Free Daily Headlines :

  • COVID-19
  • Money
  • Election 2020
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Money
    Election 2020
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

Federal health care reform will put new demands on shrinking state workforce

  • Health
  • by Arielle Levin Becker
  • October 1, 2010
  • View as "Clean Read" "Exit Clean Read"

Implementing health reform could strain the capacity of state government workforces at a time when tight budgets make hiring new employees difficult,  a new report warns.

The report, written by researchers at the Kaiser Family Foundation and the Center for State and Local Government Excellence, grew out of an effort to understand how states were addressing the requirements of the Patient Protection and Affordable Care Act while grappling with fiscal pressures and workforce cuts. Researchers focused on five states, including Connecticut.

vogel 5-4-10

Cristine Vogel

Nationwide, states, localities and school districts have cut 231,000 jobs since 2008, the report’s authors noted.

“These workforce issues have left agencies responsible for implementing federal health reform chronically short-staffed,” they wrote.

The authors also noted that 37 states are holding gubernatorial elections this fall. Many states have political appointees in charge of implementing the requirements of the health reform law, and with a change in administrations, those people could be out of state government by next year.

In Connecticut, which is certain to have a new governor in January, Cristine Vogel has been leading the state’s implementation effort as special advisor to Gov. M. Jodi Rell.

Vogel said it is too soon for the state to determine the exact workforce changes health reform will require. The state has applied for a planning grant from the federal government that Vogel said could be used in part to assess workforce requirements.

Two provisions of the law are likely to pose the biggest workforce challenges – expanded Medicaid eligibility and the health insurance exchanges.

One of the major ways the health reform law will cover more people is by expanding eligibility for Medicaid. In Connecticut, as many as 130,000 people could become eligible. Vogel said the state Department of Social Services will have to ensure that it is able to receive an influx of applications and process the paperwork to get new enrollees into the system by Jan. 1, 2014, the date by which they are to be covered.

“Those are truly the people that health care reform is supposed to be helping, and what you do not want as state government is by January 1, 2014 to not be able to provide that insurance card to people,” she said.

Vogel said it will be “a balancing act” for the department to hire and train enough people with a tight state budget.

The report noted that Connecticut’s recent early retirement incentive program for state employees led to a 10 percent drop in the state’s medical care administration workforce.

It also described the changes to Medicaid eligibility as presenting “both challenges and opportunities.” While building the infrastructure required for the expanded programs will stretch staff capacity and expertise, developing streamlined methods for enrolling people could ultimately improve Medicaid programs and create efficiencies for staff.

By 2014, each state must also have in place a health insurance exchange, which will serve as a marketplace for people to purchase coverage.  The exchanges will have multiple responsibilities, including certifying and rating insurance plans, operating a toll-free hotline and complying with a range of federal reporting requirements.  By 2015, the states must also have a way to pay for them.

States can outsource the functions of their exchanges, or form regional exchanges with other states, or have the federal government operate their exchanges.

A state agency in Massachusetts that performs functions similar to what the exchanges will do has close to 50 employees, Vogel said. She said the exchanges will likely require staff with a range of skills, including experience with insurance, marketing and communications, and health care.

The report noted that states plan to use consultants for technology and insurance expertise, but that since all states will be working to meet the same requirements in the same time frame, contractors with particular expertise could be in short supply.

The Connecticut Insurance Department also will have additional responsibilities because the law created additional reporting requirements for insurance companies. Vogel said most other state agencies affected by the reform law will likely be able to accommodate additional tasks with their existing workforces or do so with a few additional workers.

State Rep. John Geragosian, co-chairman of the appropriations committee, said he expects discussions and decisions about the state’s responsibilities under health reform to take place during the next legislative session.

“This is on everybody’s radar screen,” the New Britain Democrat said. “2014 is right around the corner.”

Geragosian said it’s not yet clear how the state will bear the administrative costs. Some changes, such as streamlining the Department of Social Services’ enrollment system, could ultimately save money, he said.

State House Speaker Christopher Donovan, meanwhile, bristled at the idea that the health reform law could require additional state costs. Donovan, a Democrat from Meriden, noted that the state is to receive up to $30 million a year under the health reform law to help pay for retiree health coverage,  and said the law is designed to save money.

“Up to this point, it’s cost savings,” he said.

The bulk of the health reform implementation work will take place under a new governor, making it difficult to predict the direction it will take.

Vogel said the current administration has been careful not to commit the next governor to a particular policy direction in implementing health reform. In applying for a federal planning grant, for example, Vogel said she was careful to focus on planning and research, rather than policy decisions.

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Arielle Levin Becker

SEE WHAT READERS SAID

RELATED STORIES
Nursing home residents are receiving the COVID vaccination at a higher rate than their caretakers
by Dave Altimari and Jenna Carlesso

Providers attributed workers' reluctance to a variety of issues, from concerns about fertility to uncertainty about the side effects.

Legislative leaders support extension of Lamont’s emergency powers during COVID
by Jacqueline Rabe Thomas

The governor's emergency powers expire Feb. 9 unless he asks lawmakers for an extension within 72 hours of that date.

For some transgender people, pandemic paves path to transition
by Carol Leonetti Dannhauser | C-HIT.ORG

The COVID-19 pandemic has given many transgender individuals the incentive to begin gender-affirming hormone therapy.

COVID deaths and infections in CT nursing homes decline as more residents are vaccinated
by Dave Altimari

There were 85 deaths in nursing homes and 312 residents infected during the week ending Jan. 12.

COVID lawsuit against CVH and Whiting hospitals dismissed
by Kelan Lyons

With vaccines for patients on the horizon, plaintiffs agreed to the case's dismissal.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion The change in leadership must not lead to complacency
by Jenna Van Donselaar

We are beginning 2021, and most people are far done with election talk. Sure, the polls are closed, and the results are in, and it is time to move on. I am weary from the hours I spent texting voters this fall, and I’d like to think all my efforts were worth it. But the work is far from done.

Opinion Treason is in the air
by David Holahan

Abraham Lincoln had been elected but had yet to assume the presidency when southern states started seceding from the Union in the months before his March 4, 1961 inauguration. Four others would follow that spring. American soldiers —like Robert E. Lee, who had taken an oath of loyalty to the nation that he had served since 1825— defected to the Confederacy. By joining the rebellion Lee and fellow travellers became, in effect, traitors.

Opinion Trump’s reaction to defeat further confirms urgency for school focus on social emotional skills 
by Sandra M. Chafouleas 

Imagine what would happen if a preschooler didn’t “use their words” when they got upset about sharing, instead stomping around yelling while adults simply observed in silence. Think about what the school climate would feel like if a student punched another during recess while others watched without seeking help.  Now consider the actions – and inactions – by Trump Jan. 6 as the electoral vote counts occurred at the U.S. Capitol.

Opinion Is Trump leading a cult?
by Elena Sada

My experience as a former cult member and researcher in the field of Social Sciences earned me the ability to identify narcissism and cultish tendencies. Furthermore, as a former  New York City resident who kept abreast of interviews with the city’s apparent “movers and shakers,” I often questioned Trump’s qualifications as a leader, let alone as national presidential leader.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO