COPYRIGH T 2002 ABC FOR HEALTH, INC / 152 W JOH NSO N ST, STE 206 / MADISO N, WI / / WEB.ORG

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1 Weekly Update ABC FOR HEALTH KEEPING YOU INFORMED CASE REPORT: Tips for Working With Spanish-Speaking Clients You may come across Spanish-speaking individuals who are asking for assistance in paying a medical bill resulting from an emergency room visit. If so it is important they realize that billing from an emergency room visit is often fragmented and that they may get multiple bills as a result of a single visit. For example: if an ambulance was involved, the ambulance company may likely bill them separately. Similarly, emergency room doctors may bill separately from the hospital. Even though no one wants to hear that there may be more bills coming, it is important to understand that extent of the medical bills incurred so that you can provide better advocacy. When helping Spanish-speaking individuals apply for Medicaid with the Simplified Medicaid form, double-check their response to the Marital Status question. Some of our past clients have stated that they are not married, even when they are, because they think they will have to verify the marriage with documents. If those documents are difficult to attain or no longer exist, they may answer that they are not married because they cannot provide proof. This is a mistake. When asking if a client is married, ask it more than once just to be sure of the response. Saying that you are not married when you are can lead to problems by opening the door to recovery of lying-in costs by a Child Support agency. These tips will also apply to your other clients as well in many cases. If you have any questions about these or other tips contact ABC for Health at 608/ or info@safetyweb.org. PROGRAM UPDATE: HHS Will Get Increased Spending, But Medicaid Would Be Cut Under the Bush administration s proposed budget, discretionary spending at the Department of Health and Human Services would rise nine percent from the last fiscal year, primarily because of an increased spending for bioterrorism protection. The administration is requesting an additional $4.3 billion for bioterrorism protections such as vaccine development, lab improvements, hospital modernization and expansion of the National Pharmaceutical Drug Stockpile. The National Institutes of Health, the Centers for Disease Control and Prevent ion and the office of the secretary (of HHS) would receive the bulk of bioterror money. Bush is also requesting an extra $190 billion over ten years to begin providing prescription drug coverage to low-income Medicare recipients. Lawmakers in both parties say about $300 billion is needed to address the problem. Of the total $489 billion HHS request, about $429 billion is dedicated to mandatory programs such as Medicare and Medicaid. But despite this, many health programs dealing with prevention and direct patient services would be trimmed or would receive no increases under the Bush budget. TO SUBCR IIBE TO THE E-MA IIL VERSIION OF THE UPDATE SEND AN EMA IIL TO SAFETYLIINE-SUBSCRIIBE@YAHOOGROUPS.COM COPYRIGHT 2002 ABC FOR HEALTH, INC / 152 W JOHNSON ST, STE 206 / MADISON, WI / / INFO@SAFETYWEB.ORG

2 President Bush's budget aims to rein in the growth of Medicaid by reducing payments to public hospitals and by cracking down on state efforts to obtain extra federal money to finance health care for the poor. The administration says it is closing loopholes and curbing "abusive practices" that states have used to expand Medicaid without putting up all the state money required by federal law. State and local officials and members of Congress of both parties have objected to the administration plan. They say cutbacks, expected to save $9 billion over the next five years, would harm Medicaid recipients and aggravate fiscal problems plaguing most states. State officials nationwide say they would lose one-fourth to one-half of the special payments they now receive for public hospitals. Senators Blanche Lincoln, (D-AK), and Thad Cochran, (R-MS), have introduced a bill to delay the cuts for a year. Representative Nathan Deal, (R-GA), has offered a similar bill in the House. Medicaid is financed jointly by the federal government and the states, while the federal government raises or supplies all the money for Medicare. Federal spending on Medicaid grew 11 percent last year, to $130 billion. The increase was driven, in part, by spending on prescription drugs, which rose 19 percent. Under the existing Medicaid rules, which took effect just ten months ago, states can pay public hospitals up to 150 percent of what would be paid for the same services under Medicare. The new Bush administration policy will lower the ceiling to 100 percent. Larry S. Gage, president of the National Association of Public Hospitals, said the higher payments were justified because public hospitals had higher costs. Many of their patients are uninsured, he said. Also, he noted, many public hospitals run costly special services like trauma care and burn units. Sara Rosenbaum, a professor of health law and policy at George Washington University, said: "The insurance proposals may help some people over time, but that's speculative. By contrast, the Medicaid cuts will have an immediate adverse effect on states' ability to cover low- income working families." For more information on the budget, visit =yes&dr_datetime=04-feb-02#9277 or A formal analysis is available at CHIP Covers 4.6 Million Children In 2001, Up 38 Percent From Previous Year The number of children ever enrolled in Children s Health Insurance Program (CHIP) increased from 3.3 million in fiscal year (FY) 2000 to 4.6 million in FY That s an increase of 1.3 million or 38 percent. Over 230,000 adults were enrolled in FY 2001 under CHIP waivers first approved in January 2001, prior to which adults were not eligible. The increase in enrollment is attributed to increased flexibility of states to develop CHIP programs that suite their specific needs. For CMS' report on CHIP enrollment visit For the HHS press release visit

