States and Medicaid Expansion

  • Medicaid expansion gap could leave poor shortchanged, By Kelly Kennedy, September 5, 2013, USA Today: “The decision of some states not to expand Medicaid means that the nation’s poorest — those the Affordable Care Act would have helped the most — may not receive any help at all. That’s because the 2010 law was written to provide Medicaid coverage for those making less than 100% of the federal poverty level, $23,550 for a family of four, in all 50 states. Because those Americans were to get Medicaid coverage, they were not made eligible for the federal tax subsidies that would help them pay for health insurance they will be required to buy…”
  • Michigan House gives final approval to Medicaid expansion, sending bill to Gov. Rick Snyder, By Jonathan Oosting, September 3, 2013, Mlive: “Michigan is poised to become the 25th state to move forward with Medicaid expansion under the federal Affordable Care Act — and just the third state led by a Republican governor and Legislature to do so…”
  • Kentucky Medicaid expansion, healthcare exchanges proceed with judge’s approval, By Tom Loftus, September 3, 2013, Louisville Courier-Journal: “The Beshear administration’s plans to expand Medicaid and begin enrollment in Kentucky’s new health care exchange survived their first court challenge Tuesday. In separate rulings, Franklin Circuit Judge Phillip Shepherd upheld both decisions by Gov. Steve Beshear intended to expand access to health care to 640,000 uninsured Kentuckians under the Affordable Care Act, also known as Obamacare…”
  • Thousands of Hoosiers will keep coverage with deal to extend Healthy Indiana Plan, By Maureen Groppe and John Russell, September 3, 2013, Indianapolis Star: “President Barack Obama’s health care overhaul envisioned that about half of Indiana’s uninsured residents would get coverage through an expansion of Medicaid, the jointly run federal and state health program for the poor. A compromise that GOP Gov. Mike Pence reached with the Obama administration Tuesday would let tens of thousands of low-income Hoosiers continue to get health care next year through an alternative Medicaid program that includes cost sharing and fewer benefits. And the deal leaves up in the air whether Indiana will see a full expansion of Medicaid to cover hundreds of thousands of poor, uninsured Hoosiers…”
  • Ballot is ‘Plan B’ for expanding Medicaid, By Catherine Candisky, September 5, 2013, Columbus Dispatch: “If lawmakers don’t approve Gov. John Kasich’s plan to expand Medicaid, voters could decide whether to give tax-funded health coverage to an additional 275,000 poor Ohioans. A coalition of health-care providers, unions, businesses, religious organizations and other advocates for the uninsured launched a campaign yesterday that could put the plan on the November 2014 statewide ballot…”

State Medicaid Programs

  • Gov: Utah won’t decide on Medicaid expansion until 2014, By Robert Gehrke and Jennifer Dobner, August 22, 2013, Salt Lake Tribune: “Utah Gov. Gary Herbert said Thursday he will not make a decision until next year about whether to expand Medicaid to cover more of the state’s uninsured. Under the Affordable Care Act, most Americans must get health insurance by 2014 or face a tax penalty. The law gives states the option of expanding eligibility for their Medicaid programs to cover more low-income residents…”
  • Snyder picking up push for Medicaid expansion, critics offering ‘hot air’ balloon rides ahead of vote, By Jonathan Oosting, August 21, 2013, MLive: “Michigan Gov. Rick Snyder is beginning his final push for Medicaid reform and expansion ahead of an expected Senate vote next week…”
  • Republican legislator proposes new cuts to Medicaid, By Catherine Candisky, August 23, 2013, Columbus Dispatch: “Thousands of poor pregnant women, parents and disabled workers would lose tax-funded health coverage under a Cincinnati-area Republican’s proposal to slash Medicaid eligibility…”

State Medicaid Programs

Amid health law expansion, some states trim the Medicaid rolls, By Phil Galewitz, August 18, 2013, Washington Post: “While millions of adults nationwide will gain Medicaid coverage next year under the federal health law, more than 150,000 people could lose their coverage in the state-federal health insurance program for the poor as four states reduce eligibility. The states planning to make the cuts in January are Maine, Rhode Island, Wisconsin and Vermont. Most people losing access to Medicaid will be eligible for federal subsidies to help buy private coverage in the law’s online insurance marketplaces also starting in January, but advocates worry some will struggle to afford higher premiums and other cost-sharing expenses…”

