• TennCare may curtail coverage to reduce costs, By Chas Sisk, November 19, 2009, The Tenneseean: “People covered by TennCare may face new limits on their coverage and reductions in their benefits next year, under a plan unveiled Wednesday to help slice state spending. TennCare officials said that they could impose a new $10,000 annual cap on hospital coverage for the 1.2 million state residents enrolled in the program…”
• NM considers scaling back Medicaid coverage, By Barry Massey (AP), November 20, 2009, Las Cruces Sun-News: “Gov. Bill Richardson’s administration is proposing to overhaul Medicaid and scale back health care services to some lower-income New Mexicans to cope with a projected budget shortfall of $300 million next year in the state’s largest health care program. Human Services Department officials told lawmakers on Thursday that Medicaid benefits and eligibility likely would be limited to minimum federal requirements, such as covering low-income pregnant woman and some children. A package of health care services would be available to other needy individuals-currently covered by Medicaid because the state has expanded eligibility-but they would need to pay premiums and copays. Those fees would vary based on income. The effort to trim Medicaid comes at a difficult financial time. The state faces a half billion budget shortfall next year…”

With aid, Mass. poor cut smoking, By Stephen Smith, November 18, 2009, Boston Globe: “Lower income Massachusetts smokers have dramatically abandoned their habit amid a major state campaign that vigorously promotes and pays for tobacco addiction treatment, according to a report scheduled to be released this morning. Smoking rates among the poor plummeted 26 percent in the first two years of the ongoing state program, a striking result that is already drawing national attention to the effort. Officials targeted a population that historically had the highest smoking rates in Massachusetts. The study, issued by the Department of Public Health, found early indications that the tobacco cessation efforts - aimed at patients enrolled in the state’s medical insurance for the poor, MassHealth - are reaping immediate health benefits…”

• Uninsured trauma patients are much more likely to die, By Karen Kaplan, November 17, 2009, Los Angeles Times: “Patients who lack health insurance are more likely to die from car accidents and other traumatic injuries than people who belong to a health plan — even though emergency rooms are required to care for all comers regardless of ability to pay, according to a study published today. An analysis of 687,091 patients who visited trauma centers nationwide from 2002 to 2006 found that the odds of dying from injuries were almost twice as high for the uninsured than for patients with private insurance, researchers reported in Archives of Surgery. Trauma physicians said they were surprised by the findings, even though a slew of studies had previously documented the ill effects of going without health coverage. Uninsured patients are less likely to be screened for certain cancers or to be admitted to specialty hospitals for procedures such as heart bypass surgery. Overall, about 18,000 deaths each year have been traced to a lack of health insurance…”
• Study: Injured uninsured more likely to die in ER, By Carla K. Johnson (AP), November 16, 2009, Idaho Statesman: “Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study. The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable. ‘This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States,’ said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist…”

House health bill includes Medicaid relief for states, By Aaron C. Davis, November 16, 2009, Washington Post: “Wedged in the House health-care bill is $23.5 billion that looks a lot more like new federal stimulus spending than anything to do with national health-care reform. The barely debated pot of money would allow Congress to continue pumping billions in new short-term aid to states to cover Medicaid costs that have increased with rising unemployment in the past year. The potential impact of the new spending became clear last week when giddy state budget officials in capitals from Annapolis to Sacramento penciled in the revenue, hoping that if health-care legislation survives in the Senate, the states’ bonus might squeak through. Medicaid relief for states comprised one of the biggest pieces of February’s $787 billion federal stimulus package, but that funding will run out next year, halfway through states’ next round of spending plans…”

• State pushed to restore dental aid, By Kim Kozlowski, November 16, 2009, Detroit News: “Advocates for the disabled, poor and elderly say the state needs to restore Medicaid dental benefits before more people suffer or another person dies. ‘We’ve got to start to thinking about these policy decisions and how they affect real lives, not just what they represent in budget numbers,’ said Sharon Parks, president and CEO of the Michigan League for Human Services. Gov. Jennifer Granholm eliminated dental benefits to adults in July to help shore up the $1.3 billion deficit in last year’s budget. They weren’t restored in this year’s budget, so only emergency dental work is now paid for by Michigan’s Medicaid program, even though advocates argue that dental care is essential to good health. Before the cut, the program paid for routine exams and fillings. Research has shown that dental services are essential to good health…”
• Planned Medicaid cuts hit dental, home care, By Kay Lazar, November 14, 2009, Boston Globe: “More than a million low-income Massachusetts residents covered by Medicaid would be required to pay more for visits to certain doctors and receive prior approval for some expensive psychiatric medications under a plan announced yesterday by the Patrick administration to narrow a $307 million shortfall in the state’s MassHealth program. Some of the biggest changes are in dental care for adults, who would no longer receive dentures or other oral care except for cleanings, X-rays, and emergency services…”

• Swine flu: Without paid sick leave, workers won’t stay home, By Patrik Jonsson, November 8, 2009, Christian Science Monitor: “Nearly half of all American workers do not have paid sick leave, and half of these are more likely to go to work feeling unwell - or send an ill child to school - rather than take an unpaid day off. These findings threaten to undermine President Obama’s effort to have anyone exhibiting swine-flu-like symptoms stay at home for as many as four days. The emphasis on prevention and individual responsibility is a welcome departure from the punitive government actions - such as quarantines and forced vaccinations - called for under previous pandemic-response plans, some health experts say. But for the 48 percent of Americans without paid sick leave, the policy presents a choice between two equally undesirable options: stay at home and lose money or go to work despite government exhortations not to. Businesses, too, say the situation leads to so-called ‘presenteeism,’ or the act of going to work while unwell, costing the economy $180 million a year, by one estimate…”
• Lawmakers call for emergency sick-leave requirement, By Joe Markman, November 11, 2009, Los Angeles Times: “Against the backdrop of the H1N1 flu pandemic, congressional Democrats are pushing for emergency sick-leave legislation and using the crisis to garner support for a wider-ranging bill — both of which, they say, would help prevent a more rapid spread of the virus by mandating that employers provide workers with paid time off. Sen. Christopher J. Dodd (D-Conn.), chairing a health subcommittee hearing Tuesday, said that requiring businesses with 15 or more employees to offer seven paid days off a year would end a dangerous choice ‘between staying healthy and making ends meet.’ But some conservatives argue that Democrats are using a public health crisis as momentum for faulty legislation that would harm businesses by inviting abuse by workers…”

Aid freeze in post-coup Honduras hurting poor, By Robin Emmott, November 12, 2009, Washington Post: “Poor Hondurans are going hungry and their sick children cannot obtain medicines as donors cut aid to the country following a June coup that deposed President Manuel Zelaya, doctors and aid workers say. Soup kitchens have closed, medicines have become scarce, foreign doctors have canceled trips to Honduras and funding for the poor to run small businesses have dried up, increasing unemployment. With Honduras already suffering from the global economic crisis, international development banks, the European Union and Venezuelan President Hugo Chavez, a close Zelaya ally, froze donor programs after the army-backed coup on June 28…”