3 LEGISLATIVE UPDATE: Wausau and Madison Hearings Of The Joint Finance Committee Governor McCallum's new budget bill (Special Session Assembly Bill 1) was introduced in the Assembly on Tuesday. It was referred to the Joint Finance Committee (JFC), which has scheduled two public hearings: Wed. Feb. 13, 10 a.m., Capitol, Room 412-East Wed. Feb. 20, 10 a.m., UW -Marathon County Theater, 518 S. 7th Ave., Wausau A Legislative Fiscal Bureau summary has been posted online at: Correction: Universal Health Care Hearing February 13, 2002 On Feb. 13, 1:30 p.m. the Senate Health Committee will hold a public hearing on SB 133, Sen. Chvala s Universal Health Coverage Legislation, in room 201-SE. The bill is available at Sen. Dayton Introduces Bill that Would Cover 75 Percent of COBRA Costs The day after economic stimulus legislation died in the Senate, Sen. Mark Dayton (D-MN) on February 7 introduced a bill (S 1916) that would help laid-off workers pay for health insurance. Under the bill, the federal government would pay 75 percent of health insurance costs for up to one year for unemployed people who are eligible for benefits through COBRA, the 1986 Consolidated Omnibus Budget Reconciliation Act (which allows unemployed workers to retain health coverage under their former employers' insurance plans by paying 102 percent of the premiums). The bill would also allow states to extend Medicaid coverage to unemployed workers who are not eligible for COBRA. The two provisions of Dayton's bill are similar to components of the Democratic version of economic stimulus legislation, which also contained a number of non-health-related financial provisions targeted at businesses and individuals. For more information visit IN THE NEWS: Milwaukee Health Care Costs 55 Percent Higher Than Rest of Midwest Total medical, prescription drug and administrative health care costs are 55 percent higher in the greater Milwaukee area than in other Midwestern metropolitan areas, according to a new study commissioned by the Healthcare Network of Wisconsin, a preferred provider organization with 144,000 beneficiaries. The Milwaukee Journal Sentinel reports that health care costs in Milwaukee may be higher in part because area health insurance plans tend to be "more generous" and cover more dependents, while residents of Milwaukee are a "bit sicker and use more health care." But the study found that the biggest factor in higher health costs was that providers in the area charge more. Some hospital executives and physicians "took issue" with the study, instead insisting that "shortfalls" in Medicare and Medicaid reimbursements "were a key factor if not the key factor driving up costs." Catherine Varma, a pediatrician and past president of the Milwaukee County Medical Society, said that Wisconsin doctors receive "just 50 cents on the dollar for treating Medicaid patients." For more information visit or - 3 -

4 Bush Pushes Health Care Plan in Milwaukee President Bush pitched a $300 billion package that he said would fix America s health care system during a trip to Wisconsin on Monday. He said that the 40 million Americans without health insurance and others in danger of losing coverage or seeing benefits erode would be helped by $117 billion worth of measures in his package. He called for creating personal health care accounts that would allow people to pay smaller premiums for major medical coverage. The savings could be put in the new accounts tax free, he said. And he said he wanted employers to pool together through industry associations or a chamber of commerce so they could seek the most competitive deals. He capped his speech by reiterating his call to provide tax credits of up to $1,000 for individuals and $3,000 for families to obtain insurance on their own. For more information visit Bush Budget Would Slice $47 Million for Wisconsin Programs It has been widely reported that President Bush s budget would be balanced in part by eliminating $1.3 billion earmarked last year for projects around the country. Wisconsin would not be exempted from the cuts and stands to lose $47 million in grants to 53 different programs. Most are health or education related. For more information visit Stimulus Bills Defeated On February 6, the Senate defeated both Senate Majority Leader Tom Daschle s (D-S.D.) narrowed version of the Senate Democrat s economic stimulus bill that was introduced last month, and the GOP-sponsored stimulus bill that passed the House last year. Although the cloture votes did not technically kill the bills, Daschle withdrew the bills from consideration in the Senate after a cloture motion failed effectively killing the bills. The Senate did pass by voice vote legislation sponsored by Daschle to extend by 13 weeks benefits for unemployed workers who exhaust their 26 weeks of regular payments. It is unclear whether that information will pass the house. For more information visit UPCOMING EVENTS: Register Now for Communities Connecting for Coverage Conference Please forward this information to individuals or lists that you think would be interested. "Communities Connecting for Coverage" March 5-7, 2002 Monona Terrace Convention Center, Madison WI Covering Kids Wisconsin, a statewide coalition of over 30 public, private and faith-based organizations, is hosting a statewide conference for service providers and community advocates interested in health care coverage and access for Wisconsin families. The conference, "Communities Connecting for Coverage," will address issues facing Wisconsin families who are uninsured or struggling to pay health care bills. It will be held March 5-7, 2002 at Monona Terrace Convention Center, Madison WI

5 The conference comes at a time when access to and financing for health care is one of the largest issues facing Wisconsin citizens. As a state we are fortunate to have one of the highest rates of insurance in the nation. But as the economy declines and the number of jobs lost spirals upward, so does the number of uninsured. Whether you are organizing in your community or working for a local clinic or hospital, Communities Connecting to Coverage will offer you both practical training and the opportunity to develop community support networks to help families in your area, with opportunities to connect to: People and organizations in your region to build community based coalitions and benefits counseling services Policymakers to share your perspective on the future of health care coverage in Wisconsin; and Health coverage training and information resources. In addition to the conference's training and networking opportunities, you will have the opportunity to hear from union leaders, legislators, and business leaders during a panel discussion about the short- and long-term prospects for reforming the health car e system. Panelists include David Newby, AFL-CIO Wayne Corey, Wisconsin Independent Businesses Joel Rogers, Center On Wisconsin Strategy (COWS) Spencer Black, Assembly Minority Leader (D-Madison) Peggy Rosenzweig, State Senator (R-Wauwautosa) The goal of the conference is to lay the groundwork for a network support a more customer - and patient -friendly health care coverage environment for Wisconsin Children and Families. Ron Pollack, executive director of Families USA, will kick off the conference with a keynote address to help frame our efforts in the context of consumer advocacy. Please share information about this conference with others who have an interest in health care coverage. For more information about the program or to register, contact ABC for Health at 608/ or info@safetyweb.org, or visit our website at