase the state’s cigarette tax to $1.34 per pack. The increase would up the current 34-cent Florida cigarette tax one dollar.

If cigarette taxes are increased, it would create $1 billion in revenue for the state government. Lawmakers have indicated that most of the funding would go toward Florida’s KidCare Plan for uninsured children.

The rest of the money would go into Florida’s general revenue fund, reported the Tallahassee Sun-Sentinel.

Other positive effects of the tax, argue the bill’s advocates, include helping the fight against teenage smoking and reducing healthcare costs related to smoking.

“Every time a state has increased the tobacco tax, smoking rates have dropped. There’s no question it’ll save lives,” said Don Webster, the CEO of the American Cancer Society in Florida.

Polls have shown state voters are largely in favor of cigarette tax increase — one poll showed 79 percent support. Another interesting poll found that 71 percent of Florida residents thought cigarette taxes were actually too low. The Sunshine State has the sixth-lowest cigarette tax in the U.S.

So far, the tax increase has bipartisan support, but some Republican lawmakers are still wary.

Republican Governor Charlie Christ has said he is not in favor of raising cigarette taxes. House Speaker Marco Rubio also expressed concern that the tax was intended to pull the state out of its $3 billion budget deficit.

“Smoking, eating too much and not exercising enough is costing us trillions of dollars at the federal level in healthcare. But I don’t think it’s a way to balance our budget. The more you tax something, the less of it you’re going to get,” reasoned the Republican House speaker.

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Democrats in the Michigan House of Representatives recently introduced a bill that would put more heavy restrictions on auto insurance companies to ease rates for state drivers.

The first provision of the bill would not allow companies to set auto insurance rates based on credit score, reported the Associated Press and Forbes New York. State lawmakers argue that rates should be set solely on driving record.

The new measure would also give more power to the state’s insurance commissioner. Any rate increases would have to be approved. If rates were determined to be unfair, insurers would be forced to refund their premiums.

“We need to rewrite Michigan [auto insurance] law so it protects consumers,” said state Representative Bettie Cook Scott.

But insurance companies in the state oppose the bill. They say the provisions could actually hurt consumers.

Insurers point out that good credit scores offer more than two-thirds of the state’s policyholders nice discounts.

Because the legislation also makes it easier to sue insurance companies, the costs for an increased number of lawsuits would be eventually passed to the policyholders.

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Health insurance companies are starting to promote a practice that is known as “medical tourism,” or traveling overseas to get medical care. Why? Because health care costs for many procedures are fractions of the cost of the same procedures in the United States.

For example, a heart procedure costing $100,000 in the U.S. may cost less than $20,000 in some Asian countries.

Because of these reduced costs, insurance companies are offering some big incentives for policyholders when they travel overseas for medical treatment.

For a patient’s medical travels, insurers are waiving copayments and deductibles, paying for traveling costs, and on top of all that, giving cash incentives, reported BusinessWeek.

There are some possible drawbacks to medical tourism. Some worry insurance companies will raise deductibles and copayments for procedures that are less expensive outside the country. It is also very difficult for patients to sue doctors in other countries for medical malpractice.

Another concern of foreign health care facilities is the quality of care. But they are accredited by the same non-profit organization that rates American facilities, the BusinessWeek article wrote.

“Medical travel is going to be part of the solution [of stopping rising health care costs],” said David Boucher, assistant vice president of healthcare services at Blue Cross and Blue Shield of South Carolina.

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Costs are skyrocketing in Massachusetts. From 2002 to 2006, spending on healthcare has gone up 33 percent to $62.1 billion every year, reported the Boston Globe.

Now lawmakers and health care experts are looking for any solutions to reduce state health care spending.

One big change would be to overhaul the way doctors are paid. The new system, supported by health officials, would pay doctors and hospitals on the services treated. It would also stop paying for “botched treatment” and increase payments for care improvements, wrote the Globe.

The bill, proposed by State Senate Majority Leader Therese Murray, would also cut costs by requiring health care providers to switch to electronic records in eight years, and ban gifts to doctors by drug companies.

It would also require any rate increase over 7 percent be subject to a public hearing.

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Over the last month, roughly 24,000 children in Texas signed up for the state's Children's Health Insurance Program (SCHIP), reported the Associated Press and the Houston Chronicle.

It was a 7 percent surge in the number of children enrolled in SCHIP, and brings the total number of kids covered to 382,000.

State officials said the increased enrollment is because of recent legislation that extended the children's insurance program for six months to a year, wrote the AP.

The new law also makes it easier for parents to get their children covered under SCHIP — they no longer have to prove income with pay stubs and submit other information.

While more children are getting SCHIP coverage, fewer children are signing on to Medicaid. In fact, around 13,000 children lost their Medicaid coverage since February. Experts are guessing the reduced enrollment in Medicaid is due to a poorly organized program.

Some children's Medicaid applications don't get processed for months.

The AP article also reported that the caseloads and applicants for state workers have significantly increased since 2002.

"The vast majority of [children's Medicaid] applications are processed as they have been for years — in state offices by state workers. We are still struggling with workload issues in our offices," said Anne Dunkelberg, who works at the Center for Public Policy Priorities.

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