• State’s poor being shifted to different medical plan, By Chen May Yee, November 10, 2009, Minneapolis-St. Paul Star-Tribune: “The Pawlenty administration, which faced criticism for proposing to eliminate a state health-care program for the indigent, has decided to transfer most of those recipients to a subsidized insurance plan for the working poor. The General Assistance Medical Care (GAMC) program for adults making less than $7,800 a year is scheduled to go away March 1, potentially leaving some 36,000 recipients — many with chronic illnesses and often homeless and mentally ill — without regular access to medical care. Now some 28,000 will be automatically enrolled in MinnesotaCare, a subsidized health insurance plan. The remainder are those whose GAMC eligibility is running out or who already are applying for MinnesotaCare…”
• More Alaska Medicaid kids may get braces, Associated Press, November 10, 2009, Fairbanks Daily News-Miner: “The state of Alaska must pay for braces on the teeth of foster children and young people on Medicaid who need them, a Superior Court judge ruled Monday. Judge William Morse issued an order in a lawsuit brought by an advocacy group for foster children called Facing Foster Care in Alaska. He granted a preliminary injunction against a state rule that limits braces to severe conditions such as cleft palate. The state argued that Facing Foster Care does not have the right to bring a lawsuit. Morse disagreed and ruled the state cannot use its own regulations to limit services that are required by federal code. The braces still have to be medically necessary - not just for the sake of appearance…”
• KidCare numbers drop; Medicaid kids rise, By Bill McCarthy, November 9, 2009, Wyoming Tribune Eagle: “The number of children on Wyoming Kid Care CHIP is declining, but the number of children on Medicaid is going up. Bob Peck, chief financial officer for the Wyoming Department of Health, said one explanation could be that parents are losing their jobs. Formerly working parents who had their children on the Kid Care program for child health insurance may be having to enroll their families directly into Medicaid, he said…”

Computer issues cause Medicaid payment lags, By Patricia Anstett, November 5, 2009, Detroit Free Press: “Dozens of Michigan nursing homes, hospices, dental offices and hospitals have encountered problems with two new state Medicaid computer programs, including payment errors, lengthy reimbursement lags and delays enrolling patients in the Medicaid program. The problems coincide with large increases in people applying for Medicaid, a program that serves 1.8 million low-income Michigan children and adults…”

Hospitals cite worry on fees in health bill, By Anemona Hartocollis, November 2, 2009, New York Times: “As Congress struggles to rein in health care costs as part of its sweeping reform efforts, hospitals in New York City and other urban areas that provide some of the most expensive care are among the primary targets. The issue pits hospitals in more rural states like Iowa and Minnesota, where spending tends to be lower, against those in areas like New York and Los Angeles, and revolves around a question that has bedeviled the medical establishment for decades: How much money do hospitals need to provide adequate care for patients, especially poor people who have not had regular access to health care…”

Wisconsin failing to approve Medicaid and food stamps applications in timely manner, By Jason Stein, November 2, 2009, Wisconsin State Journal: “Socked by tens of thousands of childless adults applying for a new state health plan, Wisconsin is failing to meet requirements in federal law for timely approvals of applications for both the Medicaid health coverage and food stamps. Since June 15, more than two-thirds of childless applicants with virtually no income - the highest priority cases - haven’t received food stamps within the federally required seven days, state figures show. Nearly two-thirds of all the childless adults seeking food stamps haven’t received them within the required 30 days. The same process is used to check whether applicants are eligible for both Medicaid and the federal FoodShare, or food stamps, program. Officials from the state Department of Health Services met Monday with federal officials to brief them on the delays and said they would seek to resolve the most pressing backlogged food stamp cases by the end of this week…”

Ky. increases number of kids in health programs, By Beth Musgrave, November 3, 2009, Lexington Herald-Leader: “State officials said Monday that they are on target to enroll 35,000 children in two key public health programs by the end of 2009, six months ahead of schedule. In November 2008, Gov. Steve Beshear pledged to increase the number of children in Kentucky Children’s Health Insurance Program or Medicaid programs by decreasing some of the road blocks to the government health insurance program for low-income families. Currently, there are 32,000 new children enrolled in the two programs, Beshear said at a press conference Monday at Second Street School in Frankfort. But both programs combined have enrolled on average 2,600 children a month. Current rates indicate that the Cabinet for Health and Family Services, which oversees the health insurance programs, will meet the 35,000 goal by December instead of June 2010, as originally projected…”

• Medicaid plan draws fire, By Marsha Shuler, Baton Rouge Advocate: “A state health agency proposal to scale back rates paid to Medicaid providers drew opposition Monday from nursing home and hospital interests. State Department of Health and Hospitals Undersecretary Charles Castille said reducing the rates to the levels they were three years ago would lower spending by $232 million. The program grew $1 billion in one year and now costs more than $6 billion. State Treasurer John Kennedy, the chairman of a Commission on Streamlining Government advisory group, said cutting the budget across the board, such as this one, is not the way to go. Kennedy asked DHH officials to instead consider prioritizing spending for Medicaid, the health insurance program for the poor…”
• Analysis: Missouri finally produces Medicaid report, By David A. Lieb (AP), St. Louis Post-Dispatch: “After claiming for more than a year that it could not do so, the Missouri Department of Social Services finally has obeyed a state law and published a list of employers whose workers get government-funded Medicaid health care coverage. Yet compliance with the Medicaid reporting law may be only an experiment. Although the list is supposed to be published quarterly, the department says there’s no telling when it will produce the report again. As lawmakers in Washington, D.C., debate a national health-care overhaul, Missouri’s experience shows how slow and difficult it can be for bureaucracies to implement even incremental changes in the health care system. Missouri was one of several states to mandate employer-Medicaid reports in recent years as a way to gauge the extent to which government was picking up the slack for businesses that either didn’t offer their employees affordable health insurance or paid them so little that they qualified for Medicaid…”

• Medicaid, S-CHIP expansion plan could hurt states’ budgets, By Richard Wolf, October 18, 2009, USA Today: “The government programs that provide health care to the poor would expand to cover nearly one in five Americans under health insurance legislation pending in Congress, putting pressure on federal and state budgets. Medicaid, one of the fastest-growing government programs for two decades, and the State Children’s Health Insurance Program would grow from about 50 million people today to more than 60 million in 2019, according to data from the Congressional Budget Office and Kaiser Family Foundation. That would be the biggest single expansion since Medicaid was created in 1965…”
• Medicaid expansion brings pro, con reactions, By Emily Bregel, October 19, 2009, Chattanooga Times Free Press: “Local physicians said health care reform proposals to expand Medicaid coverage drastically, while well-intentioned, are likely unsustainable. ‘Where is the money going to come from to make this happen?’ said Dr. Mack Worthington, a family practice physician in Chattanooga who said almost one-quarter of his patients are on TennCare. ‘I’m all for increasing access, but I just wonder how it’s going to be funded.’ The U.S. Senate Finance Committee last week passed a health reform proposal that would expand Medicaid programs to anyone who earns up to 133 percent of the poverty level, or about $29,000 a year for a family of four…”
• Uninsured & overwhelmed, By Ben Piper, October 18, 2009, Hattiesburg American: “Casey Little finds herself in a health care predicament. Little, 25, of Seminary needs health insurance to be able to afford treatments that could relieve the pain she suffers from fibromyalgia. But the nerve disorder has left her constantly hurting, unable to work - and unable to get insurance…”
• Pressure mounts: 12,000 caught in a backlog, By Andra Bryan Stefanoni, October 19, 2009, Joplin Globe: “When Candice Sinclair was nearing the end of her pregnancy, she applied for Medicaid to cover her expenses and those of her soon-to-be-born son, Jake. That was in June. Their applications still haven’t been processed, meaning Sinclair is left without means to pay an estimated $5,000 hospital bill, and for Jake’s first year of immunizations and checkups…”
• Kansas has backlog of 12,000 Medicaid applications, Associated Press, October 19, 2009, Kansas City Star: “Rising unemployment, the swelling ranks of the uninsured, outdated technology and the state’s budget problems have led to a backlog of 12,000 Medicaid applications in Kansas, health officials said. A contractor that processes applications for the Kansas Health Policy Authority is supposed to complete them in two to six weeks, but has taken up to four months in some cases…”
• Lessons from the Massachusetts healthcare experiment, By James Oliphant and Kim Geiger, October 17, 2009, Los Angeles Times: “Three years ago, Massachusetts passed the most sweeping healthcare bill in the country, adopting a plan that closely resembles the proposals being considered by Congress. It is a plan that now offers powerful lessons for the whole nation. The state’s system, like the proposals moving toward votes in the House and Senate, focused on three goals: making medical insurance almost universal, fostering competition through a regulated insurance exchange, and helping low-income workers pay for coverage. Today, Massachusetts leads the nation with 96% of its residents covered by insurance — an even larger share than some of the plans before Congress would cover. The employer-based insurance system remains intact despite fears that the state’s healthcare overhaul might cause companies to pull back…”