Health Insurance Coverage for the Uninsured

  • King County health officials map strategy to reach uninsured, By Lisa Stiffler, August 8, 2013, Seattle Times: “Health officials in King County are rallying the troops and drafting maps to prepare for an all-out effort to get health-care coverage for uninsured residents. Countywide, approximately 16 percent of the population lacks health insurance. But from Burien and Tukwila south to the county line, and in scattered pockets to the north, those numbers are higher, reaching nearly one-third in some places…”
  • Colorado presses for uninsured to enroll, By Abby Goodnaugh, August 2, 2013, New York Times: “Television commercials have already run suggesting that buying health coverage through the state’s new insurance market, Connect for Health Colorado, will feel like winning the World Series…”
  • Critics say Obamacare may tempt subsidy applicants to lie about benefits, By Tony Pugh, August 6, 2013, Kansas City Star: “The Obama administration is trying to quiet growing concern that people will lie about their incomes and other personal information in order to land larger health insurance-premium tax credits, the cash assistance that will help millions pay for coverage next year. Once health plan enrollment begins on new state insurance exchanges in October, an estimated 7 million people are expected to purchase individual and small-group coverage by the end of March…”

States and Medicaid Expansion

  • Who loses out under Obamacare, By Tami Luhby, July 25, 2013, CNNMoney: “When the state-based insurance exchanges open next year under Obamacare, many Americans should finally have access to affordable insurance. But millions of others will most likely be left out in the cold and remain uninsured. These folks — mainly low-income adults in the 21 states that aren’t expanding Medicaid — will not be eligible for either the long-standing government health insurance program for the poor, or for premium subsidies in the new exchanges…”
  • State lawmakers not giving up on Medicaid expansion, By Natasha Lindstrom, July 28, 2013, The Sentinel: “Lawmakers who lost their push last month to get Pennsylvania to expand Medicaid are gearing up to press even harder when the General Assembly reconvenes in September…”
  • Much is at stake for minorities in Medicaid debate, By Steve Twedt, July 25, 2013, Pittsburgh Post-Gazette: “As Pennsylvania decides whether to expand its Medicaid program, a new study says the decision will have a major impact on the state’s racial and ethnic minorities. A Kaiser Family Foundation analysis found that 15 percent of African Americans in Pennsylvania are without health insurance and nearly two-thirds of them would qualify for coverage under federal poverty level criteria set out by the Affordable Care Act if Medicaid were expanded…”
  • Medicaid changes spur concerns locally, By Marissa Harshman, July 29, 2013, The Columbian: “In the next year, the state of Washington expects to have more than 600,000 newly insured residents. A significant portion — about 330,000 people — will receive medical coverage through the state’s expanded Medicaid program…”
  • Medicaid expansion a must to qualify for federal dollars, By Whitney Evans, August 1, 2013, Deseret News: “As Utah leaders explored options for expanding Medicaid coverage, one thing became clear: The state needs to act. ‘By far the costliest option to the state is sending our tax dollars to Washington and getting nothing back,’ Sven Wilson, economist and senior consultant for the Utah Department of Health, told members of the Medicaid Expansion Options Community Workgroup…”

Supplemental Nutrition Assistance Program

House plan on food stamps would cut 5 million from program, By Ron Nixon, July 30, 2013, New York Times: “Nearly half a million people who receive food stamps but still do not get enough to eat would lose their eligibility for the program under proposed cuts that are expected to be taken up again by Congress. An additional 160,000 to 305,000 recipients who do get enough to eat would also lose their eligibility and the ability to adequately feed themselves. In total, about 5.1 million people would be eliminated from the program, according to a new report…”

Child Are Subsidies – Maryland

Md. child care subsidy program underfunded, By Tricia Bishop, July 15, 2013, Baltimore Sun: “Maryland’s Child Care Subsidy program, which gives poor families vouchers for care so parents can work or go to school, is so underfunded that it hasn’t met federal rate guidelines in a decade and still uses income eligibility criteria from 2001. The deficit prevents thousands of families from participating and relegates many of those who do to the least expensive care available — often the lowest caliber in terms of facilities, educational offerings and staff training…”

