Comparing the vexing issues connected to the delivery of affordable healthcare to the pieces of an intricate puzzle, State Rep. Dan Short (R-Seaford) and several colleagues have unveiled a package of proposals aimed at putting some of those pieces together.
“There is no easy fix to get everyone affordable healthcare, but there are things we can do to move us closer to that goal,” Rep. Short said. “This package is intended to attack different aspects of the problem.”
The package includes seven new proposals. Rep. Short said he is also calling for passage of two bills previously introduced by other legislators.
“Our package is split into two categories, recognizing that we’re dealing with two related, but separate challenges,” Rep. Short said. “We want to help the uninsured get access to healthcare coverage, but we also need to help those who currently have insurance retain it.”
Rep. Short said one common sense measure he’s sponsoring will require health insurance companies operating in Delaware to offer a “skinny” healthcare policy, stripped of all state mandates. “The irony of obligating healthcare companies to offer a plan free of the nearly three dozen mandates the state requires is not lost on me,” Rep. Short said. He added that while many customers will want the coverage provided by the mandates, others will not and they should be given that option.
Although it is not yet clear how much money skinny policies could potentially save Delawareans, at least one study indicates it could be significant. According to the Galen Institute -- a nonprofit research organization based in Alexandria, Va. – state mandates range from a low of 14 in Idaho to 63 in Minnesota. “In the 10 states with the greatest number of mandates, it costs a family about $2,100 more a year to purchase insurance than it does in the 10 states with the fewest,” said Grace-Marie Turner, the organization’s president.
The package also includes changes to Delaware law that should streamline the pricing of healthcare plans and improve healthcare administration. “One of these changes is designed to encourage the transition of high-risk customers out of the small group market and into individual plans,” said State Rep. Donna Stone (R-Dover South), the chair of the House Economic Development, Banking and Insurance Committee. “Not only could this potentially reduce the rates for the remaining participants, it could lead to lower rates for the high-risk people through the creation of a state-subsidized high-risk pool that would be created in conjunction with these Chapter 72 revisions,” she said.
Another proposal calls for a state tax credit to help small business owners retain the healthcare they’ve purchased for themselves and their families. “This is intended mainly to help modest small businesses, many of which are literally ‘mom and pop’ operations,” said State Rep. Deborah Hudson (R-Fairthorne), the chair of the House Revenue & Finance Committee. “One thing we have heard repeatedly from small business people is that they need help to retain the healthcare plans they have. They’re also telling us that they have avoided or delayed hirings and purchases of equipment because they needed the money to pay for insurance. I see this bill being as much about economic development as I do about battling the rising cost of healthcare.”
“The thing I like about the tax credit is that it is clean and efficient,” Rep. Short said. “Every dollar spent is a dollar that is applied directly to reduce healthcare costs. There is no money wasted in setting up a new state bureaucracy or creating new processes.”
The package also includes a number of proposals aimed at increasing enrollment in the State Children's Health Insurance Program (SCHIP). Two of these initiatives have already been introduced. Senate Bill 200 seeks to eliminate premium payments for families that have children enrolled in the SCHIP program, while House Bill 286 calls for using school lunch program data to increase outreach and enrollment of SCHIP-eligible families.
“Both SB 200 and HB 286 are excellent proposals,” Rep. Short said. “The bulk of the SCHIP program is paid with federal money, so it’s cost-effective for state taxpayers. But at any one time there are thousands of people that are eligible for the program that are not enrolled in it. There are also many families that join only long enough to get assistance then drop out again. These proposals should combat both of these issues.”
State Rep. Pam Maier (R-Drummond Hill), the prime sponsor of HB 286, said she welcomes the proposed companion bill unveiled as part of the package. That bill, which has not yet been numbered, will enlist the help of the Division of Revenue in identifying eligible families. “It’s my understanding that the division, aside from needing some modest resources to carry this out, does not foresee any significant problem with implementing this. I think it will compliment what we’ve proposed in HB 286 and holds the promise of expanding outreach efforts to our neediest families.”
