• Maine Governor LePage backs nation’s toughest Medicaid cuts, By Christine Vestal, February 6, 2012, Stateline.org: “Medicaid spending is a matter of urgency almost everywhere in the country right now, but in few places is the urgency as palpable as it is here, where the governor refers to the federal-state health insurance program for the poor as ‘welfare,’ says it’s necessary to eliminate coverage for 65,000 adults, and wants to stop paying room and board for some 2,000 elders who live in group homes. All these ideas are part of Republican Governor Paul LePage’s plan to close a $220 million hole in the state’s biennial Medicaid budget. ‘If we are to bring our welfare system to a manageable level that Maine can afford,’ LePage insists, ‘we must make the necessary structural changes … The state can no longer use gimmicks to fill the hole.’ The size of Maine’s Medicaid shortfall is substantial, but it pales in comparison to gaps in many other states. In fact, health experts in Maine say the program has survived far bigger shortfalls in recent years without cutting the rolls. Still, LePage argues that the program can no longer provide a ‘free lunch’ to poor 19- and 20-year olds, or to healthy adults responsible for the care of others…”
• Obama administration rejects Medi-Cal copayments, By Judy Lin (AP), San Francisco Chronicle: “Federal health officials on Monday said California cannot force Medi-Cal recipients to make a co-pay for doctor visits and prescription drugs, a decision that brings relief to low-income patients but complicates the state’s effort to close a $9.2 billion budget deficit. A letter from the Centers for Medicare & Medicaid Services said agency officials were ‘unable to identify the legal and policy support’ for the state’s request. The decision is the latest in a string of legal and regulatory challenges that have made it difficult for the state to reduce spending and balance its budget. Gov. Jerry Brown and lawmakers were planning to save $511 million a year in the health insurance program by requiring low-income patients to pay a share of their medical costs…”

• State Medicaid programs face $141 million shortfall, report says, By Jason Stein, January 31, 2012, Milwaukee Journal Sentinel: “Wisconsin’s health programs for the poor have a $141 million shortfall in state money over the next year and a half, new estimates show. So far, GOP Gov. Scott Walker’s administration has saving plans that would more that cover that potential deficit in the state’s Medicaid health programs. But a new report by the Legislature’s nonpartisan budget office questions whether all of the saving will materialize. With costs in the program still substantial and the saving uncertain, the Legislative Fiscal Bureau found in its new report that the finances of the health programs will need careful monitoring. The report comes ahead of new estimates expected next week that should shed more light on the overall condition of the state’s strained budget…”
• Medicaid rolls rose even as Pa. disqualified many, new calculation shows, By Don Sapatkin, January 26, 2012, Philadelphia Inquirer: “The Pennsylvania Department of Public Welfare’s stepped-up efforts over the summer to target waste, fraud, and abuse quickly bore fruit in the fall. Adult Medicaid enrollment alone was down 109,000 through November. Cause and effect seemed clear. Advocates for the poor and disabled were outraged. Now, DPW has suddenly changed its reporting method. Revised calculations show a decline of just 6,000 participants for the same period. And when December is added in, enrollment is up by 23,000 since August - a time when officials agree that tens of thousands of people lost benefits after overdue reviews found they were ineligible. DPW says the new reporting method is just as accurate as the old one, merely different. But it will not disclose its new method or recalculate the latest Medicaid data using the old formula…”
• Medicaid copays could increase in South Dakota, By Megan Luther, January 31, 2012, Sioux Falls Argus Leader: “Medicaid recipients in South Dakota will face larger copays for their medication if the federal government signs off on a state plan designed to drive down costs in the program that provides health care to poor people. Requiring the larger copays is one of 11 recommendations put forth by the Medicaid Solutions Work Group, an assembly of health care providers, lawmakers and state employees assigned with finding savings the the program. The group began work last year at the request of Gov. Dennis Daugaard…”
• Medicaid change to cut pharmacy payments in Texas, By Jim Fuquay, January 28, 2012, Fort Worth Star-Telegram: “When Marwan Hattab opened Wedgwood Pharmacy just over a year ago, he knew from his previous years in the business how much it costs to fill a prescription. And he knows it’s quite a bit more than he’ll be paid under a new reimbursement system for Texas’ Medicaid program. The state’s move to managed care for Medicaid prescriptions goes into effect March 1, and Hattab and other independent pharmacists say they stand to lose money on every prescription they write for the federal/state healthcare program for the poor. A coalition of Texas pharmacies said last week that the dispensing fee that pharmacists receive for filing a Texas Medicaid prescription will plunge from about $6.50 to as little as $1.35. The change is part of legislation passed last year that aims to save the state an estimated $100 million over the next two years…”