Inner-city L.A. hungers for good grocery stores, By Daniel B. Wood, October 10, 2009, Christian Science Monitor: “East L.A. resident Olga Perez has to take two buses to a store about eight miles away to get fresh fruits and vegetables, or decent cuts of meat, for her family. ‘The only thing I can get at my corner store are spoiled or expired,’ explains Ms. Perez, a dental assistant and single mother who lives in a two-bedroom apartment with two daughters and a granddaughter. The round trip costs her $5 and limits what she can carry home. ‘I can only get so much milk and when I get home the eggs are cracked and the bread is smashed,’ she says. And because she works until 6:30 p.m. most nights, Perez doesn’t often have the time to make the trip and get home in time to cook for her family. Her solution: ‘Open a can of ravioli or make hot dogs,’ but that sometimes keeps her daughter and granddaughter up at night, complaining of insomnia and stomach aches. It’s a situation the Alliance for Healthy and Responsible Grocery Stores, a city-wide coalition of 25 community, faith-based and environmental organizations, is trying to change. They formed a Blue Ribbon Commission in early 2007 to address the chronic absence of quality grocery stores in several L.A. neighborhoods including East L.A. and South Central - and are now trying to draw such stores to these underserved areas…”

From healthy kids to healthy adults, By Megha Satyanarayana, October 12, 2009, Detroit Free Press: “Jamel Bomer of Redford Township, a Westin Book Cadillac valet, is the father of a 1-year-old on Medicaid. ‘He can go to any doctor that accepts it,’ Bomer said of son Ryan. ‘Without it, we wouldn’t be able to provide him care.’ Even with publicly funded Medicaid, which many doctors don’t take, Bomer and his fiancée are working off a $230 bill for the part of Ryan’s birth that wasn’t covered on Bomer’s $5.15 per hour plus tips. ‘Our income is tight to the penny.’ Although Ryan is covered, neither Bomer nor his fiancée, a TV news intern, have insurance. While Congress and the president debate over comprehensive health care reform, local and national experts say making sure all children have coverage now will mean they have a better chance of growing into healthy adults who will be less of a burden on the health care system…”

• Proposed Medicaid expansion could heap big costs on cash-poor California, By Mike Zapler, October 12, 2009, San Jose Mercury News: “An expansion of Medicaid contemplated by health care reformers in Congress may be good news for the uninsured, but it could be a bitter pill for cash-strapped California that would cost the state hundreds of millions of dollars it doesn’t have. President Barack Obama and Democrats in Congress want to use Medicaid as one of the main vehicles for extending health insurance to many of the 46 million Americans who lack coverage. But because Medicaid costs are split between the federal and state governments, California officials fear that this change would saddle California with a costly mandate at a time when the state can’t afford its existing Medicaid program, called Medi-Cal…”
• Lynch wary of Medicaid reform cost, By Daniel Barrick, October 12, 2009, Concord Monitor: “Gov. John Lynch is one of several governors raising concerns about the health care reform proposals being debated in Congress. Specifically, Lynch is worried that a plan to expand Medicaid, the government-run insurance program for the poor and elderly, will saddle state budgets with hefty costs. Pam Walsh, Lynch’s deputy chief of staff, said the governor supports the larger goal of expanding health care coverage, but he doesn’t think states should be stuck with the bill…”
• Medicaid keeps stretching, By Catherine Candisky, October 11, 2009, Columbus Dispatch: “The recession and continuing job losses are pushing Medicaid enrollment and spending to record levels, raising concerns about how Ohio will continue to meet the soaring demand. Every month, 10,000 to 15,000 Ohioans join the Medicaid rolls, most after losing their job and the employer-provided health insurance that came with it. Over the past 12 months, Ohio’s rolls increased by 154,000, the largest caseload growth in nearly seven years…”
• Expected $1B shortfall looms for Fla. Medicaid, By Lloyd Dunkelberger, October 10, 2009, Ocala Star-Banner: “Florida is heading for a cliff when it comes to Medicaid spending. The federal government has boosted its support for Medicaid, the joint federal-state health care program for the poor and disabled, in Florida during the economic recession. But the extra funding is scheduled to dry up in December 2010, leaving Florida perhaps more than $1 billion short and facing the prospect of having to cut back critical medical services for some of the state’s poorest and sickest residents. Florida isn’t alone. A new report says the states, facing the loss of federal stimulus funding, may experience cuts ‘perhaps on a scale not ever seen in Medicaid…’”

• ‘Shockingly wide’ health gaps among states, By Rita Rubin, October 8, 2009, USA Today: “A new ’scorecard’ lists ’shockingly wide variations’ among the states when it comes to the health of their residents, says the president of the Commonwealth Fund, which compared such factors as access to care, insurance coverage and avoidable hospital admissions. ‘The differences we see among the states translate to real lives and real dollars,’ Karen Davis said Wednesday at a news conference…”
• Report shows healthcare disparities among states, By Andrew Zajac, October 7, 2009, Chicago Tribune: “Even as state and federal initiatives have extended a medical safety net beneath children in recent years, more and more adult Americans have been living without insurance coverage - compounding the already-serious problems of the healthcare system and fueling sharp disparities in the cost and quality of care across the country. Those disparities, graphically documents in state-by-state rankings released Wednesday by the non-partisan Commonwealth Fund, underscored one of the biggest challenges in designing a healthcare overhaul: The nation doesn’t have one system and one reality, it has at least 50 - each with its own economic, social and demographic characteristics…”

