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A long day at the NASHP conference today. We heard about challenges facing states; the common theme was planning deep reforms on very short timelines with limited staff capacity and growing budget deficits. William Hazel, recently hired Virginia Secretary of Health and Human Services, pulled together the heads of departments to look for savings. When they all told him they had been cut to the bone, he commented that it was pretty funny that they sent them an orthopedic surgeon as the new Secretary. Another speaker compared giving insurance cards to people without making sure they can access care and get appointments, is like giving a parking permit to a college kid – it’s just a license to hunt.
We learned about the parameters of building state insurance exchanges, updates on states building patient centered medical homes, and the challenges of measuring and paying for quality. Rosemary Gibson, author of the Treatment Trap, described the dangers and costs of overtreatment. A fascinating panel focused on undocumented immigrants, completely left out of public coverage programs, and the likely impact on the safety net. New data from SHADAC estimates that there are 10.4 million undocumented immigrants in the US and 3.7 million of them live in low-income households (138% or less of the federal poverty level) that would have qualified for Medicaid but for their immigration status. SHADAC researchers estimate that there are between 50,000 and 100,000 undocumented immigrants in CT and between 10 and 19% of CT low income adults are undocumented immigrants, one of the highest proportions among states.
Ellen Andrews