Although the process has not yet been fully devised, the new bill will likely call for the Division of Revenue to screen its family income data for Delawareans that may have an opportunity to enroll their children in SCHIP. Once the determinations are made, the division would likely include a notification in one of its regular tax mailings indicating that the family was potentially SCHIP-eligible and including information on who they could contact to get additional details.
The final piece of the package seeks to create a task force to craft a pilot program to establish two in-hospital urgent care facilities. The goal will be to reduce the number of people using emergency rooms for non-emergency treatment by diverting these patients to the urgent care center. “This approach would save money for hospitals, taxpayers and ratepayers,” said State Rep. Joe Booth (R-Georgetown). “Under federal law, hospitals cannot turn away anyone who comes into an emergency room. This has led some uninsured people to use emergency rooms for non-emergency medical treatment. Emergency room costs are much higher than traditional care and the hospitals, the government and insurers all pay for these unrecovered expenses. Helping to keep emergency rooms tasked to help those that need immediate attention will pay dividends for everyone, especially those people seeking treatment.”
“We’re introducing this package with the full knowledge that it doesn’t fully fix all the issues we have with the delivery of affordable healthcare,” Rep. Short said. “Having said that, we think that these bills do move the ball down the field. I’d also like to see this package gain Democrat and Republican sponsorship in both chambers. There is nothing partisan about the need to make healthcare accessible.”
Rep. Short noted the existing bills that are part of this package – House Bill 286 and Senate Bill 200 – are already bipartisan measures, with both House and Senate sponsorship.
House Republicans Propose Five Professional Conduct Measures
House Republicans have introduced five new proposals addressing professional conduct that they believe will help strengthen the public’s confidence in the state legislature.
Thus far, all 22 members of the House Majority Caucus have signed the bills as sponsors or co-sponsors. They have been joined by Sens. Karen Peterson (D-Stanton), Charles Copeland (R-West Farms), Gary Simpson (R-Milford), Colin Bonini (R-Dover South) and Liane Sorenson (R-Hockessin).
State House Majority Leader Richard Cathcart (R-Middletown) said every member of the General Assembly has been invited to sponsor the proposals:
Prime sponsors: Reps. Greg Lavelle (R-Sharpley) & Rep. Deborah Hudson (R-Fairthorne)
“This bill would require disclosure of family members who work for the state,” Rep. Lavelle said. “We already disclose investment holdings and related issues, so this simply extends existing disclosure laws. It allows the public to be aware of these situations and gives them the power to decide.”
Prime sponsor: Rep. Greg Hastings (R-Millsboro)
“As one of the newest members of the General Assembly, I know how challenging it can be to be a freshman legislator,” Rep. Hastings said. “This measure will help get new lawmakers off on the right foot and keep incumbents thinking about how to manage their conduct in an often difficult environment. This type of training is done in many professions as standard procedure and we should have it here as well.”
Prime sponsor: Rep. Richard Cathcart (R-Middletown)
“I want to make it clear that this bill is about the institution,” Rep. Cathcart said.
“This bill would draw a bright line in the Delaware Code and remove any ambiguity in existing law. When this bill is enacted, it will be against the law for legislators to use their influence to interfere in the state employment process on behalf of a family member. Anyone violating it will be subject to punishment under the law and through our House Ethics Committee.”
Sponsor: Rep. Vince Lofink (R- Caravel Farms)
Sponsor: State Rep. Donna Stone
Rep. Cathcart said he anticipates that violations of the bills would be unclassified misdemeanors, punishable by up to 30 days in jail, a fine of up to $575 and other court-order sanctions.
Rep. Cathcart said he’d like to see all members of General Assembly pledge their support for the package. “While the public has always rightfully expected the highest level of conduct from their elected officials in the legislature, the means by which those standards are maintained has changed over the years. It is time for us to revisit these laws and update our procedures to ensure that the Delaware General Assembly remains an organization of integrity.”