Drug Testing and Assistance Programs – North Carolina

Revised proposal still may deter welfare recipients, By Annalise Frank, July 8, 2013, Charlotte Observer: “An effort to require all welfare recipients to pass a drug test to qualify for benefits that passed the Senate earlier this session has been given a facelift, but advocates for the poor say it’s still an ugly bill. House Bill 392 requires county Social Services employees to do background checks on all applicants for Work First benefits – the state’s welfare program – and food stamps to ensure they’re not parole or probation violators, or have outstanding felony warrants. It also requires drug testing of any Work First recipient suspected of being a drug user. That provision is a step back from a bill the Senate passed in April that required drug testing for all Work First applicants. Worries over the legality of the Senate bill led lawmakers in the House to insert a new version of the testing requirement into the background checks bill…”

SNAP Eligibility and Enrollment – Los Angeles, CA

Nearly half of those eligible for food stamps refuse benefits, By Christina Villacorte, June 16, 2013, Los Angeles Daily News: “The food bank at Meet Each Need with Dignity in Pacoima was bustling on a recent day with people reaching for donated fruits, vegetables, juice and other goods. And yet, when a volunteer grabbed a microphone to ask the hungry crowd, ‘Who wants to apply for food stamps?’ no one raised a hand. The scene captured the dilemma of the county Department of Public Social Services, which has struggled to boost enrollment in the federal food stamp program, known locally as CalFresh. In Los Angeles County, 1.1 million low-income Americans and legal residents receive up to $200 per individual, or $668 per family of four, every month for groceries…”

Supplemental Nutrition Assistance Program – Pennsylvania

A year later, Pa. food-stamp test called too complex, By Alfred Lubrano, May 3, 2013, Philadelphia Inquirer: “A year ago this week, Pennsylvania tied eligibility for food stamps to the assets people possess. Since then, nearly 4,000 households have lost or were denied benefits because they had too many financial resources, according to the Department of Public Welfare. In that same time, many more people – around 111,000 households – were denied benefits because they failed to provide proper documentation for the asset test…”

Supplemental Nutrition Assistance Program – New York City

Many Staten Islanders in need miss out on food stamps, By Judy L. Randall, May 13, 2013, Staten Island Advance: “The way Saeeda Usmani sees it, her participation in the federal food stamp program has been a godsend. At 71, the retired nurse from Stapleton couldn’t afford to maintain her medically mandated gluten-free diet, which can be pricey, without assistance. As it is, because Ms. Usmani tires easily, she goes to the supermarket only every three weeks and carefully husbands the fresh fruits and vegetables that she purchases with the $173 she receives each month from the Supplemental Nutritional Assistance Program (SNAP), the current name for food stamps. But Ms. Usmani is something of a rarity among SNAP-eligible low-income Staten Islanders 60 and older: Only 23 percent participate in the program here, the lowest percentage among the five boroughs…”

Supplemental Nutrition Assistance Program – Pennsylvania

Tougher standards mean fewer food stamp recipients in Pennsylvania, By Jan Murphy, April 15, 2013, Patriot-News: “Nearly a year ago, Gov. Tom Corbett put in place a policy that his administration said would limit government-provided food stamps to those truly in need. His administration re-introduced an asset test that had been abandoned four years before to help rein in spending at the Department of Public Welfare. The idea behind factoring in all of an applicant’s assets was to ensure that people with a certain amount of cash or other assets, such as second cars of a certain value or boats, tap those dollars first before dipping into the pool of taxpayer-funded food assistance. Previously, the department used income levels to determine eligibility…”

SNAP Eligibility and Enrollment – California

Study: Californians leave billions in federal food stamp funds unclaimed, By Beau Yarbrough, February 20, 2013, Whittier Daily News: “If every Californian eligible for federal food stamp programs signed up for them, they would generate an additional $8.3 billion in economic activity each year, according to a new study. The California Food Policy Advocates on Wednesday released its annual Program Access Index, which measures the portion of people who can receive food stamps in each of the state’s 58 counties and actually sign up for them. Only 55 percent of Californians eligible for the federal food aid program enroll, according to the study by the Oakland-based nutrition policy and advocacy organization…”

Medicaid and Dental Care – Colorado

Dental treatment not reaching most Medicaid-eligible youth, By Jeffrey A. Roberts, February 10, 2013, The Coloradoan: “When she was 3, Torrie Smith tripped on an uneven sidewalk, fell face down onto some steps and broke four front teeth. An emergency room doctor stopped the bleeding and gave her something for the pain, but Torrie didn’t get to a dentist for six months — her first time ever to a dentist — because her parents didn’t have dental insurance and didn’t have cash to pay for an examination. Now 4, Torrie’s dental problems are so severe she has to go to an operating room, not a dentist’s chair, to have them fixed. While she is under anesthesia, an abscessed incisor will be pulled and nine other cavity-ravaged teeth will be pulled or treated. Torrie’s toothaches, along with the risk and high cost associated with curing them, probably could have been avoided. She is like many children in low-income families in Colorado who rarely, if ever, see a dentist even though they can go for free…”