• Governor lobbies for Medicaid expansion, By Michelle Saxton, October 6, 2009, Charleston Daily Mail: “A proposed expansion of Medicaid has some governors voicing concern about how states will afford greater coverage in a challenging economy, but Gov. Joe Manchin argues that an expansion focused on prevention will help reduce costs from uncompensated care. ‘You have to expand that to get people more involved in the system,’ Manchin said Monday. ‘We’re paying for them now anyway. People will wait and go to the emergency room when they get deathly ill or seriously ill at the highest cost,’ he said. ‘But if you get them into more of a managed type of care, showing them how to take action on the preventive side, you can really cut down the costs on the most expensive side. That’s the debate that’s going on…’”
• Expansion of Medicaid could impose costs on Ohio, By Jack Torry and Jonathan Riskind, October 7, 2009, Columbus Dispatch: “As Ohio officials try to close an $850 million budget hole, the key U.S. Senate health-care overhaul package could cost Ohio $922 million in additional Medicaid spending in the plan’s first five years. The health-care bill, which is expected to win the Senate Finance Committee’s approval this week, would add nearly 800,000 Ohio residents to the state’s Medicaid roll. The bill would do so by allowing a family of four with an annual income of up to $29,300 to be eligible for Medicaid coverage instead of the current limit of $22,050 for such a family…”
• Levine: Health bill hurts Medicaid, By Gerard Shields, October 7, 2009, Baton Rouge Advocate: “Louisiana’s top health official is criticizing a provision in the U.S. Senate’s health-care bill that would give four states, including that of Senate Majority Leader Harry Reid, of Nevada, full federal funding for increases in the Medicaid rolls. Louisiana would have to pay a 5 percent match for any new federal money for expansion of Medicaid amounting to $614 million over five years, said Alan Levine, secretary of the state Department of Health and Hospitals. ‘The cost to Nevada?’ Levine said. ‘Zero.’ The news of the provision comes at a time when Louisiana is struggling to get control of its Medicaid budget…”

Many children still don’t get Medicaid dental care, By Ann Sanner (AP), October 7, 2009, Tuscaloosa News: “Two years after a 12-year-old Maryland boy died from an untreated tooth infection, more low-income children are getting dental care under Medicaid but many still don’t ever see a dentist, government investigators said Wednesday. State officials told the Government Accountability Office that a lack of available funding, low provider participation and administrative burdens are some of the barriers to providing dental care to more children through Medicaid…”

• States resist Medicaid growth, By Shailagh Murray, October 5, 2009, Washington Post: “The nation’s governors are emerging as a formidable lobbying force as health-care reform moves through Congress and states overburdened by the recession brace for the daunting prospect of providing coverage to millions of low-income residents. The legislation the Senate Finance Committee is expected to approve this week calls for the biggest expansion of Medicaid since its creation in 1965. Under the Senate bill and a similar House proposal, a patchwork state-federal insurance program targeted mainly at children, pregnant women and disabled people would effectively become a Medicare for the poor, a health-care safety net for all people with an annual income below $14,404. Whether Medicaid can absorb a huge influx of beneficiaries is a matter of grave concern to many governors, who have cut low-income health benefits — along with school funding, prison construction, state jobs and just about everything else — to cope with the most severe economic downturn in decades…”
• Proposed Medicaid Expansion: Plan could be costly to Nevada, By Ed Vogel, October 5, 2009, Las Vegas Journal-Review: “The number of Nevadans receiving free medical care would nearly double by 2015 under provisions of the health care bill being developed in the U.S. Senate Finance Committee. A record 222,022 residents now receive medical care through the state-federal Medicaid program. That total would increase by 217,000 under the national health care bill, according to an analysis done by the state Health Care Financing and Policy Division. The move to expand Medicaid comes at a time when the state can least afford it, although Senate Majority Leader Harry Reid, D-Nev., has proposed an amendment to prevent Nevada from absorbing additional costs under the health care bill. But Charles Duarte, administrator of the division, is not convinced the amendment will be approved. If it fails, then Duarte said Nevada would be responsible for 13 percent to 18 percent of the costs of adding the 217,000 new Medicaid recipients, along with what it already pays for the current recipients. Providing Medicaid to Nevadans already costs the state about $1.5 billion a year, of which $450 million is state funds, Duarte said. Medicaid is the second most costly state government expenditure, trailing only the funding of public education…”

• Reports predict increasing financial burden from health care, By Brian Tumulty, September 30, 2009, Elmira Star-Gazette: “New York’s Medicaid program will experience a financial crisis if Congress doesn’t enact health care legislation, according to two studies released Wednesday. Ten years from now, state officials could face a 93 percent rise in the cost of providing Medicaid services to adults and related health services to children from low-income families, the Robert Wood Johnson Foundation and the Urban Institute predict in one report…”
• Medicaid crisis looms for state, By Jerry Zremski, October 1, 2009, Buffalo News: “New York, which has continued to expand Medicaid while other fiscally pressed states trimmed benefits, now faces a potential double whammy of federal-level changes that could cost the state health care program for the poor nearly $6 billion in 2011 alone. The state’s deficit, projected at $7 billion in the fiscal year beginning next April, is projected to grow to $13 billion a year later…”
• Nearly a quarter of Florida residents have no health insurance, By Drew Harwell and Andy Boyle, October 2, 2009, St. Petersburg Times: “Lawrence Rill, an out-of-work Clearwater tradesman, was preparing to donate plasma when a nurse gave him the news: His blood pressure was dangerously high and his body was in ’stroke mode.’ Rill, 50, needed prompt medical attention. But he hasn’t been able to afford health insurance for 15 years. Even when times were better, and he was working at Home Depot, the weekly $75 premium would have eaten up a fifth of his paycheck. Sound familiar? Florida has the second-lowest rate of health insurance for people younger than 65 in the country, trailing only Texas, a new U.S. Census survey shows. Excluding Medicare-eligible senior citizens, one in four Floridians lives without any form of medical coverage…”

• Rate of enrollment in Medicaid rose rapidly, report says, By Kevin Sack, September 30, 2009, New York Times: “The recession is driving up enrollment in Medicaid at higher than expected rates, threatening gargantuan state budget gaps even as Congress and the White House seek to expand the government health insurance program for the poor and disabled, according to a survey released Wednesday. The annual survey of state Medicaid directors, conducted for the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, found that the program had been spared the worst effects of massive state budget shortfalls because of federal aid in the stimulus package. But it also revealed grave concerns about what will happen when that relief dries up at the close of 2010…”
• 100,000 Ohio workers getting Medicaid, By Catherine Candisky, September 30, 2009, Columbus Dispatch: “They might work for some of Ohio’s largest employers but more than 100,000 low-wage employees rely on taxpayers for their health coverage. Legislation that soon will be introduced in the General Assembly would require the state to publish annually the names of companies with the most employees receiving Medicaid and other government subsidies…”
• Feds may pay for R.I. Medicaid expansion, By Ted Nesi, September 29, 2009, Providence Business Journal: “The federal government would pick up the full cost of expanding Medicaid coverage in Rhode Island for five years under a special provision of the Senate Finance Committee’s health care reform bill. Increasing the number of Americans eligible for Medicaid, the federal health insurance program for the poor, is a key provision of all the various health bills moving through Congress…”
• Medicaid on chopping block, By Chris Christoff, September 29, 2009, Detroit Free Press: “A major hurdle to enacting a new state budget by the Thursday deadline could be resolved this afternoon with expected approval of major cuts in Medicaid and state help for the mentally ill. That will intensify lobbying for a 3% assessment on all Michigan physicians to offset the Medicaid reductions. ..”

