The following highlights health issues mentioned in governors' recent state of the state addresses.
Alaska: In her Jan. 17 speech, Gov. Sarah Palin (R) said she will make an administrative order to create an "Alaska Health Strategies Council." The council will "effectively provide access and help lower the costs of health care," Palin said. She added, "We must deal with our looming health care crisis from the young to our elderly." Palin also said her administration will propose continuing the SeniorCare program for eligible state residents (Palin speech text, 1/17).

Hawaii: In her Jan. 22 speech, Gov. Linda Lingle (R) said that although Hawaii recently was "rated the fourth healthiest state in the nation," high "costs and low reimbursements are driving hospitals out of business and physicians out of the practice of medicine." She said she is "renewing the call for sensible, medical malpractice reform based on the California model," which "ensures that plaintiffs can recover for their actual damages ... while putting reasonable limits on so-called noneconomic damages." She said malpractice legislation has been "stalled in committee ... while more hospitals threaten to close and more doctors leave." Lingle also called on state lawmakers to "join together with our congressional delegation to work at the national level to increase Medicare rates, the basis for most payments to doctors and hospitals." She said lawmakers "need to make sure that health insurance is affordable ... by eliminating tax barriers that have kept competition out of the marketplace ... and by enabling sole proprietors to obtain the same rates as larger companies." In addition, Lingle proposed several other health care initiatives, including a "Good Samaritan" law that would "exemp[t] from lawsuits those doctors who provide medical treatment without compensation, except in cases of gross negligence;" reinstatement of the state Insurance Commissioner's "authority to disapprove rates that are excessive, inadequate or unfairly discriminatory;" an increase in funding for the University of Hawaii School of Nursing to address a statewide nursing shortage; and modifications to the process used to determine whether hospitals or other medical facilities can be built, so "local communities have the final say in determining which new medical facilities and services to support" (Lingle speech text, 1/22).

Indiana: In his Jan. 16 speech, Gov. Mitch Daniels (R) proposed increasing the price of cigarettes to reduce smoking rates and create revenue for a health insurance program. Daniels' health insurance plan would offer preventive care at no cost, "promote wellness and lower future health costs," he said. He added that the plan "would provide full protection against financial hardship" and is "constructed to be as large as this Assembly chooses: the more you raise the cost of cigarettes, the more Hoosiers can be provided coverage." He also said he would restore funding to smoking cessation programs, which was cut during the state's deficit, and urged that more children be vaccinated. Daniels said, "Every dollar spent to immunize a child saves $17 later when" they become sick (Daniels speech text 1/16).

Missouri: In his Jan. 24 speech, Gov. Matt Blunt (R) discussed "an entirely new system," called MO HealthNet, that would replace the current Medicaid system. According to Blunt, "With MO HealthNet, for the first time in Missouri history we will guarantee that every participant has access to primary and preventive care." He said that under HealthNet, participants would be able to choose their own health plan and doctors would be paid "for results, not just visits or tests." In addition, Blunt said the program would "use a health risk assessment to develop a plan of care for improved health and help to avoid unnecessary" ED visits and hospitalizations. The proposal also includes a Chronic Care Improvement Program and increased use of health information technology. Blunt said that the state should continue efforts to "support the creation of new health centers across the state" and that federally qualified health centers would be "a budget priority." Blunt said his proposal to eliminate the franchise tax for businesses that provide health insurance for workers "could eliminate the tax for 87% of employers and virtually all of our small businesses paying the tax." Blunt also said he has committed $20 million for a proposal that would combine federal, state, public and private resources to lower the price of insurance; offer incentives to employers that provide insurance; allow employees to retain health insurance when they switch jobs; pool the purchasing power of the uninsured to negotiate lower rates; and allow employers and employees to pay for insurance with pre-tax dollars. Blunt also called for full-tax deductibility for long-term care insurance costs (Blunt speech text, 1/24).

Montana: In his Jan. 24 speech, Gov. Brian Schweitzer (D) discussed expanding the Insure Montana program to include an additional 1,000 state residents. Schweitzer also discussed increasing in-home and community-based Medicaid services, as well as legislation that would expand the SCHIP program to cover children in families with annual incomes below 175% of the federal poverty level, rather than 150%. The expanded eligibility could allow an additional 3,000 children to receive coverage under the program, Schweitzer said (Schweitzer speech outline, 1/24).

Nevada: In his Jan. 22 speech, Gov. Jim Gibbons (R) said it "is essential we reform Medicaid to assure it continues to provide health care services" to state residents. Gibbons proposed increasing Nevada Medicaid physician payments "up to the most recent federal Medicare fee schedule, while also holding physicians responsible for the care they provide." In addition, Gibbons will include in his budget proposal funding that would allow state residents to have "access to a professional health care coordinator that would help them sort out our confusing health care system." He added, "Coordinating health care services in Medicaid is a key part of controlling Medicaid spending." He said he also will include in his budget proposal $7.5 million to open 22 acute care hospital beds "to assist in alleviating the [ED] crisis." Gibbons said another $2.8 million would go for triage centers in the northern and southern areas of the state to "reduce overcrowding and provide more efficient use of public and private resources." Gibbons also proposed to expand three Medicaid programs to allow Nevada residents ages 60 and older "to live in their homes and communities rather than in nursing homes" (Gibbons speech text, 1/22).

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