|
E-mail this page to a friend!
Medicaid News
States Making Drastic Cuts in Medicaid Coverage;
Could Leave Indigent Elderly with No Options
State actions may force faster action on national
health care system
 Jan. 5, 2009 The health care crisis in America
may reach a boiling point faster than expected as state governments
struggling to stay out of the red in this imploding economy are
rapidly cutting the coverage they provide in Medicaid. Californias Gov.
Arnold Schwarzenegger wants to stop paying for dental, psychological,
optometry and other services that would leave many indigent elderly with
no options for care.
States Consider Further Cuts to Medicaid Programs
Amid Continuing Recession
The
Washington Post recently examined how many states "are being forced
to curtail" Medicaid services "as they struggle to cope with the
deteriorating economy." Medicaid, which provided health coverage to 50
million U.S. residents in 2007, is the largest or second-largest expense
in every U.S. state, the Post reports.
According to the Post, 19 states have lowered
payments to hospitals and nursing homes, eliminated coverage for some
treatments and excluded some beneficiaries from the program completely.
Eighteen of these states, as well as six others, are considering
additional reductions for fiscal year 2010 in preparation for the
possibility that additional money will not be available, the Post
reports.
Many states are suspending coverage for services
not required by the federal government, such as physical therapy,
eyeglasses, hearing aids and hospice care, and a few states are
requiring that beneficiaries pay a larger portion of the cost of their
care.
The Post also examined financial issues facing the
Medicaid programs of California, Maryland, Rhode Island, South Carolina,
Virginia and Washington, D.C.
Diane Rowland, executive vice president of the
Kaiser Family Foundation and executive director of the Foundation's
Commission on Medicaid and the Uninsured, said the financial crises
facing Medicaid programs are exacerbated because of a milder recession
earlier in the decade, when states implemented many "cuts that were
making the program more efficient." She added, "Now they are making ...
cuts to the core."
According to the Post, governors and state
legislators "have been pleading with Congress" and President-elect
Barack Obama's administration for financial help with Medicaid.
Congressional Democrats and Obama have proposed
providing additional funding to the state Medicaid programs in an
economic stimulus package. Lawmakers have suggested $100 billion for the
programs, which would increase the portion funded by the federal
government over the next two years.
In addition, some lawmakers also are considering
allowing people who have recently lost their jobs to enroll in Medicaid,
with the federal government paying for the entire cost of their coverage
(Goldstein, Washington Post, 12/26/08).
Schwarzenegger Proposes Medicaid Cuts
Aides to California Gov. Arnold Schwarzenegger (R)
on Wednesday released a proposal to address the state's budget deficit
in part by cutting funds for
Medi-Cal and other health care programs, the
Sacramento Bee reports (Yamamura, Sacramento Bee, 1/1).
Medi-Cal is the state's Medicaid program. The state
faces a projected $40 billion budget deficit over the next 18 months.
Schwarzenegger's plan calls for borrowing, tax increases and spending
cuts to close the deficit and provide a $2 billion reserve.
Schwarzenegger plans to submit his official budget language to the state
Legislature this week.
Schwarzenegger proposed cutting $744.2 million from
Medi-Cal spending by:
● Eliminating coverage for dental, psychological,
optometry and other services;
● Limiting benefits for some documented
immigrants;
● Increasing the income eligibility requirements
to pre-2000 levels;
● Reducing hospital reimbursement rates by 10%;
and
● Scaling back cost-of-living increases for
county-based administration of Medi-Cal services (Sacramento
Bee, 1/1).
The governor's proposal also contains elements of
state Republican lawmakers' budget proposal, including a plan to ask
state residents to approve reallocating funds for mental health services
and early childhood health care and education programs to the state
general fund (Yamamura, Sacramento Bee, 1/1).
The plan would shift Proposition 63 funds for
mental health services to mental health managed care services.
Schwarzenegger estimates that the proposal would save the state $226
million.
In addition, Schwarzenegger proposed eliminating
the state
First 5 Commission and shifting its funds to the state general fund
for children's programs. The move also would shift half of the funds
currently held by 58 county First 5 commissions to the state general
fund.
The governor projects that the plan would save the
state $275 million (Sacramento Bee, 1/1). Both plans would require voter
approval, likely in a special election that the governor could call this
year (Yi et al.,
San Francisco Chronicle, 1/1).
Kaiser Daily Health Policy Report Highlights
Medicaid News in Three Other States
Summaries of recent news involving Medicaid in
Connecticut, Louisiana and Rhode Island appear below.
● Connecticut: Approximately 60,000
households with family members enrolled in
HUSKY must switch from
Anthem Blue Care, one of the program's managed care providers, to a
new managed care network by Feb. 1, according to letters sent by the
state
Department of Social Services, the
Hartford Courant reports.
According to the Courant, the switch is "staunchly
opposed by advocates who say the new networks" --
AmeriChoice and
Aetna Better Health -- "don't have enough doctors." The switch is
required following the program's decision to end its relationship with
Anthem.
According to DSS officials, Anthem's participation
in the program has prevented physicians from joining the other HUSKY
plans. In March 2008, HUSKY withdrew from bidding for the program but
has continued to provide coverage. As of Dec. 1, 2008, 138,126 of the
state's 343,785 HUSKY beneficiaries were covered by Anthem, but DSS
spokesperson Matthew Barrett said the number likely has since declined
(Levin Becker, Hartford Courant, 12/30/08).
● Louisiana: Gov. Bobby Jindal (R) last
week proposed reducing state spending by $341 million, including some
cuts to health care, the
Baton Rouge Advocate reports.
Jindal's proposal includes reducing health care
spending by $118 million in part by reducing the number of prescriptions
Medicaid beneficiaries can receive monthly from eight to five, unless
additional prescriptions can be medically justified. The plan also calls
for reductions to consultant contracts for services for individuals with
developmental disabilities (Millhollon, Baton Rouge Advocate, 12/31/08).
● Rhode Island: The state Senate's first
task on Jan. 6 will be to vet a
waiver between Gov. Don Carcieri (R) and the Bush administration
that would set a $12 billion, five-year spending cap on the state's
Medicaid program in exchange for greater Medicaid spending flexibility,
the
AP/Boston Globe reports.
Incoming Senate President Teresa Paiva-Weed (D)
last week in an interview said that the state might lack the medical
resources necessary to implement the changes. She said, "It does not
appear the administration has taken any of the necessary steps to
prepare for implementation of the waiver," adding, "That really is
probably one of our primary concerns."
The General Assembly must act on the waiver within
30 days of Carcieri sending the measure, which was on Dec. 19, 2008;
otherwise, the measure becomes binding (Henry, AP/Boston Globe,
12/30/08).
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