Utah’s Medicaid wants a big boost, By Lisa Rosetta, September 28, 2009, Salt Lake Tribune: “With its enrollment fast approaching 200,000 Utahns — an all-time high — the state’s Medicaid program is poised to ask the Legislature for $17 million in additional funding to keep it afloat through fiscal 2010. But it’s a request that may fall on unsympathetic ears. Alarmed by an audit that said Medicaid’s Bureau of Program Integrity could save as much as $20 million if it more scrupulously examined bills and claims for services, House Speaker Dave Clark said the public health insurance program is going to have to find those savings and plug its own funding hole…”

• Kentucky insures greater share of children, By Jere Downs, September 21, 2009, Louisville Courier-Journal: “Kentucky has provided health insurance for a greater share of its children than Indiana or the nation as a whole, the U.S. Census Bureau reported Tuesday. Ninety-three percent of the children in Kentucky had health insurance, greater than Indiana’s 82 percent and higher than the national average of 90 percent, the Census figures showed…”
• Census: Nevada leads nation in uninsured children, By Frank X. Mullen, Jr., September 23, 2009, Reno Gazette-Journal: “Nevada has a larger percentage of children without health insurance than any other state. And among the 75 percent of adult Nevadans covered by employer-sponsored health insurance, family insurance premiums have risen 97 percent since 1999 as wages increased an average of 43 percent. That’s the verdict of the Census Bureau’s American Community survey released Tuesday, the first time the annual update has included health insurance data…”
• Survey shows disparities in health care coverage for Minnesota kids, By Tim Nelson, September 22, 2009, Minnesota Public Radio: “Minnesota ranks third in the nation in the percentage of people who have health insurance, according to recent figures from the U.S. Census. But new survey data indicate some disparities around the state - particularly for kids. The Census Bureau’s annual American Community Survey looked closely at health insurance coverage for the first time in 2008. Overall, Minnesota fared well, ranking behind only Massachusetts and Hawaii in the percentage of its population covered by health insurance…”

• Proposing a public health option as a ’safety net’, By Robert Pear, September 19, 2009, New York Times: “Senator Olympia J. Snowe, a pivotal Republican, described on Saturday the changes she wanted to see in a comprehensive health care bill to make insurance more affordable, and she proposed a government insurance company as a possible backup to the private market if coverage remains too costly. Ms. Snowe’s proposal was among 564 amendments filed in the last couple of days by members of the Senate Finance Committee, which plans to take up the legislation this week as the struggle over health care enters a critical new phase…”
• How health overhaul would affect the uninsured, By Christopher Weaver, September 21, 2009, National Public Radio: “How many Americans are uninsured? According to the Census Bureau, in 2008, more than 46 million Americans - about 15 percent of the population - did not have health insurance. Because of the recession, many experts believe the number is now larger. Who are the uninsured? Income is a strong factor in identifying the uninsured. About two-thirds of uninsured Americans earn less than twice the federal poverty level, which is $22,050 for a family of four. Almost 25 percent of the uninsured are poor enough to be eligible for Medicaid but are not enrolled…”
• Uninsured take a toll on all North Texans, By Robert T. Garrett and Jason Roberson, September 20, 2009, Dallas Morning News: “Up to one-third of Dallas-area residents don’t have health insurance, and the number is rising. Everybody in North Texas pays the cost, through taxes and higher insurance costs - as much as $1,800 per family. Illegal immigrants pump up the numbers. But even if there weren’t any here, Texas still would virtually lead the nation in percentage of residents without health insurance, according to both conservative and liberal researchers. And Dallas County is close on Harris County’s heels as the major metro county with the lowest rate of health insurance coverage…”

Cost of racial disparities in health care put at $229 billion between 2003, 2006, By Kelly Brewington, September 18, 2009, Baltimore Sun: “Racial health disparities cost the United States $229 billion between 2003 and 2006 - money that could help cover an overhaul of the nation’s health care system, according to a new report by Johns Hopkins and University of Maryland researchers. Minorities are generally sicker and more likely than whites to die of numerous diseases, and until now, medical experts and advocates fighting to close those gaps have made their pleas on moral grounds. But the new figures aim to break down the issue into dollars and cents at a time when everyone is trying to figure out how to rein in soaring health care costs…”

Michigan struggles to insure kids, By Kim Kozlowski, September 15, 2009, Detroit News: “Michigan’s budget crisis is expected to prevent expansion of children’s health insurance coverage because the state can’t afford to match an extra $100 million in federal funds. Michigan has to come up with a 26 percent match, or about $33 million, for its MIChild program to get federal funds from the recently renewed Children’s Health Insurance Program, state health officials say. But the need comes as lawmakers scramble to close a $2.8 billion deficit for the fiscal year that begins Oct. 1. Democratic and Republican lawmakers agree it is unlikely the state can come up with the $33 million at a time when budget talks are focused on cuts, and millions of federal dollars for other health programs have been bypassed due to cuts made earlier this year…”

• Medicaid expansion stalls health talks, By Jennifer Haberkorn and Ralph Z. Hallow, September 15, 2009, Washington Times: “A proposed expansion of Medicaid, the health care program for lower-income Americans, has emerged as one of the last sticking points in the Senate Finance Committee’s health care reform bill, with governors and state legislatures around the country worried they’re going to get left with the tab. Proposals in the House and Senate would expand Medicaid eligibility to 133 percent of the federal poverty level, potentially putting millions of new people on the public health program for the poor younger than 65…”
• Congressional health plans could break state budget, By Lesley Stedman Weidenbener, September 12, 2009, Louisville Courier-Journal: “Gov. Mitch Daniels last week weighed into the national health care debate with a letter to Indiana’s congressional delegation that opposed the insurance reform plans currently under consideration. ‘There is no disputing the fact that aspects of American health care, such (as) access and affordability, truly do need to be restructured and improved,’ Daniels wrote. ‘Yet, I have serious concerns about Congress’ proposed solutions to these problems. In fact, I fear the current rush to overhaul the system will ultimately do more damage than good and create far more problems than it solves.’ But as described in his letter, Daniels’ opposition has as much to do with protecting the state’s finances as it does with political philosophy. In fact, Daniels is part of a group of governors and other state government leaders across the country who are trying to draw attention to a part of the health care debate that has been largely ignored – an expansion of Medicaid…”
• Congress should extend help with Medicaid, Editorial, September 15, 2009, Des Moines Register: “Billions in federal economic-stimulus dollars rescued state governments this year. The influx of money - about $2 billion in Iowa - helped this state avoid laying off workers and cutting vital programs. But another fiscal year is coming. Iowa was not among the states that raised taxes to generate revenue, and the federal stimulus money is almost gone. This state is facing a shortfall of between $900 million and $1 billion for the next budget year, and has about $133 million left in stimulus money. Everyone knew the federal help was temporary, and there is likely little political will in Washington for passing another stimulus package…”

• Rule limits reach of Iowa health program, By Nigel Duara (AP), September 14, 2009, Des Moines Register: “A state program offering health care to low-income adults without children is serving thousands of people who have never had health insurance, but more than half of those enrolling are from six Iowa counties. That’s because people seeking care through IowaCare can only go to the University of Iowa Hospitals in Iowa City. The exception are people who live in Polk County, who can request a waiver to seek treatment at a Des Moines hospital. The situation has frustrated some hospital administrators and legislators, who call it unequal treatment that hurts patients and hospitals…”
• ALL Kids insurance program eligibility expands Oct. 1, By Phillip Rawls (AP), September 14, 2009, Montgomery Advertiser: “Many middle-class Alabama children will qualify for publicly funded health insurance starting Oct. 1 because the Legislature is expanding eligibility to cover families of four making up to $66,150 annually. ‘For so many middle-income families, it never entered their minds they would be eligible for a public program,’ Cathy Caldwell, who directs the ALL Kids health insurance program for the state Department of Public Health…”