Wind Project Legislation Moves Forward
Two resolutions dealing with Bluewater Wind’s proposed off-shore wind farm cleared a key House committee this week, but their ultimate impact on the controversial project remains unclear.
The House Energy & Natural Resources Committee released House Concurrent Resolution 38 and House Concurrent Resolution 40 – the latest legislative action dealing with a process the General Assembly set into motion two years ago.
The Electric Utility Retail Customer Supply Act was enacted in 2006 to reduce price volatility in the electricity market for Delmarva Power’s residential ratepayers by calling for the utility to enter into a long-term contract to purchase power from a generating facility located within the state. The legislation was a reaction to an electricity rate hike of approximately 59-percent in May 2006 resulting from the deregulation of Delaware’s electricity market.
The law empowered four agencies - the Public Service Commission; the Office of the Controller General; the Office of Management and Budget; and the Department of Natural Resources and Environmental Control - to rule on which proposal should be selected to supply Delmarva Power with electricity. In mid-December, Controller General Russell Larson, who represents the General Assembly in the process, noted that state lawmakers were split on the issue and moved to table the proposal so legislators could revisit it.
HCR 38 is an attempt to advance the stalled process. It calls for the Controller General to “vote to approve the Power Purchase Agreement between Bluewater Wind and Delmarva Power.” It further directs the Public Service Commission “to determine if it is in the public interest to distribute costs for the Bluewater Wind contract among all Delmarva Power customers.” The Electric Utility Retail Customer Supply Act currently calls for those charges to be borne solely by Delmarva’s residential and small business customers.
HCR 40 requests for legislation to be written that, if enacted, would spread the costs associated with the 150-turbine off-shore wind farm to all electricity customers in the state, including members of Delaware Electric Cooperative. It’s anticipated that the co-op will not be purchasing power from the project. The bill’s sponsor, State Rep. Gerald Hocker (R-Ocean View), maintains the offshore wind farm would provide an environmental benefit enjoyed by all Delawareans, so all citizens should share in its cost.
However, on Friday (3/14), Rep. Hocker indicated he would strike HCR 40 in favor of another piece of legislation that has yet to be introduced.
When the remaining measure, HCR 38, will come up for debate on the House floor is not yet clear.
Open Government Bills Introduced in House
Apparently operating on the belief there is more than one way to shell a walnut, a group of reform-minded legislators are reintroducing a package of good government bills that have stalled in the Senate.
Five of the six bills (detailed below) in the package seek to increase governmental accountability by giving the public access to state and school district financial data via the Internet. The remaining bill would change the state constitution to require that the state’s operating and capital budgets be completed and introduced a few days before the end of the legislative session, giving the press and the public time to see the spending plans before they’re voted on.
All six bills were introduced in the Senate at the start of the 2008 legislative session in early January, where they have been bottled up in committees ever since.
“We are re-introducing the transparency package … because we want these bills to have a hearing and so we have to introduce these bills into the House,” said State Sen. Charles Copeland (R-West Farms), the prime sponsor of the original Senate bills.
The package consists of the following bills:
“We’ve heard that there may some issues with some of these bills,” Sen. Copeland said. “To be honest, I don’t know what those issues are because these bills have not had a hearing. So nobody from the school districts or the executive branch has been able to been able to come and say on the record: ‘I have this problem or that problem with the bill’. They have been ‘desk drawer vetoed’, and that is simply wrong.
“There is a wave of openness and transparency that is sweeping the country,” Sen. Copeland continued. “There have been bills passed at the federal level … bills passed in numerous states … and Delaware is, once again, sitting on the sidelines and watching as the rest of the country moves forward into the 21st Century.”
Sen. Copeland said financial predicaments in the Christina, Red Clay and Brandywine school districts in recent years emphasize the need for this legislation.
