13 States Cut Medicaid To Balance Budgets
By Phil
Galewitz and Matthew Fleming
Jul 24, 2012 - Kaiser Health News
This story was produced in collaboration with USA TODAY.
Thirteen states are moving to cut Medicaid by reducing benefits, paying
health providers less or tightening eligibility, even as the federal government
prepares to expand the insurance program for the poor to as many as 17 million
more people.
States routinely trim the program as tough times drive up enrollment and
costs. But the latest reductions – which follow more extensive cuts last year -- threaten to limit access to
care for some of its 60 million recipients.
"With more people on Medicaid, states will have to continue to ratchet down
payments and limit services," says Nina Owcharenko, director of the center for
health policy studies at the conservative Heritage Foundation.
Some worry the cuts to doctors and hospitals could make it more difficult to
expand the state-federal program in 2014, as called for by the federal health
law. "Some providers may be unwilling to accept new Medicaid
patients," says former New York Medicaid Director Deborah Bachrach.
But she notes the law may counter that effect with its funding boosts to
community health centers and its temporary rate increases for primary
care doctors beginning in January 2013.
Most of the cuts went into effect this month, according to a 50-state survey
by Kaiser Health News for USA Today. Among them:
--Illinois cut enrollees to four prescriptions a month; imposed
a copay for prescriptions for non-pregnant adults; raised eligibility to
eliminate more than 25,000 adults and eliminated non-emergency dental care for
adults.
--Alabama cut pay for doctors and dentists 10 percent and
eliminated coverage for eyeglasses.
--Florida cut funding to hospitals that treat Medicaid patients by 5.6
percent – following a 12.5 percent cut a year ago. The state is also seeking
permission to limit non-pregnant adults to two primary care visits a month
unless they are pregnant, and to cap emergency room coverage at six visits a
year.
--California added a $15 fee for those who go to the emergency
room for routine care and cut reimbursements to private hospitals by $150
million.
--Wisconsin added or increased monthly premiums for most
non-pregnant adults with incomes above $14,856 for an individual.
South Dakota, Maryland, Colorado, Louisiana, New Hampshire, Hawaii and Maine
also are making reductions to their programs. Connecticut is weighing cuts
likely to go into effect this fall.
A few states have increased Medicaid benefits, including Arizona, which
will boost pay for mental health providers next April. And some are looking at
restoring cuts made during the worst of the recession, said Vernon Smith,
managing principal with consulting firm Health Management Associates and a
former Michigan Medicaid director.
Stacey Mazer, senior staff associate with the National Association of State
Budget Officers, notes that fewer states are cutting the program this year,
partly because many are in better economic shape and partly because "states are
hearing a lot of hue and cry about the impact on access."
Last November, for instance, about 3,500 Medicaid recipients in New Hampshire
had to find new doctors after cuts led LRGHealthcare in Laconia to stop offering
primary care to non-pregnant adults, says Senior Vice President Henry
Lipman.
"To see two decades of providing access for our community basically erased
has been very disheartening," he says.
It is unclear how many states will participate in the law's Medicaid
expansion since the Supreme Court ruled last month that they may not be
penalized for opting out. A number of Republican governors have vowed not to
participate, citing costs. Although the federal government will pay for the
first three years, states will still have to cover up to 10 percent of the costs
after that.
© 2012 Henry J. Kaiser Family Foundation. All rights
reserved.