In dour economy, more indigent burials get public funds, By Laurel Walker, September 8, 2009, Milwaukee Journal Sentinel: “Recent elaborate funeral services for the likes of Sen. Edward Kennedy or Michael Jackson may grab the public’s attention. But among the ranks of the impoverished, the number of indigents who need publicly financed burials has been quietly growing. The Wisconsin Department of Health Services has recorded a nearly 15% increase in indigent burials qualifying for public subsidy between 2006 and 2008, when the number jumped from 3,169 to 3,629. Department spokeswoman Stephanie Smiley said the state spent just over $6.1 million in general purpose funds in 2006 to reimburse funeral homes and cemeteries for those services. The figure grew to $7.4 million last year. Through August of this year, the total is $6.1 million. Anecdotal evidence from news stories around the country, from California to West Virginia, suggests a common theme - that more people are needing government help to bury their loved ones…”

Governors worry federal health reform could strain budgets in states with many poor, jobless, By Emily Wagster Pettus (AP), September 14, 2009, Los Angeles Times: “States with high levels of poverty and unemployment have been struggling with growing Medicaid budgets during the recession, and some governors worry their financial burdens could get worse as Congress works on a comprehensive health care bill. They’re especially worried about possible expansion of Medicaid, the federal-state health insurance program for the needy and disabled…”

• Recession’s cost: More in poverty, without health coverage, By Tony Pugh, September 10, 2009, Miami Herald: “The early impact of the worst recession since the 1930s pushed median incomes down, forced millions more people into poverty and left more Americans without health care in 2008, according to new annual survey data from the U.S. Census Bureau…”
• Recession’s toll: more Americans in poverty, without health insurance, By Mike Swift and Steve Johnson, September 11, 2009, San Jose Mercury News: “Surveying the pain of the first full year of the recession, a new U.S. Census Bureau report shows that household income has dropped, millions more are in poverty - and for the eighth year in a row, fewer Americans are covered by private health insurance…”
• Recession takes a toll as US poverty surges, By Mark Trumbull, September 11, 2009, Christian Science Monitor: “America’s poverty rate surged upward last year, underscoring the toll of recession on ordinary households across the nation. Some 13.2 percent of Americans were living below the poverty line in 2008, the Census Bureau said Thursday. That’s a significant jump from the 12.5 percent poverty rate a year earlier. The rise means that nearly 40 million Americans are living in poverty, defined by incomes of less than $10,991 for an individual or $22,025 for a family of four…”
• Government programs helped control tally of uninsured, By Richard Wolf, September 10, 2009, USA Today: “The Census Bureau added some clarity Thursday to the fierce debate over government’s role in health care: Without government intervention, the number of uninsured would have soared last year. Though the 46.3 million people without health insurance in 2008 was slightly more than in 2007, private and employer-based insurance declined significantly. What made up the difference: Medicare, Medicaid and the state Children’s Health Insurance Program…”
• Rolls of privately insured Americans dip, census report says, By Bill Barrow, September 11, 2009, New Orleans Times-Picayune: “As Congress grapples with legislation that could expand health insurance coverage nationally, a U.S. Census Bureau report issued Thursday found that the number and percentage of Americans with private insurance fell from 2007 to 2008. The number of people with employer-based coverage also fell, while the rolls of government insurance programs increased. Altogether, the percentage of people without health insurance of any kind remained about the same, but the numbers reflect the correlation between a weakening economy and access to the private insurance market…”

• Poverty rate rose in 2008, Census finds, By Erik Eckholm, September 10, 2009, New York Times: “In the recession last year, the nation’s poverty rate climbed to 13.2 percent, up from 12.5 percent in 2007, according to an annual report released Thursday by the Census Bureau. The report also documented a decline in employer-provided health insurance and in coverage for adults. The rise in the poverty rate, to the highest level since 1997, portends even larger increases this year, which has registered far higher unemployment than in 2008, economists said…”
• Census: Income fell sharply last year, By Dennis Cauchon and Richard Wolf, September 10, 2009, USA Today: “Household income fell sharply and poverty rates rose in 2008 as the severe effects of the recession took their toll on Americans’ finances, the Census Bureau reported Thursday. Median household income dropped 3.6% to $50,303 in 2008, the bureau reported. That was the sharpest drop since at least 1967 and sent income to its lowest point since 1997…”
• U.S. poverty rate hit 11-year high in 2008, By Don Lee, September 10, 2009, Los Angeles Times: “Reporting from Washington - Showing the scars of the deep recession last year, the nation’s poverty level jumped to an 11-year high, household incomes sank and the number of people without health insurance rose slightly to 46.3 million, the government reported today. The Census Bureau said that median household incomes fell 3.6% from 2007 to $50,303 last year. That was the biggest decline since 1991 and represented millions of job cuts by employers in 2008…”
• Growth of gov’t insurance outpaces private care, By Hope Yen and Frank Bass (AP), September 10, 2009, Houston Chronicle: “The number of Americans covered by government-sponsored health insurance plans surged to 87.4 million last year - or 29 percent of the U.S. population - amid a fierce, national debate about whether to create a new U.S.-run plan that any American could join. The number of people covered by federal Medicaid, Medicare and military insurance plans was an increase from 83 million in 2007, according to census figures released Thursday. It partially offset the eighth straight year of declines in the percentage of people with employer-provided plans and highlighted the growing role of a government-offered insurance safety net…”
• Decade of income growth lost, Census report finds, By Carol Morello, September 10, 2009, Washington Post: “The recession has erased an entire decade of growth in household incomes, according to a Census Bureau report released Thursday that also showed more Americans last year were living in poverty and without health insurance. Median household incomes sank 3.6 percent in 2008, to $50,303, and the nation’s poverty rate rose to 13.2 percent, up from 12.5 percent in 2007. In all, 39.8 million Americans were living in poverty, defined as $22,025 for a family of four. That was the highest number since 1960…”
• Recession takes heavy toll on U.S., By Conor Dougherty, September 10, 2009, Wall Street Journal: “The recession has slashed families’ earnings, increased poverty and left more people without health insurance, according to the Census Bureau’s annual snapshot of living standards, offering sharp evidence of how much the falling economy has touched Americans of every income and race. The report released Thursday showed median household income, adjusted for inflation, fell 3.6% last year to $50,303, the steepest year-over-year drop since at least 1967. The poverty rate, at 13.2%, was the highest since 1997, while about 700,000 more people were living without health insurance in 2008 than the year before, although the share of the population living without health insurance was about the same…”

