"The bills seek to enact reforms signed into law by President Barack Obama in March. Among other changes, they would prohibit health insurers from denying coverage because of pre-existing conditions and create an exchange through which individuals could buy insurance. A separate bill would take state reforms further than federal requirements by making insurance companies obtain state approval before raising their fees" (5/31). Sea Coast Online: "The recent debate in the New Hampshire Legislature over the constitutional legitimacy of the massive federal health care reform bill could be a harbinger of a hot political issue for candidates for state and federal office. [But] ... the complex provisions of the health care bill have begun to move forward on a range of fronts. Some provisions for the 10-year, $820 billion law, such as rebates to seniors for Medicare drug prescription coverage and tax credits for small businesses, have already begun, some will go into effect later this year, and others will be in place in 2014 and beyond." Meanwhile, businesses such as Anthem Blue Cross and Blue Shield, the largest health insurance provider in New Hampshire and Maine, and Exeter Health Resources, parent company of Exeter Hospital, and community health centers prepare for a "changing health care marketplace" (McCord, 5/30). The (Clark County, Wash.) Columbian: Washington State has made its decision to create new federally funded high-risk insurance pools by July 1. "Congress appropriated just $5 billion to fund the program through Jan. 1, 2014 ” not enough, critics say, to extend coverage to more than a tiny percentage of the 5.6 million to 7 million Americans with pre-existing conditions who qualify for help. The $102 million Washington will receive has to last three and a half years, until the new exchanges kick in. Only those who have been uninsured for six months and have a preexisting condition will be eligible. But state Sen. Karen Keiser, D-Kent, who chairs the Senate Health and Long-Term Care Committee, said that $102 million will make a huge difference. Washington already has a high-risk pool. Last year it covered 3,578 people with serious health problems at a cost of $71.1 million, paid for by insurance premiums and an assessment on private insurance companies" (Durbin, 5/30). The Virginian-Pilot: Signs are that Virginia's Medicaid program will continue to grow in size and costs as a result of the federal health care overhaul and other trends. "Republicans, Democrats and health care industry leaders all agree that paying for the growth in Medicaid is a challenge." The program claimed "about 5 percent of the state general fund budget in 1985" and soon it will take up "nearly 20 percent, or about $3 billion." And, "as the federal health care overhaul begins to take effect, more people will qualify for Medicaid -- that's one way of extending coverage to millions of uninsured Americans. Even though the federal government is expected pay the lion's share of Medicaid expenses under the health care overhaul, Virginia will see higher costs as well. Between 2014 and 2022, the additional state costs are estimated to be $1.5 billion. [Dr. William Hazel Jr., Virginia's Health and Human Resources secretary] has said Virginia's Medicaid rolls could grow by 270,000 to 425,000 recipients in the coming years under the new requirements" (Walker, 6/1). The Texas Tribune: "The biggest consumer benefit of federal health care reform ” adding millions more Americans to insurance rolls ” could spell disaster for some public hospitals. At best, they'll face an identity crisis, Texas public hospital CEOs and health care economists say, as they're forced to compete with private doctors and hospitals for newly covered patients. At worst, some of the state's safety-net hospitals could hemorrhage money and shut their doors all together. To survive, these experts say, public hospitals will have to start operating more like private institutions ” or else dramatically alter their health care delivery systems to cut costs" (Ramshaw, 6/1).

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