SAMHSA222s Weekly Financing News Pulse: National Edition September 3, 2010 9/3/10 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News HHS Accepts Organizations Into Early Retiree Reinsurance Program Kaiser Poll Fi nds Declining Support for Health Reform ONDCP Awards $85.6 Million in Drug Free Communities Support Program Grants HRSA Awards $2.6 Million for Behavioral Health Training to Improve Access to Care Studies Released Study Finds Medicaid Beneficiaries Receiving MH/SUD Treatment Have Higher ER and Inpatient Service Utilization Rates KFF Finds Employers Shifting Health Costs to Employees, Altering Plans to Comply with MHPAEA Census Bureau Finds ARRA and Entitlement Programs Increased Federal Spending Commonwealth Fund Projects Health Reform222s Small Business Tax Credits T oo Small to Incent ivize Coverage USA Today Analysis Finds Health Spending Growth Declines RWJF Study Cites Iowa as Model for CHIP Enrollment Improvements Around the Hill: Hearings on Health Financing To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/service/multi_subscribe.html?code=USSAMHSA& origin=http://www.samhsa.go v/enetwork/success.aspx For questions or comments, please contact Rasheda Parks ( Rasheda.Parks@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: National Edition September 3, 2010 9/3/10 2 National News HHS Accepts Organizations Into Early Retiree Reinsurance Program: On August 31, the U.S. Department of Health and Human Services (HHS) accepted nearly 2,000 employers and unions into the Early Retiree Reinsurance Program , established under national health care reform . The law allocates $5 billion for businesses, unions, and state and local governments to cover health care costs of early retirees between the ages of 55 and 65. The program will cover 80 percent of the costs of retirees222 claims between $15,000 and $90,000 and offer coverage for early retirees222 spouses and dependents . Employers receiv ing the federal funds must use the m to lower early retirees 222 health care costs and continue providing any current contributions to retiree health benefits. HHS officials say the program is designed to counter the declining number of employers offering retiree insurance . E mployers and unions began submitting claims September 1 and will begin receiving payments in October ( The Hill, 8/31 ). Kaiser Poll Finds Declin ing Support for Health Reform: The August Kaiser Family Foundation (KFF) Kaiser Health Tracking Poll found that the percentage of Americans that hold a favorable view of the national health care reform law declined from 50 percent in July to 43 percent in August. In addition, the percentage of Americans holding an unfavorable view of the law rose from 35 percent to 45 percent over the same period. KFF found that 29 percent of America ns believe their families will be 223better off224 under the law, 30 percent believe they will be 223worse off,224 and 36 percent believe they will be largely unaffected. In addition, the poll found that 39 percent of Americans believe the law will benefit the country, while 37 percent believe it will have a negative impact ( KFF, 8/30 ). ONDCP Awards $85.6 Million in Drug Free Communities Support Program Grants : On August 31, the White House Office of National Drug Control Policy (ONDCP) awarded $85.6 million in FY2010 Drug Free Communities (DFC) Support Program grants, including $22 million in new grants and $63 million in continuation grants for ongoing programs. The $85.6 million will fund 718 regular grants and 23 mentoring grants. Regular grants offer up to $625,000 over five years for community -level programming to prevent and reduce youth substance abuse. Eligible coalitions must include representation from 12 specific sectors of the community, have a s ix-month history of collaboration on substance abuse reduction programming, develop a long-term substance abuse reduction plan, and participate in th e program222s national evaluation. M entoring grants offer up to $150,000 over two years for current DFC gran tees to mentor other community coalitions in providing substance abuse prevention programming , preparing new coalitions for future DFC grants. ONDCP directs the DFC grants in conjunction with the Substance Abuse and Mental Health Services Administration (SAMHSA) ( ONDCP, 8/31 ; Newswise, 9/1 ) . HRSA Awards $2.6 Million for Behavioral Health Training to Improve Access to Care : On August 13, the U.S. Health Resources and Services Administration (HRSA) awarded $2.6 million to 19 educational institution s under HRSA222s Graduate Psychology Education Program (GPEP) , a 60 percent increase over the program222s FY2009 funding. T he grants fund training to expand access to behavioral health services in vulnerable and underserved populations through FY2012 . GPEP funded programs include interdisciplinary training and perfo rmance measurement , focusing on serving vulnerable populations including the elderly, children, individuals with chronic illnesses or disabilities, and victims of trauma and abuse. HRSA officials say that , as of June 2010, 3,483 U.S. communities had a sho rtage of behavioral health services , affecting access for 84 million individuals ( HRSA, 8/13 ). SAMHSA222s Weekly Financing News Pulse: National Edition September 3, 2010 9/3/10 3 Studies Released Study Finds Medicaid Beneficiaries Receiving MH/SUD Treatment Have Higher ER and Inpatient Service Utilization Rates: A study in Psychiatric Services examined service utilization by Medicaid beneficiaries receiving mental health and substance abuse services through fee-for -service (FFS) plans . The study f ound that 11.7 percent of Medicaid beneficiaries received mental health or substance abuse services, representing 10.9 percent and 0.7 percent of all Medicaid beneficiaries , respectively. The authors concluded that Medicaid beneficiaries using either ment al health or substance abuse services had higher rates of utilization for both emergency room (ER) and general inpatient services. Among beneficiaries using mental health services, 47.4 percent visited the ER, 7.8 percent received inpatient treatment for their mental