Bill Graves on Health Care Former Republican KS Governor

Eliminate waiting period for HealthWave child health care

More funding for Medicaid matching & pharmaceuticals

No federal pre-emption of employee health plan regulation.

The Issue

NGA’s Position

The Governors support efforts designed to enable small employers to join together to participate more effectively in the health insurance market. In fact, Governors have taken the lead in facilitating the development of such partnerships and alliances. However, these partnerships must be carefully structured and regulated by state agencies in order to protect consumers and small businesses from fraud and abuse and underinsurance. NGA opposes attempts to expand federal authority under ERISA. The Governors have identified the prevention of such federal legislation in the 107th Congress as a top legislative priority.

States have the primary responsibility for health insurance regulation. Across the nation, Governors are working to protect consumers and patients and to properly regulate the complicated health insurance industry.

More federal funding for rural health services.

1. Western Governors want rural areas to have an adequate and able workforce to deliver needed health care services. The governors call on the federal government to provide necessary funding for programs such as the National Health Service Corps (NHSC) that have a state-based component, and the Health Professions programs that help health professionals serve in rural and frontier areas.
2. Western Governors believe that rural health care providers should be paid fairly by Medicare in order to ensure access to health care for rural citizens. The governors encourage the federal government to take further steps to ensure equity in Medicare reimbursement for urban and rural areas.
3. Alaska, Hawaii, America Samoa, the Northern Mariana Islands and Guam face extraordinary geographic barriers in providing healthcare services and they should be designated for special consideration and adequate funding to overcome their frontier barriers.
4. Federal programs like the Rural Health Outreach Grants and the Rural Hospital Flexibility program need to continue to provide funds to states and communities to experiment with new programs, integration of services and coalition building to develop new types of providers, facilities, and services.
5. Western Governors believe in strengthening the existing health care system. Support for home health agencies, rural health clinics, public health nursing and critical access hospitals are partial solutions.
6. Western Governors support the elimination of barriers to the use of telemedicine as outlined in the WGA’s 1998 report. In particular, we request that the federal efforts to increase reimbursement for telemedicine consultations, to protect the privacy of patient-identifiable medical information and to support rural health provider telecommunication costs with universal service funds continue.

Tax credits for those without employee health insurance.

H.R. 1181 the Health Insurance Affordability and Equity Act
With 40 million Americans currently living without health insurance, Republican Main Street Partnership members have been leading the effort to find new and innovative ways to secure health care for our citizens. Easing the burden on businesses entering into insurance purchasing pools, and expanding the use of medical savings accounts (MSAs) have been included in previous economic stimulus packages. RMSP Congresswoman Nancy Johnson (CT) in conjunction with Representatives Jo Ann Emerson (MO), Melissa Hart (PA), Jim Kolbe (AZ), Connie Morella (MD), Doug Ose (CA), Marge Roukema (NJ), Rob Simmons (CT), Fred Upton (MI), and Jim Walsh (NY) introduced legislation that targets tax credits to those that are not offered employee provided health insurance, or are self employed.

Tax deduction for long-term care insurance.

H.R. 831/S. 621 the Long Term Care and Retirement Security Act.
Republican Main Street Partnership Senators Lincoln Chafee (RI), Susan Collins (ME), and Gordon Smith (OR) joined House of Representatives sponsors Reps. Charlie Bass (NH), Dave Camp (MI), Tom Davis (VA), Greg Ganske (IA), Ben Gilman (NY), Dave Hobson (OH), Steve Horn (CA), Nancy Johnson (CT), Sue Kelly (NY), Ray LaHood (IL), Connie Morella (MD), Deborah Pryce (OH), Jim Ramstad (MN), and Rob Simmons (CT) in securing health insurance for seniors and those in long-term care facilities. As new medicines and healthier lifestyles are extending life, more and more Americans need to prepare for their long-term health needs. This legislation allows a tax deduction on long-term care insurance premiums for taxpayers, including accelerated deductions persons for people 55 years of age and up.

Support telemedicine for underserved areas.

H.R. 2706, The Medicare Telehealth Validation (MTV) Act.
Republican Main Street Partnership members Congressman Doug Ose (CA) and Jo Ann Emerson (MO) have introduced this bill to increase the use of telehealth services under the Medicare program. Currently, telehealth services are restricted to use in certain geographically underserved areas. The MTV Act provides sufficient funding and regulatory relief to expand high technology medical diagnostic tools, across the Internet, to urban as well as rural underserved areas. The bill further provides for expansion of store-and-forward techniques, and for a study of the restrictions on telemedicine due to state licensing rules.

$350 billion for prescriptions for poor seniors.

Medicare Prescription Drug Benefit
One of issues to be addressed this year by Congress is that of providing a prescription drug benefit to our nation's Medicare beneficiaries. Legislation currently being drafted [by Republican Main Street Partnership members] intends to authorize $350 billion over the next 10 years to provide purchasing assistance for prescription medications. The benefit reaches out to low and moderate income seniors by extending coverage to incomes up to 150% of the poverty level. The bill could also include provisions to correct reimbursement reductions for physicians, nurses, hospitals, technicians, home health care providers, and long-term care facilities.

Maintain Medicare funding of HMO benefits.

• WHEREAS, Medicare premiums paid to Health Maintenance Organizations (HMO) are set at 95% of the current fee-for-service Medicare spending on residents of the county where the HMO is to be offered; and
• WHEREAS, The lack of readily accessible medical care in some areas results in lower utilization of medical services and lower Medicare spending; and
• WHEREAS, The combination of the Medicare HMO premium formula and differences in medical care service utilization results in fewer medical benefits for many Medicare HMO participants in rural, and other low medical care utilization areas; and
• WHEREAS, Medicaid will likely be used to fill the coverage gap in these areas, requiring additional state money; and
• WHEREAS, Language in the 1997 Balanced Budget Act was designed to address these inequities; now therefore be it,
• RESOLVED, That the Midwestern Governors’ Conference encourages Congress to continue its effort to address these inequities, and to resist efforts to reverse the changes made to Medicare HMO premiums in the Balanced Budget Act of 1997.

Protect state tobacco settlement funds from federal seizure.

As you know, preserving and protecting the state tobacco settlement funds is the nation’s Governors’ highest priority. We strongly urge you to reach final agreement and pass the conference report on the emergency supplemental appropriations bill soon, and to retain the Senate provision that protects our settlement funds from federal seizure.

Many of our state legislatures are currently in session, and some have already completed work on their budgets. Therefore, it is critical that conferees reach agreement quickly on this issue. Governors are unified in their commitment to ensuring that the funds remain in the states and that there be no restrictions on states’ ability to tailor spending to meet the needs of their citizens.

We offer our strongest support for conferees to recede to the Senate version of the bill containing the Hutchison/Graham bipartisan tobacco recoupment protection legislation.