State issues

State governments are implementing the controversial healthcare law, even in places where elected officials are challenging its constitutionality.

GOP Sens. Olympia Snowe and Susan Collins of Maine join Democrats in approving the legislation.

Obesity is quickly becoming a national epidemic, and the costs to treat its related ailments is approaching $150 billion a year, the Centers for Disease Control and Prevention (CDC) reported Tuesday.

Nine states in 2009 had an obesity prevalence above 30 percent, CDC found — triple the number with such high rates in 2007. A decade ago, no state had an obesity rate above that threshold.

Different ethnic groups suffer the scourge disproportionately, the CDC found. Black women, for instance, have the highest obesity prevalence, at 41.9 percent. 

Education levels are also a factor, with non-high-school graduates reporting obesity levels of 32.9 percent.

Regional discrepancies also play a role. The South tallied an obesity prevalence of 28.4 percent.

And those numbers — based on hundreds of thousands of phone interviews where respondents volunteered their height and weight — are underestimates. Why? Because "research has found that both men and women often say they are taller than they actually are, and women often say they weigh less than they do in telephone surveys," CDC notes.

The trend doesn't come cheap.

The Robert Wood Johnson Foundation (RWJF) has just released a new study highlighting the steps 12 states are taking to prevent a looming crisis in nursing. Experts predict the United States could be short more than 260,000 nurses by 2025 and the study authors say state-level partnerships must take the lead in addressing the problem.

Some of the efforts highlighted in the report, according to a press release, include:
• Bringing the business community and others into a coalition supporting expansion of capacity to secure a bigger state appropriation;
• Strong gubernatorial leadership to coordinate a series of reforms, including Web-based management of clinical placements for nursing students, and the creation of a statewide nursing corps to rapidly educate faculty and students;
• Multi-state partnerships among community colleges and baccalaureate programs to bridge the gaps between programs offering associates and Bachelor of Science in Nursing (BSN) degrees;
• Alliances of nursing programs from institutions around the state — including an alliance of rural programs — to share curriculum, administrative resources, faculty, admissions standards, and relying on Web-based instruction and mobile simulators to maximize reach; and
• A focused program of distance-learning, Web-based simulation and other approaches to overcome geographical challenges.

Here is a breakdown of what the states in the study are doing:

Sens. Bob Casey Jr. (D-Pa.) and Sherrod Brown (D-Ohio) on Thursday scaled back their proposal to extend COBRA health benefits for the nation's millions of unemployed workers. 

Like earlier versions, the revised bill would extend eligibility for the premium assistance program through Nov. 30; unlike earlier versions, it would limit the benefits to six months (instead of 15) for those entering the program between June 1 — when enrollment expired — and Nov. 30. 

To address the deficit-spending concerns of budget hawks, the new bill would offset the cost by eliminating the advance earned income tax credit. Though the Congressional Budget Office has not yet scored the scaled back proposal, Casey's office said Thursday that the $1.5 billion offset should be enough to cover the tab.  

The lawmakers are hoping to offer the bill today as an amendment to the tax extenders bill being considered by the Senate this week, though it remains unclear if they'll succeed in getting a vote.

More than 58 million Americans — or 19.4 percent of the country — were without health insurance during some part of last year, according to a report released Wednesday by the Centers for Disease Control and Prevention (CDC).

The figure, based on preliminary data from the 2009 National Health Interview Survey (NHIS), marks a jump above 2008, when 18.7 percent of Americans were without coverage at some point in the year. 

Among the other highlights of the CDC survey, in 2009: 

— 46.3 million Americans (or 15.4 percent) were uninsured at the time of survey; 

— 32.8 million (10.9 percent) had been uninsured for more than a year at the time of the survey;

— Among states, Massachusetts had the lowest uninsured rate (3.7 percent), while Texas ranked highest (24.6 percent).

The numbers, based on an analysis of more than 88,000 people, will be updated quarterly.  

An unexpected source has added its voice to the chorus of states asking for $24 billion in enhanced Medicaid payments: Susan Komen for the Cure. The organization's vice president of Government Affairs and Public Policy, Jennifer Luray, writes on the Huffington Post that "women's lives are at stake" as the Senate takes up the tax extenders bill this week.

"Without the extension, states must make further cuts to vital state services, including investments in potentially life-saving breast cancer screening services for under-served women," Luray writes. "Without these services, many of the otherwise-eligible women will not get regular screenings."