Washington Post: Fed judge rules anti-gay marriage law, benefits limit for domestic partners unconstitutional

A judge in California has ruled that the federal law that prohibits recognition of same-sex unions is unconstitutional because it denies long-term health insurance benefits to legal spouses of state employees and retirees.

U.S. District Judge Claudia Wilken also concluded Thursday that a section of the federal tax code that made the domestic partners of state workers ineligible for long-term care insurance similarly violates the civil rights of people in gay and lesbian relationships. Both laws were based on what she called “moral condemnation” of same-sex couples.

“Congress’s restriction on state-maintained long-term care plans lacks any rational relationship to a legitimate government interest, but rather appears to be motivated by antigay animus,” Wilken wrote in ordering the California Public Employees’ Retirement System to allow current and former state employees to enroll their same-sex spouses and partners in the extended care plan.

The Hill: Medical specialists push back on initiative from healthcare law

Medical specialists are urging regulators to slow implementation of an initiative funded by the 2010 healthcare law that aims to streamline care for some low-income elderly and disabled patients.

In a letter, the Alliance of Speciality Medicine asked the Centers for Medicare and Medicaid Services (CMS) for a one-year delay on the grounds that the current “direction and speed” of the project’s implementation would jeopardize payments to medical professionals as well as the care of so-called dual eligibles — people enrolled in both Medicare and Medicaid.

“While the goal of the program is to eliminate duplication of services for these patients,” the group wrote, “we are deeply concerned about unintended consequences.”

The average cost of care for a dual eligible is five times more than that of a regular Medicare beneficiary, according to the Kaiser Family Foundation. The CMS program would give 15 states up to $1 million to create pilot programs aimed at increasing the efficiency of that care.

The alliance’s letter expressed “significant concern” that the demonstrations would trigger “unsustainable cuts in provider payment rates.”

U.S. Citizenship and Immigration Service (USCIS) launched the first phase of its electronic immigration benefits system, known as USCIS ELIS. The system has been created to modernize the process for filing and adjudicating immigration benefits. This initial launch brings the agency closer to realizing the future of immigration services. Beginning May 22, 2012, individuals can establish a USCIS ELIS account and apply online to extend or change their nonimmigrant status for certain visa types. Eligible individuals include foreign citizens who travel to the United States temporarily to study, conduct business, receive medical treatment, or visit on vacation. USCIS ELIS will also enable USCIS officers to review and adjudicate online filings from multiple agency locations across the country.
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U.S. Citizenship and Immigration Service (USCIS) launched the first phase of its electronic immigration benefits system, known as USCIS ELIS. The system has been created to modernize the process for filing and adjudicating immigration benefits.

This initial launch brings the agency closer to realizing the future of immigration services. Beginning May 22, 2012, individuals can establish a USCIS ELIS account and apply online to extend or change their nonimmigrant status for certain visa types. Eligible individuals include foreign citizens who travel to the United States temporarily to study, conduct business, receive medical treatment, or visit on vacation. USCIS ELIS will also enable USCIS officers to review and adjudicate online filings from multiple agency locations across the country.

Huffington Post: Illinois Legislators Shave $1.6 Billion from Medicaid Budget

Illinois legislators have approved $1.6 billion in budget cuts to the state’s Medicaid program, which will reduce health coverage for hundreds of thousands of poor Illinois residents.

The budget adjustments were passed by a 94-22 vote in the House, and the Senate approved it 44-13 Thursday evening, according to the Chicago Tribune. The plan will raise prescription drug costs for 180,000 low-income seniors by eliminating the state-paid pharmacy assistance program, Illinois Cares Rx, freeing up $72.2 million.

Another almost $399.8 million will be saved by making Medicaid and Family Care requirements stricter, rendering hundreds of thousands of Illinoisans ineligible for supplemented care, according to the Tribune.

Dental and vision care for adults will be heavily scaled back, and chiropractic and podiatric coverage has been cut altogether, according to St. Louis Today. During the floor debate Thursday, Sen. Mattie Hunter (D-Chicago) outlined her objections to the cuts:

“They are…balancing the budget on the backs of the poor. I don’t see how they’re going to sleep.”

Healthcare Finance News: Explosion of direct-care workforce will cause industry change

The direct-care workforce is expected to add 1.6 million jobs to the economy in the next decade, totaling approximately 5 million workers by 2020, found an analysis by the Paraprofessional Healthcare Institute (PHI), a nonprofit advocating for the direct-care workforce and improvements in long-term care.