• Dallas leads nation in repeat teen births, study finds, By Robert T. Garrett, September 1, 2009, Dallas Morning News: “Dallas leads the nation in the percentage of teen births that aren’t the mother’s first delivery, a nonpartisan national research group finds in a new report. Dallas had the highest percentage of teen births that are repeat births - 28 percent - among 73 major U.S. cities in 2006, the latest year for which city-level data are available. Texas has the highest repeat rate of any state - 23 percent of teen births. And five of the 15 worst-ranked cities are in Texas, according to the group Child Trends, in a report to be released Wednesday…”
• Houston had the most girls under 15 giving birth in 2006, report says, By Todd Ackerman, August 31, 2009, Fort Worth Star-Telegram: ” More girls under 15 give birth in Houston than in any other U.S. city, according to a new national report. And among all births involving teenage mothers, Dallas had the nation’s highest percentage of repeat births, at 28 percent, while Fort Worth was eighth, at 25 percent. The report, by the research organization Child Trends, found that 20 percent more babies were born to girls 14 or younger in Houston than in New York and Los Angeles in 2006, the latest year for which data are available…”
• Texas has restrictive birth control policy for minors, By Robert T. Garrett, September 6, 2009, Dallas Morning News: “Texas, a leader in teen pregnancy and the state where more teens give birth to subsequent children than in any other, maintains one of the most restrictive policies in the nation for minors to obtain prescription birth control. Not even young parents in Texas can get birth control without their own parents’ permission at nearly a third of the family planning clinics on contract with the state health department…”

• Flu season: N.H. lawmakers may mandate paid sick days, By Michael McCord, September 8, 2009, Portsmouth Herald: “As concerns grow over the medical and economic impact of the H1N1 flu virus, a bill currently dormant in the New Hampshire Legislature to mandate paid sick leave may be revived by supporters. According to a state study in 2007, more than 50 percent of employers in New Hampshire had no paid sick leave policy for full-time employees and the number grew to 80 percent for part-time workers…”
• Swine flu brings a quandary to the workplace, By L.M. Sixel, August 30, 2009, Houston Chronicle: “When Ben - along with more than two dozen of his classmates - got sick with the swine flu last spring, his north Houston elementary school closed for the rest of the year. His mother, Melinda Flannery, said she was lucky because her son never got really sick. It also helped, she said, that her boss at Rice University was supportive of the 2½ weeks she had to spend away from the office…”
• Paid sick leave draws closer for city workers, By Jennifer 8. Lee, August 20, 2009, New York Times: “New York City could soon join San Francisco and Washington in requiring paid sick days for employees - a move that could affect as many as one million workers in the city. On Thursday, the City Council introduced legislation mandating that large employers give workers the ability to earn least nine paid sick days to workers per year, while small businesses who have fewer than 10 employees would earn five sick days…”
• Swine flu fight: Keep sick kids at home, but parents need paid sick days, says hero school nurse, By Samuel Goldsmith, September 8, 2009, New York Daily News: “Keeping kids at home from school when they get sick is one of the most important ways to stop the spread of swine flu. But plenty of parents can’t skip a day of work to watch their children - and that worries the hero school nurse who first detected the virus in New York. The head nurse at St. Francis Preparatory - the Queens school that became the epicenter of swine flu in the spring - says New York City needs a law to force all employers to provide paid sick days…”

• 10,000 working parents to lose health insurance, By Casey Newton, September 8, 2009, Arizona Republic: “Nearly 10,000 working parents will lose their health insurance this month in the wake of state budget cuts, leaving some families with nowhere to turn as they seek affordable coverage. KidsCare Parents, a program that provides low-income families with inexpensive insurance, will end Sept. 30. The Arizona Health Care Cost Containment System, which administers the program, could not pay the $6 million annual cost following cuts by the Legislature. The state faces a $3 billion budget shortfall. The move comes as demand for government assistance is skyrocketing. Arizona has lost an estimated 240,000 jobs since December 2007, and AHCCCS has added 150,000 people to its rolls since January…”
• Legislature gets one right: Healthy Kids continues, Editorial, September 8, 2009, Vacaville Reporter: “The California Legislature came together last week and accomplished the seemingly impossible. On a bipartisan vote — unanimous, even, in the Assembly — it found a way to keep more than 600,000 children from losing their health insurance. More amazing, it found a way to pay for the Healthy Families program. During the summer’s contentious budget negotiations, the Legislature sliced $144 million from the program that provides medical insurance for children whose parents cannot afford it. Then the governor lopped off another $50 million in a line-item veto. Both were insane decisions. Not only does the federal government contribute $2 for every $1 the state puts into the program, but Healthy Families has consistently proven that it saves taxpayers money in the long run…”

• Federal Katrina dollars can impact Louisiana’s Medicaid benefits, By Matthew Hamilton, September 7, 2009, Monroe News-Star: “G.B. Cooley chief executive officer Ben Pitts and ARCO executive director Roma Kidd refer to it as Louisiana’s ‘Medicaid cliff.’ In January 2011, a little-known formula will prompt the federal government to slash $1 billion in health care spending for the poorest residents of one of the poorest states in the country. Unless legislators make tough political choices to close the gap, the Louisiana Department of Health and Hospitals and Medicaid providers like Pitts and Kidd fear a devastating economic blow and the loss of health care for thousands across the state. The seeds of the crisis were planted in the wake of Hurricane Katrina. After the storm, the federal government pumped billions of dollars into the state, including $5.4 billion in Road Home subsidies. According to the DHH, the cash infusion spiked Louisiana’s per-capita income growth more than 42 percent in Louisiana…”
• Alabama Medicaid rolls jump by 50,000 over two year span, By Kim Chandler, September 7, 2009, Birmingham News: “Alabama Medicaid enrollment jumped by nearly 50,000 people in the past two years, with the largest increase coming in the number of children, teens and pregnant women enrolled. ‘When we’re at double-digit unemployment, it has an effect on the entire safety net,’ said Sen. Roger Bedford, chairman of the Senate General Fund budget committee and a Democrat from Russellville. ‘You see it not only in Medicaid, but also in food stamps.’ Alabama Medicaid Agency spokeswoman Robin Rawls said agency officials believe the economy is likely the cause, and the largest increase is in the program most likely to include working families…”

For Marylanders, insurance affordability will depend on subsidies, By Kelly Brewington, September 7, 2009, Baltimore Sun: “Even if lawmakers can agree on how to overhaul the nation’s health care system, the hope of universal coverage could crumble if individuals can’t afford their share. Take Howard County. Less than five months into an innovative program to give low-income people access to medical care for as little as $50 a month, nearly one in 10 participants is at risk of being cut off because they can no longer afford the cost. Howard officials say their fledgling program, called the Healthy Howard Access Plan, provides a cautionary lesson for federal policymakers battling over how to re-imagine the nation’s health care system and extend insurance to some 47 million Americans. While the major congressional proposals would require that nearly everyone have insurance or pay a penalty, low-income people could qualify for subsidies to help cover the cost of premiums. But lawmakers are wrangling over who would get financial help - and how much. If the subsidies fall short, millions of Americans could continue to struggle without health insurance, say advocates for the uninsured. Besides, if people in Howard County - among the richest localities in the nation - can’t manage $50 a month, how could those struggling elsewhere afford the plans under consideration in Washington that would require a much higher out-of-pocket cost?…”