States and Medicaid

  • Spending on Medicaid has slowed, survey finds, By Abby Goodnough, October 25, 2012, New York Times: “The annual growth in spending on Medicaid slowed sharply last year as the economy began to improve, a survey by the Kaiser Family Foundation found. Enrollment in the program grew only modestly as well, but that may change as millions of people are due to become eligible in 2014 under the new national health care law. Medicaid provides health and long-term care coverage to more than 60 million poor people, at a combined cost to the states and federal government of more than $400 billion a year. During the recession, as Americans lost jobs and health insurance, enrollment in the program rose sharply, and states struggled under the weight of its costs…”
  • Medicaid expansion option would impact tens of thousands in Clark County, but details raise questions, By Kari Bray, October 22, 2012, The Oregonian: “About 20,000 uninsured individuals in Clark County could qualify for Medicaid if Washington state chooses to accept federal funds to expand the program in 2014. However, some legislators have voiced concerns that the state lacks the detail needed to implement the optional Medicaid expansion. The expansion was originally mandatory under the Affordable Care Act, but a U.S. Supreme Court ruling in July resulted in the expansion becoming voluntary…”
  • Ohio’s high Medicaid cost estimates questioned by some experts, By Kate Irby, October 24, 2012, Cleveland Plain Dealer: “Gov. John Kasich’s administration says it is bracing for a billion-dollar hit. Officials say it’ll come from 400,000 new Medicaid clients in the 24 months after the Affordable Care Act begins requiring most people to have health insurance. These are folks who are currently eligible for Medicaid but have never signed up. Just across the border, however, state Medicaid officials in Indiana and Michigan see things much differently. They expect drastically smaller numbers of people to climb aboard their programs — just 15,000 in Michigan and 92,000 in Indiana — when the so-called individual mandate for health coverage begins in 2014…”
  • Deal may reinstate Pa. residents dropped from Medicaid, By Aubrey Whelan, October 24, 2012, Philadelphia Inquirer: “More than 100,000 Pennsylvanians who lost Medicaid benefits last year can reapply within the next 30 days, thanks to a settlement between a Philadelphia legal team and the state Department of Public Welfare. Applicants who lost their benefits last year and incurred medical bills could see those bills resolved if the state determines they were eligible for Medicaid all along. Last year, DPW identified about 385,000 households that were overdue for redetermination – in other words, the agency needed to check whether those recipients were still eligible for Medicaid…”
  • Cuomo’s Medicaid changes are at Washington’s mercy, By Nina Bernstein, October 23, 2012, New York Times: “Depending on who is doing the talking these days, New York State is either a national model of how to curb Medicaid spending, or the nation’s prime example of Medicaid abuse. Now billions of dollars in state revenue may ride on which image prevails, as presidential politics puts a new spotlight on the joint federal and state spending program for care of the disabled, the elderly and the poor. No state spends more Medicaid money than New York — $54 billion a year. But Gov. Andrew M. Cuomo, a Democrat, persuaded health care providers and major health worker unions to live within a strict Medicaid spending limit last year, and to accept an ambitious Medicaid redesign that promises better health outcomes at a lower cost…”

States and Medicaid – Tennessee, Michigan

  • Medicaid debate hits home in Tennessee, By Chas Sisk, October 10, 2012, The Tennessean: “Marvin Berry Jr. was just 7 years old when a ricocheting bullet struck his spinal cord at the point where his head joins his neck. Told by doctors that he would be lucky to live 20 years, Berry has reached age 40. He has earned a bachelor’s degree in finance from Austin Peay State University despite having almost no use of his arms or legs. ‘I know that there are a lot of people out there that believe in entitlements or the government may owe them something,’ he said. Without government assistance, he said, ‘there’s no way I could function.’ The debate over Medicaid means more for some Tennesseans than others. To Berry and the approximately 263,300 other disabled and elderly Tennesseans whose long-term care is covered at least partially by Medicaid, the discussion is as important as life itself…”
  • Report: Medicaid expansion could save Michigan $1 billion, By Scott Davis, October 14, 2012, Lansing State Journal: “Michigan taxpayers could save nearly $1 billion over a 10-year period if the state expands its Medicaid program under federal health care reform, according to a newly released report. Most of the savings would come from reduced state expenditures for mental health services for low-income residents and medical care for prisoners, which would be shifted to the federal government under the Medicaid expansion, according to the Center for Healthcare & Transformation, a nonpartisan group that studies ways to improve health policy in Michigan. Since July, state lawmakers and the Gov. Rick Snyder administration have studied whether Michigan should expand Medicaid eligibility and add 450,000 to 619,000 residents to Medicaid rolls over the next decade…”