Such figures would make the direct-care workforce – personal care aides, nursing aides, orderlies, attendants, home health aides and others – the largest occupational group in the country, PHI estimates, and would make those workers a powerful force.

“Carework in America is at a crossroads,” said Dorie Seavey, PhD, director of policy research at PHI. “We can continue the status quo, adding direct-care positions that are poorly supported and poorly compensated, and then backfill them with public assistance. Or we can acknowledge this workforce as a key underutilized asset in our healthcare system and exploit its enormous potential as one of the strongest job engines that our economy has to offer.”

Washington Post: Katie Beckett, whose case led to disabled children being allowed to live at home, dies in Iowa at 34

Katie Beckett spent most of the first three years of her life at St. Luke’s after encephalitis infected her brain, caused a coma and left her with severe breathing problems, which required the use of a respirator 12 hours a day. Doctors predicted she would live until she was 10…

Her parents’ insurance ran out, so the case fell to Medicaid, the federal-state program that helps pay for health care for the disabled and low-income families with children. Doctors said she could leave the hospital with proper support at home, but Medicaid refused to pay. At the time, Medicaid policy required a hospital stay for coverage of a respirator, even though the device could be used at home.

Then-U.S. Rep. Tom Tauke, an Iowa Republican, brought the family’s plight to the attention of President Ronald Reagan, who took up the cause. The case led to development of the “Katie Beckett waiver,” under which Medicaid pays for home care for disabled children. The U.S. law was passed in 1982, and Iowa’s version took effect in 1984…

More than 11,000 Iowa children are enrolled in the Katie Beckett waiver program. Chuck Palmer, director of Iowa’s Department of Human Services, praised the Becketts for pushing government officials to change their policies.

“This is another example of where a committed and determined family can change the system, not only for their family but for many other vulnerable people,” he said.

Wall Street Journal: Medicaid Gets a Rehab

Medicaid, the state and federally run health-insurance program for the poor, is getting a rehab under the Affordable Care Act, with some changes phasing in now. For many people who qualify that means free health care.

Historically, difficulty with enrollment and lack of awareness of eligibility have been barriers to the program, says Samantha Artiga, associate director of the Kaiser Family Foundation, a health-policy nonprofit. Many low-income adults tend not to qualify, as the programs are typically restricted to children, parents, pregnant women, and older, blind and disabled people.

That’s all set to change in 2014, when Medicaid becomes one of the health overhaul’s main vehicles for insurance coverage expansion. Individuals making up to 133% of the poverty level, or about $14,494 per year, or a family of three that earns some $24,645 a year, can qualify.

But if the Supreme Court strikes down the law as unconstitutional, according to Kaiser, the roughly 16 million low-income adults that the Medicaid expansion would help would likely remain uninsured. Federal funds for the states to expand would presumably not be available.

Changes already happening:

  • At least seven states are acting early and have begun expanding Medicaid to the 2014 levels for adults. These are Colorado, California, Connecticut, Minnesota, New Jersey, Washington state and Washington, D.C., according to Kaiser.
  • Over the past several years, many states also have increased their eligibility levels for children. Some states now have a simplified two-page application to get kids enrolled.
  • States are starting to streamline their application processes. States including Utah, Georgia, Wisconsin and Michigan have moved the process online. Some of these systems can also cross check other state databases, which makes it easier to renew enrollees each year. This will become standard in 2014, but some states are already there so it pays to check if your state is one of them.
  • The government also is raising payment rates so your doctors might be more willing to accept Medicaid. Starting next year Medicaid is increasing reimbursement rates for primary-care providers.

LA Times: Violence Against Women Act becomes latest immigration battleground

Republicans in Congress are proposing to strip away existing protections for immigrants who are the victims of domestic violence.

The Republican-drafted version of the Violence Against Women Act, originally passed in 1994, is scheduled to be debated on the House floor on Wednesday and could be brought to a vote this week.

Currently the law offers anonymity to victims of domestic abuse who are applying for residency visas so that their applications cannot be sabotaged by their abusers. To encourage victims of domestic abuse crimes to remain in the U.S. and cooperate with police, witnesses are able to apply for a special residency visa and eventually apply for permanent residency.

Both of these safeguards have been removed from the House bill…

The White House has threatened to veto the bill if it passes without restoring existing protections. The Senate version of the bill, which preserves and expands the existing protections, passed last month with bipartisan support, 68 to 31.