Qualifying income limits for
Medicaid eligibility in 1989 ranged from 28 percent to
106 percent of the federal poverty level.
Of the estimated 1 percent of
Americans under age 65 who are uninsurable, approximately
60,000 participate in state risk pools.
One study found that if there were
no state mandates (including continuation-of-coverage
mandates), 16 percent of those small firms not now
offering health insurance would begin to do so.
Seven states recently passed
legislation exempting small employers that do not offer
health insurance from state mandates on coverage.
It has been estimated that about
50,000 Hawaiians (about 5 percent of the state
population) fall through the gap between Medicaid and
mandated employer-sponsored health coverage and are left
without insurance.
Maine recently established a
five-year demonstration project, to begin in 1992, in
which advisory committees in designated medical specialty
areas develop practice parameters. These parameters, or
protocols, will be used as evidence in medical liability
suits.
Several states, including Iowa,
Florida, and Pennsylvania, have developed programs that
collect and disseminate detailed information about
hospital costs. This information allows purchasers to
compare hospital costs by diagnosis.
The effects of certificate-of-need
(CON) laws vary considerably among states: one study
found that more stringent CON regulation actually
increased hospital costs, while another found that, after
controlling for patient and hospital characteristics,
states with stringent CON programs had higher mortality
rates among Medicare patients than states without such
programs.