illness, and 13.8 percent received inpatient treatment for non-behavioral health treatment. Among beneficiaries receiving substance abuse treatment services, 60.7 percent had ER visits, 12.6 percent received inpatient treatment for substance abuse, and 24.7 percent received other inpatient treatment ( Psychiatric Services, September 2010 ). KFF Fi nds Employers Shifting Health Costs to Employees, Altering Plans to Comply with MHPAEA: In conjunction with the Health Research & Educational Trust (HRET), KFF released the 2010 Employer Health Benefits Survey , finding that employers are increasingly shifting health c osts to their employees . The survey found that employees222 share of family health coverage increased 14 percent since 2009, while total premiums rose only 3 percent over the same period. KFF noted that worker contributions for health insurance premiums r ose 47 percent since 2005 while premiums and wages rose 27 percent and 18 percent respectively over the same period. In addition, the survey found that 31 percent of firms with more than 50 employees made changes to their behavioral health benefits in response to the Mental Health Parity and Addiction Equity Act (MHPAEA). Most eliminated covera ge limits to comply with the law. In addition , 5 percent of those that changed their behavioral health benefits elected to eliminate the benefits completely ( KFF, 9/2 ). Census Bureau Finds ARRA and Entitlement Programs Increased Federal Spending : On August 31, the U.S. Census Bureau released a report which found that federal domestic spending obligations increased 16 percent to $3.2 trillion in 2009, the largest annual increase since the bureau began compiling federal spending data in 1 983. The Census Bureau suggests that much of that increase is attributable to spending under the American Recovery and Reinvestment Act (ARRA). The report also notes that Medicare, Medicaid, and Social Security comprised 45.7 percent of all federal domes tic spending, or $1.5 trillion. In addition, the bureau found that grants distributed by the U.S. Department of Health and Human Services (HHS) totaled $414.9 billion in 2009. The bureau also released a n additional report outlining federal grants to state and local governments. The report found that the Centers for Medicare & Medicaid Services (CMS) provided states with $256 billion in 2009, including $31 billion in increased ARRA federal medic al assistance percentage (FMAP) funding, while the Substance Abuse and Mental Health Services Administration (SAMHSA) provided $3 billion to states and local governments that year ( U.S. Census Bureau, 8/31 ; Kaiser Health News, 9/1 ). Commonwealth Fund Projects Health Reform222s Small Business Tax Credits Too Small to Incent ivize Coverage: On September 2, the Commonwealth Fund released a brief ex amining the national health care reform law222s tax credits for small businesses offering employee health insurance. The brief found that 16.6 million individuals work for potentially eligible firms but suggests that only 3.4 million are employed by firms t hat will utilize the credits . The authors contend that firms already offering employee health coverage will receive the credits ; however, those that do not already cover SAMHSA222s Weekly Financing News Pulse: National Edition September 3, 2010 9/3/10 4 their employees will not consider the credits a large enough financial incentive to begin doing so. The brief projects that , over the next 10 years, the credit program may yield $40 billion in federal funding for small firms ( The Commonwealth Fund, 9/2 ; The Washington Post, 9/2; Kaiser Health News, 9/2 ). U SA Today Analysis Finds Health Spending Growth Declines: A n analysis of government data by USA Today found that per capita health care spending on doctors, hospitals, and prescription drugs rose by 2.7 percent in the first half of 2010, a 0.2 percent decrease when adjusted for inflation . The spending reduction includes 1.1 percent decline in hospital spending and 1.6 percent decline in prescription drug s pending. USA Today analysts cited the poor economy and high unemployment a s factors in the reduced spending, suggesting that prescription drug spending fell in part due to higher utilization of generic drugs and increased insurer purchasing power. In addition, USA Today found that public health insurance programs accounted for 46.1 percent of medical spending in the second quarter of 2010, up from 42.3 percent in December 2007, before the economic recession began. The analysis also found that over 50 million individuals are currently enrolled in Medicaid, a 17 percent increase from December 2007 ( Kaiser Health News, 9/2 ; USA Today, 9/2 ; USA Today, 8/30 ). R WJF Study Cites Iowa as Model for CHIP Enrollment Improvements : A report by the Robert Wood Johnson Foundation (RWJF) examined an Iowa program under which parents are asked to indicate their dependent children222s health status on their tax forms to facilitate Children222s Health Insurance Program (CHIP) enrollment. Iowa devised the program in light of financial incentives offered under the 2008 Children222s Health Insurance Program Reauth orization Act (CHIPRA) for improving outreach and maximizing CHIP coverage. RWJF found that Iowa222s method was an effective means of potentially eligible children and outlines lessons that other states can extrapolate from Iowa222s experience ( RWJF, 8/23 ; Kaiser Health News, 8/27 ). Around the Hill: Hearings on Health Financing Congress is out of session for the August recess. The Senate will reconvene Monday, September 13 and the House will reconvene Tuesday , September 14 . House Veterans222 Affairs Committee : Personality Disorder Discharges: Impact on Veterans222 Benefits September 15, 10:00 a.m., 334 Cannon Senate Veterans222 Affairs Committee : VA Disability Compensation September 23, 9:30 a.m., 418 Russell House Veterans222 Affairs Subcommittee on Health: Veterans Health Administration Contracting and Procurement Practices September 23, 10:00 a.m., 334 Cannon House Veterans222 Affairs Subcommittee on Health: Veterans222 Health Bills September 29, 10:00 a.m., 334 Cannon