“I believe we need to hold government more accountable,” said Jim Bowers with the Delaware Taxpayer Coalition, who helped craft many of the proposals in the package. “Recent studies have certainly shown that trust in government is at all-time low. These bills would give tools to the average citizen [allowing them] to identify waste, fraud and abuse. … I believe if taxpayers are picking up the bill, they should be able to look at the receipt.”
Mr. Bowers noted that the federal government already operates a website, www.federalspending.gov, that is similar to what he is calling for in Delaware. “It’s a searchable website for all federal contracts and grants above $25,000.”
State Rep. Greg Lavelle (R-Sharpley), the lead House sponsor on all six bills, pledged that there would be committee hearings on the measures.
“Maybe by having these hearings, and showing that those excuses emanating from the Senate are just that – excuses – that may help break that logjam [that these bills have faced there],” Rep. Lavelle said. He added that he was confident any concerns that might arise during the committee process could be addressed and that the bills could be passed before the General Assembly concludes its business June 30th.
Action on Bills
House Bill 327 – (Sponsors: Rep. Plant, et. al,) – HB 327 is reportedly based on the Model Employment Termination Act promulgated by the National Conference of Commissioners on Uniform State Laws in 1991. Supporters of the bill maintain it is intended to balance the competing interests of employers and employees. Under the measure, employees who have worked for an employer for more than one year may only be fired for “good cause.” Part-time employees, working less than 20 hours per week, would not covered by the act. It would also not apply to state, county or municipal employees or those working for private companies with fewer than five workers. Under HB 327, “good cause” for a termination is defined as a “reasonable basis” related to an employee’s conduct on the job, job performance and employment record; or the exercise of business judgment in good faith by the employer.
Status: Pending action in the House Labor Committee.
House Bill 329 – (Sponsors: Rep. Lee & Sen. Ennis) – This bill would direct the State Fire Prevention Commission to create regulations requiring financial audits of volunteer fire and ambulance companies and the Smyrna and Georgetown American Legion ambulances and the Mid-Sussex Rescue Squad. Under HB 329, the State Fire Prevention Commission would also have the authority, after a hearing, to impose a fine of up to $100 against any group not complying with the regulations created as a result of this bill.
Status: Pending action in the House Public Safety & Homeland Security Committee.
Senate Bill 211 – (Sponsors: Sens. Adams & Simpson, Reps. Carey and Ewing) – This bill would allow the Milford and Woodbridge school districts to review and redefine their common boundary in Sussex County using tax parcel data. The two districts earlier conducted an identical process regarding their common Kent County boundary. The State Board of Education would affirm the result, after notifying residents and holding public hearings. Status: Passed the Senate. Pending action in the House Education Committee.
House Bill 276 w/HA1 – (Sponsors: Reps. Wagner & Miro, et. al.) – HB 276 would double the potential jail time faced by those found guilty of preparing animal fighting venues or attending animal fights by changing these offenses from class A misdemeanors to class G felonies. Under Delaware law, a class A misdemeanor carries a sentence of up to one year in prison and a maximum fine of $2,300. As a class G felony, animal fighting patrons could face up to two years in jail and a fine deemed appropriate by the court. The measure would also lengthen the statute of limitations for all animal fighting offenses from one year to five years. Additionally the bill was amended to increase the charge for wagering on animal fights to a class F felony, punishable by up to three years in jail. The conviction of former Atlanta Falcons’ quarterback Michael Vick on federal charges connected to his involvement in a dog fighting ring last August prompted many states to reexamine their animal fighting laws.
Status: Passed the House. Pending action in a Senate committee.
House Resolution 43 – (Sponsors: Rep. Cathcart, et. al.) – This requests the Department of Technology and Information (DTI) to study and estimate the cost of five separate options for webcasting audio and/or video content of Delaware General Assembly proceedings via the State of Delaware website. Sponsors of the measure say it is a further attempt to use technology to make the state legislative process more accessible to the public. The House of Representatives started streaming the audio of its floor proceedings last year. The estimates requested by HR 43 are to be delivered no later than April 7, 2008.