Will safety net hospitals survive health reform?, By Carla K. Johnson (AP), September 3, 2009, San Jose Mercury News: “Janie Johnson has no health insurance, so when she cut her toe while giving herself a pedicure, she limped to the emergency room at one of Chicago’s safety net hospitals and waited her turn. ‘I’m 44, but I probably look about 55 right now,’ Johnson joked in Stroger Hospital’s emergency department where more than 100 patients sat waiting. Urgent cases, from chest pains to gunshot wounds, are rushed to doctors first. Johnson was glad to have somewhere to go for health care. ‘I don’t know what I would do’ without the hospital, she said. ‘My health would probably get worse.’ To all the knotty issues involved in health care overhaul, add one more: The proposals in Congress may threaten the funding and future of the nation’s already-struggling safety net hospitals…”

Firefighters become medics to the poor, By Ian Urbina, September 3, 2009, New York Times: “Peeling off his latex gloves after treating a 4-year-old boy having a severe asthma attack, J. R. Muyleart sighed with a touch of frustration. It was 3 a.m. and in the past 24-hour shift, Mr. Muyleart, a firefighter, had responded to at least one emergency call per hour. But only two of those calls were for fires; most of the others involved heart attacks, diabetic sores, epileptic seizures and people complaining of shortness of breath. ‘I joined the force to battle blazes, not to be an emergency room doctor,’ Mr. Muyleart, 35, said as he and the rest of Engine Company 10 drove back to their firehouse, which for most of the last 15 years has been the busiest in the country, according to industry surveys. Among the hidden costs of the health care crisis is the burden that fire departments across the country are facing as firefighters, much like emergency room doctors, are increasingly serving as primary care providers…”

Good news, bad news for Colo. low-income health clinics, By Allison Sherry, September 3, 2009, Denver Post: “Health clinics for the poor must chop $32.9 million from their budgets at the same time they are receiving millions in stimulus dollars to expand - creating a situation where new buildings may stand empty. Mountain Family Health Centers received half a million dollars in federal stimulus money to build a new clinic in Rifle, but director Dave Adamson said he’s not sure he will be able to staff it. In fact, he may have to cut staff at his existing clinic in Glenwood Springs. The Metro Community Provider Network clinics will get $1.6 million in new solar panels and medical and dental equipment, but state budget cuts are forcing the director to close three clinics in the next two months - one in Bailey, where there are few other options…”

Fighting blindness may prevent deaths in Ethiopia, By Carla K. Johnson (AP), September 1, 2009, Washington Post: “An antibiotic widely used in Africa to treat eyesight-robbing infections seems to help prevent Ethiopian children from dying of other diseases. A study in Wednesday’s Journal of the American Medical Association suggests an unintended benefit from efforts to wipe out trachoma, the world’s leading preventable cause of blindness. The World Health Organization has set 2020 as the target for eliminating trachoma. The United States has been free of the disease since the 1970s, but it persists in 48 countries. In Ethiopia, a hotbed, 40 percent of children under 10 show signs of active trachoma…”

A Milwaukee clinic fills a need but faces failure, By Kevin Sack, September 1, 2009, New York Times: “Like many low-income neighborhoods, the north side of Milwaukee has seen a gradual depletion of its primary care doctors over the last two decades. One by one, they have retired or surrendered to financial reality, rarely to be replaced. At the few remaining practices, the wait for an appointment can make it almost purposeless to seek one. When Martha Brown’s 3-year-old daughter, Loverree, woke up with a runny nose last Thursday, her doctor’s office told her it would be a week. ‘I couldn’t wait,’ Ms. Brown said. ‘I had to see what was wrong with my baby. I think she’s got an infection.’ Rather than heading to an emergency room, Ms. Brown took her three children to the Milwaukee Immediate Care Center, a small nonprofit clinic that has treated the north side’s largely African-American community since 1986. The clinic, which keeps hours at night and on weekends, is the only full-time operation in the neighborhood that provides urgent care, luring patients with a sign that reads, ‘When You Need a Doctor Today…’”

Healthy Indiana Plan to reopen to childless adults, By Ken Kusmer (AP), September 1, 2009, Indianapolis Star: “Indiana wants to enroll more childless adults in its state-funded medical savings account program and will reopen enrollment for them in the future, a state consultant told lawmakers Tuesday. The federal government, when it approved the Healthy Indiana Plan, said the state could enroll no more than 34,000 childless adults, consultant Seema Verma told the Medicaid Oversight Commission. However, HIP has proven most popular among such non-caretaker adults, and the Family and Social Services Administration closed the program to that group in March. At the end of July, they made up more than 26,000 of the nearly 46,000 people enrolled, Verma said. The program, partially funded by the Medicaid program for needy and disabled people and a state cigarette tax increase, was designed to enroll a total of 130,000 people, mostly parents…”

Massachusetts cuts back immigrants’ health care, By Abby Goodnough, August 31, 2009, New York Times: “State-subsidized health insurance for 31,000 legal immigrants here will no longer cover dental, hospice or skilled-nursing care under a scaled-back plan that Gov. Deval Patrick announced Monday. Mr. Patrick said his administration had struggled to find a solution ‘that preserves the promise of health care reform’ after the state legislature cut most of the $130 million it had previously allotted immigrants, to help close a budget deficit. Although their health benefits will be sharply curtailed in some cases, Mr. Patrick portrayed the new program as a victory, saying the services that the affected group tends to use the most will still be covered…”

Arizona faces ‘financial tsunami’ over Medicaid, by Jeff Brady, September 1, 2009, National Public Radio: “Arizona has one of the highest Medicaid rates in the country. About 1 out of every 5 residents is covered by the program for the poor and disabled. That doesn’t include illegal immigrants, who are barred from receiving state services. And the Medicaid rolls there are increasing rapidly in this economy, primarily due to slumps in the construction and service industries…”

Debit cards reward Medicaid patients for care, By Tom Murphy (AP), August 31, 2009, Washington Post: “Some Indiana Medicaid patients can now earn money to spend on health care simply by visiting the doctor or seeking routine preventive care. Managed Health Services on Monday announced a new debit card program that rewards patients for making regular trips to the doctor, taking their babies in for checkups and getting screened for several conditions. Participants can earn between $10 and $20 on their cards for each visit or screening. They can then use the funds to buy health-related items like cough syrup or thermometers…”

Tennessee food stamps, waistlines expand, By Christina E. Sanchez, August 30, 2009, The Tennessean: “More Tennesseans are receiving food stamps than ever before - nearly one in six - and the numbers are only expected to increase. But as the food stamp program expands, so too may the waistlines of the people who use the benefit to put food on the table, according to a recent study. Researchers at Ohio State University found that people who used food stamps were more likely to be obese. Women on average were about 6 pounds heavier than women who did not get food aid. They tracked 10,000 people, both on and not on food stamps, over 14 years and found that poverty, lack of access to healthy foods, and nutritional education of people on food stamps contributed to the obesity rates…”

Developing world’s parasites, disease hit U.S., By Stephanie Simon and Betsy McKay, August 22, 2009, Wall Street Journal: “Parasitic infections and other diseases usually associated with the developing world are cropping up with alarming frequency among U.S. poor, especially in states along the U.S.-Mexico border, the rural South and in Appalachia, according to researchers. Government and private researchers are just beginning to assess the toll of the infections, which are a significant cause of heart disease, seizures and congenital birth defects among black and Hispanic populations. One obstacle is that the diseases, long thought to be an overseas problem, are only briefly discussed in most U.S. medical school classes and textbooks, so many physicians don’t recognize them…”