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Governors Sticking to 'Health Care Light' at Winter Meeting

FEBRUARY 24, 2006 -- Although health is the theme of the National Governors Association winter meeting in Washington this weekend, the issue won't carry the legislative weight it did a year ago when state executives were pushing Congress to make controversial revisions to the Medicaid program. Instead, the focus will be on helping states take advantage of those recently legislated revisions, and on fostering "wellness initiatives" around the United States.

A "Healthy America" forum will kick off the first two days of the meeting, showcasing the efforts of NGA Chairman Mike Huckabee, R-Ark., to spread anti-obesity programs around the country.

"We cannot regulate our way out of this obesity crisis and we are not looking to be the Grease Police or the Sugar Sheriff, but there are things governors can do to battle this epidemic," Huckabee notes in a brochure on his Healthy America initiative.

Huckabee lost 110 pounds and became a marathon runner after being diagnosed with Type 2 diabetes. He has been prodding his fellow governors to promote better health in homes through steps like encouraging families to eat meals together and take walks, and awarding grants to establish fresh food retailers in underserved urban areas.

His initiative also is showcasing state programs to improve school nutrition and increase the time students spend in physical education classes each week. And it aims to encourage employers to adopt exercise breaks during the day and preventive screening.

The meeting's Tuesday afternoon session will feature a speech by former president Bill Clinton, who has joined Huckabee in promoting his health initiative. Will Clinton address other health care issues? As one state official said, "It's hard to script" the former president.

Some Meatier Fare . . .
A session at 3 p.m. on Monday will examine recent Medicaid changes. Centers for Medicare and Medicaid Services Administrator Mark B. McClellan will advise governors how they can take advantage of benefits flexibility, copayment, prescription drug, and asset transfer provisions to save money.

With those revisions expected to spur health plan competition in Medicaid, Scott Beeken, an executive with Great American Insurance Co., will advise governors on the lessons they can learn from the private sector on delivering health care.

Mark Birdwhistell, secretary of health and family services in Kentucky, will describe that state's revised Medicaid program that includes a cap on spending increases and health plan competition.

Chris Jennings, White House health care advisor in the Clinton White House, will caution states on changes that could undermine access to care such as excessive premium or other out-of-pocket charges.

. . . And a Little Red Meat Too
Wal-Mart CEO Lee Scott is scheduled to deliver a speech Sunday afternoon widely viewed as an attempt to ward off efforts by other states to follow Maryland's lead in requiring the giant retailer to spend a certain percentage of its payroll on health care.

Slammed by Democrats and labor unions for skimping on health care benefits for its low-wage workforce, Wal-Mart recently announced changes in its health plan and says it plans still others in the near future.

"During our most recent open enrollment period, we signed up more than 70,000 associates who didn't have our health insurance before," Scott said in a press release previewing his speech. "Fifty thousand of those working men and women were previously uninsured. And this is just a start."

Wal-Mart employees—known as "associates"—now have access to a "Value Plan" that charges $11 per month. Enrollees have access to three doctor visits and three generic drug prescriptions per year before a $1,000 deductible kicks in for individual coverage and a $3,000 deductible applies for family coverage. The plan also caps insurance payouts at $25,000 in the first year of coverage but does not have a cap in subsequent years.

Under the changes, part-time workers will qualify for the Value Plan in six months, the same waiting period as full-time workers. Part-time workers must now wait two years. In addition, children of part-time workers will be eligible for the plan. Wal-Mart will also add health clinics in at least 50 stores this year. It has nine clinics now as part of a pilot program.

Clinics in the pilot program offer care at "affordable" rates for 20 common, non-emergency health conditions and also provide flu shots. The average cost of a clinic visit is $45. In some cases, insurance covers that cost.

Wal-Mart covers 615,000 of its 1.3 million workers. Twenty-five percent of its workforce has no coverage whatsoever.

Legislators in 23 states have introduced bills this year to adopt laws like Maryland's, says Maureen Riehl, vice president for government and industry relations at the National Retail Federation, which opposes such legislation. The bills remain alive in 19 of the states, she said. The states with political environments most conducive to such legislation are Rhode Island, Massachusetts, West Virginia, Connecticut, New York, New Jersey, and California.

Wal-Mart said 10 states have either rejected such legislation or had key state lawmakers voice objections to it.

The Democratic Governors Association (DGA) will urge the NGA to adopt a proposal that would ask the federal government to offer a tax credit of up to 17 percent for premiums states pay for health coverage.

DGA spokesman Jon Summers said the proposal would make U.S. companies more competitive globally. The NGA isn't expected to adopt that legislative proposal, however.
In addition, Democratic governors will urge a legislative fix for snafus in the startup of the Medicare drug benefit, including reimbursement of states that resumed Medicaid coverage. The NGA isn't endorsing that step either.

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