House Bill 286 – (Sponsors: Rep. Maier, et. al.) – This bill is intended increase enrollment in the State Children's Health Insurance Program (SCHIP). HB 286 calls for using school lunch program data to increase outreach and enrollment of SCHIP-eligible families. Children up to 19 years old, in families with household incomes under 200% of the federal poverty level ($41,300 for a family of four), are possibly SCHIP-eligible. However, many eligible Delaware families are not in the program. The program is an attractive way for the state to expand affordable healthcare coverage to needy families because the federal government pays 65-percent of the cost. Last year the state had to reportedly return about $3 million of the $10 million it received from the feds for SCHIP because the program was not fully utilized. The bill is one of nine measures being supported by House Republicans dealing with the issue of affordable healthcare.
Status: Passed the House. Pending action in a Senate committee.
House Bill 283 – (Sponsors: Rep. Spence, et. al.) – This bill seeks to add a new provision to the Public School Employment Relations Act to provide a dispute resolution procedure for issues that arise in negotiating a collective bargaining agreement. Under the current law, there are provisions for fact-finding, but the fact-finder’s recommendations are not binding. HB 283 would impose binding arbitration that the bill’s backers say will provide both parties with a “much greater incentive to arrive at a voluntary agreement”. The bill provides a mechanism allowing arbitration decisions to be appealed to the Court of Chancery. Supporters note similar legislation was enacted by the 140th General Assembly dealing with collective bargaining for police and firefighters.
Status: Passed the House and Senate. Heading to the governor for consideration.
House Resolution 45 – (Sponsors: Reps. Wagner & Hocker) – This resolution requests the state Division of Facilities Management to investigate the use of Green Cleaning products and services in all state-owned facilities. “Green” or environmentally-preferable products are defined as “products or services that have a lesser or reduced effect on human health and the environment when compared with competing products or services that serve the same purpose”. Green Cleaning is a comprehensive program that evaluates the unique needs of the building and its occupants, and also evaluates the cleaning chemicals, janitorial paper, cleaning equipment, procedures and training programs. The Division of Facilities Management will report back to the House of Representatives by April 30, 2008.
House Bill 290 – (Sponsors: Rep. Longhurst, et. al.) – This bill would mandate that most health insurance policies issued in Delaware include coverage to pay for a scalp hair prosthesis. Such devices are intended to assist people who suffer hair loss as a result of contracting an autoimmune disease. Currently, Delaware has 35 health insurance policy mandates.
Status: Pending action in the House Economic Development/Banking & Insurance Committee.
House Bill 308 – (Sponsors: Rep. Maier, et. al.) – This bill seeks to establish rules and procedures for licensing of professional acupuncturists in Delaware.
Status: Pending action in the House Policy Analysis & Government Accountability Committee.
House Bill 319 – (Sponsors: Rep. Wagner, et. al.) – This legislation seeks to require health insurance coverage of a common form of anesthesia used in colorectal screenings. HB 319 would require Delaware insurers to provide coverage for the use of anesthesia in colorectal screenings if the health care provider treating the patient believes that its use is appropriate and beneficial.
The bill was a response to a proposal by health insurer Aetna Inc., which earlier this year indicated it would restrict payment for the use of “propofol”, a type of anesthetic administered by an anesthesiologist. Some doctors had complained that would leave many patients with less effective options. They argued that the fear of increased discomfort during the procedure, which involves inserting a scope into the patient, could result in fewer people getting the potentially life-saving screening. According to the American College of Gastroenterology, the screenings are a useful tool in spotting growths (polyps) inside the colon and rectum that may become cancerous. Colorectal cancer is the third most common cause of cancer-related death in the United States in both men and women. If caught early – which is what the screenings are designed to do – it is often curable. Aetna Inc. has since indicated it would not implement the proposed coverage restriction.
Status: Pending action in the House Economic Development/Banking & Insurance Committee.
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