Medicaid Program – Florida

Fla. Medicaid program in limbo, By Kelli Kennedy (AP), October 7, 2012, Miami Herald: “Millions of uninsured Florida families and health care providers are in a purgatory of sorts. Gov. Rick Scott and the Republican-led Legislature want to privatize the state’s Medicaid program, but need the Obama administration’s permission. The Obama administration wants to make more low-income Floridians eligible for Medicaid, but needs Scott and the Legislature to agree. The sides have been negotiating a package deal for more than a year and won’t comment. Without a solution billions of federal dollars could go to other states and many uninsured Floridians will continue to receive their health care in emergency rooms – the most expensive, least effective place. Safety nets, like community health centers, say they don’t have enough funding to keep up as more uninsured patients end up in their waiting rooms…”

State TANF Program – Maine

New welfare time limit cuts thousands from rolls, heightens focus on work programs, By Robert Long, September 28, 2012, Bangor Daily News: “The number of Maine households receiving welfare benefits through the Temporary Assistance for Needy Families program decreased by more than 3,000 between January and July of this year. State welfare officials and advocates agree that the approximately 26 percent drop in Maine’s TANF caseload since January results directly from the implementation this year of a 60-month limit on how long each household can receive benefits. They also agree that what happens to families whose benefits expire must be monitored closely — and that the system will have to change to better meet their needs…”

States and Medicaid

  • Making $11,000 a year, but excluded from Medicaid, By Kelli Kennedy (AP), August 14, 2012, Atlanta Journal-Constitution: “Sandra Pico is poor, but not poor enough. She makes about $15,000 a year, supporting her daughter and unemployed husband. She thought she’d be able to get health insurance after the Supreme Court upheld President Barack Obama’s health care law. Then she heard that her own governor won’t agree to the federal plan to extend Medicaid coverage to people like her in two years. So she expects to remain uninsured, struggling to pay for her blood pressure medicine. ‘You fall through the cracks and there’s nothing you can do about it,’ said the 52-year-old home health aide. ‘It makes me feel like garbage, like the American dream, my dream in my homeland is not being accomplished.’ Many working parents like Pico are below the federal poverty line but don’t qualify for Medicaid, a decades-old state-federal insurance program. That’s especially true in states where conservative governors say they’ll reject the Medicaid expansion under Obama’s health law…”
  • Frequent Medicaid patient doctor visits no longer allowed, By Liz Freeman, August 13, 2012, Naples Daily News: “Medicaid patients with chronic health problems, be prepared: Frequent doctor visits are no longer allowed. Hospitals also are taking new hits from the state Medicaid program for the poor and disabled. Payments for ‘frequent flier’ patients to emergency room stops with the seventh visit in one year. The Florida Legislature approved the caps this past spring. The state Agency for Healthcare Administration recently notified hospitals and doctors of the changes that kicked in Aug. 1. The catch is a consumer watchdog group, Florida CHAIN, says it has asked the state for proof it has sought approval from the federal government to make the changes…”

States and Medicaid Expansion

States could leave millions of low-income people uninsured in a new Medicaid ‘doughnut hole’, Associated Press, July 17, 2012, Washington Post: “For Gov. Rick Perry, saying ‘no’ to the federal health care law could also mean turning away up to 1.3 million Texans, nearly half the uninsured people who could be newly eligible for coverage in his state. Gov. Chris Christie not only would be saying ‘no’ to President Barack Obama, but to as many as 245,000 uninsured New Jersey residents as well. The Supreme Court’s recent ruling gave governors new flexibility to reject what some Republicans deride as ‘Obamacare.’ But there’s a downside, too. States that reject the law’s Medicaid expansion risk leaving behind many of their low-income uninsured residents in a coverage gap already being called the new ‘doughnut hole’ – a reference to a Medicare gap faced by seniors…”