States struggle with Medicaid issues

Various newspapers examine Medicaid issues including the coverage needs of kids in Michigan, financial worries for Medicaid programs in California and New Hampshire and concerns that Medicaid pay may be cut again when stimulus money runs out.

The Detroit Free Press reports on the need to cover uninsured and underinsured children in Michigan: "While Congress and the president debate over comprehensive health care reform, local and national experts say making sure all children have coverage now will mean they have a better chance of growing into healthy adults who will be less of a burden on the health care system. There are 7.3 million uninsured children in the country, about 151,000 of them in Michigan, and many more children who are underinsured" (Satyanarayana, 10/12).

San Jose Mercury News reports: "An expansion of Medicaid contemplated by health care reformers in Congress may be good news for the uninsured, but it could be a bitter pill for cash-strapped California. ... But because Medicaid costs are split between the federal and state governments, California officials fear that this change would saddle California with a costly mandate at a time when the state can't afford its existing Medicaid program, called Medi-Cal. In fact, Medi-Cal is already running on fumes after it was slashed by Gov. Arnold Schwarzenegger and state lawmakers this year to help close the state's massive budget deficit. Patients can no longer get dental or podiatry coverage, among other benefits that were eliminated, and many doctors won't see Medicaid recipients because the state's reimbursement rates for the program are so low" (Zapler, 10/12).

The Concord Monitor reports that New Hampshire Gov. John Lynch has raised concerns about an expansion of the Medicaid program. "Specifically, Lynch is worried that a plan to expand Medicaid, the government-run insurance program for the poor and elderly, will saddle state budgets with hefty costs. ...," the  Monitor reports. "New Hampshire now offers Medicaid coverage to the following groups: low-income children, pregnant women, elderly individuals and people with disabilities. Parents are covered, too, if the family earns less than 63 percent of the federal poverty level (or about $13,900 a year for a family of four). But several proposals before Congress would require all states to extend Medicaid coverage to anyone who earns less than 133 percent of the poverty level. That comes to $14,400 for an individual, or about $29,300 for a family of four)" (Barrick, 9/12).

American Medical News reports on Medicaid growth and spending: "Federal stimulus funding has helped state Medicaid programs avoid drastic reductions in eligibility and physician fees, but program directors already are contemplating such cuts when the additional federal support runs out at the end of next year. States ... experienced a surge in new Medicaid enrollees and a historic decline in tax revenues. States coped by trimming or freezing Medicaid fees and restricting benefits, among other actions, according to a ninth annual survey of state Medicaid directors released Sept. 30 by the Kaiser Family Foundation and Health Management Associates. ... Medicaid enrollment grew by 5.4% in fiscal 2009 -- the highest rate in six years -- while total program spending increased by 7.9%, the fastest pace in five years. Meanwhile, state revenues plummeted: Tax collections dropped by 16.6% in the 12 months leading up to June 2009, according to U.S. Census Bureau statistics. This contributed to a 6.3% decline in the state portion of Medicaid spending -- the first in the program's history," according to the report's co-author Vernon K. Smith of Health Management Associates (Trapp, 10/12).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.