Medicaid dispute pits ’shared responsibility,’ care of poor, By Michael Booth, January 29, 2012, Denver Post: “Colorado policymakers are wrestling to bring the burgeoning Medicaid budget under control, as critics fear health insurance for the poor will consume the state budget. But even the smallest cuts or cost-shares raise protests from patient advocates and objections that such measures will prove more expensive in the long run. ‘Sharing responsibility’ by raising co-pays and enrollment fees for public health care actually discourages patients from seeking care until they require budget-busting emergency or specialty help, researchers say. ‘There is indisputable evidence that when you ask poor people to pay more for medical care, some of them cannot afford it, so they avoid seeking the doctor or cannot afford their medications,’ said Leighton Ku, director of the Center for Health Policy Research at George Washington University. Some of those patients, Ku said, will eventually require ‘the most expensive forms of care at emergency rooms or in hospitals.’ The constraints inherent in Medicaid - a tangled web of mandates, entitlements and patients’ behavior - frustrate critics, who see the program growing even more onerous. Federal health reform and expansions from a state hospital fee will add hundreds of thousands of people to public insurance rolls who are unlikely to ever leave…”

• After a contentious political year, Republicans may moderate their approach, By John Gramlich, January 9, 2012, Stateline.org: “From the moment he took office last year, Florida Governor Rick Scott made clear that a new and unabashedly conservative administration had taken power in Tallahassee - just as it had in state capitals around the country following an historic election haul for Republicans in 2010. Scott, a Tea Party-backed Republican, stood before a cheering crowd and introduced a state budget that contained more than $4 billion in tax cuts for corporations and property owners, even as it slashed funding for K-12 education…”
• Washington and the states: a year of uncertainty and foreboding, By Pamela M. Prah, January 10, 2012, Stateline.org: “A long siege of deadlock and dysfunction in Washington has left states frustratingly unclear what to expect from the federal government in the coming year. About the only thing they know for sure is that it is not going to be a year of generosity. In fact, it’s likely to be quite the opposite. As a result of last summer’s deal to raise the federal debt ceiling, and the consequent failure of the congressional ’super committee’ to decide on budget cuts, states are bracing for automatic across-the-board cuts in education, social welfare and other programs for the upcoming 2013 fiscal year. Those cuts would come atop federal cuts in 2011 and 2012, not to mention the continuing wind-down of federal stimulus aid…”
• Medicaid: a year of excruciating decisions, By Christine Vestal, January 11, 2012, Stateline.org: “In health care history, 2012 will be remembered for the U.S. Supreme Court’s upcoming decision on the Obama administration’s health overhaul. But in the states, 2012 will likely be remembered less as an historic turning point than as a gradual continuation of their longstanding struggles to get Medicaid costs under control. That’s not to say the states aren’t watching the Supreme Court closely. The case set to be heard in March and decided in June was brought by 26 states who argued the federal law’s ‘individual mandate,’ as well as a massive expansion of Medicaid in 2014, were unconstitutional. While the outcome could have long-term consequences for states, it likely won’t change their most pressing short-term budget considerations…”
• Unions adapt to new rules, even as they fight to reverse them, By Ben Wieder, January 12, 2012, Stateline.org: “It took nearly a year for Dale Kleinert to negotiate his first teachers’ contract. When Kleinert started his job as schools superintendent in Moscow, Idaho, the talks were already underway. Then, discussions reached an impasse. There were disagreements over pay and health care costs, and the pace slowed further when first an outside mediator and later a fact-finder didn’t render a decision. It wasn’t until May of 2011 that Kleinert and his union counterparts finally reached an agreement. Just before then, while Kleinert and the teachers were still stuck, Republican lawmakers in Boise were finishing work on plans to take away much of the leverage that Idaho teachers had long enjoyed in these kinds of negotiations. So for Kleinert’s next round of talks with Moscow’s teachers, which began pretty much right after the previous ones wrapped up, the rules were very different…”
• At last, a state budget year when the sky is not falling, By Daniel C. Vock, January 13, 2012, Stateline.org: “During the depths of the Great Recession, states had to do many unsavory things to balance their budgets. But few things left a more bitter taste than Arizona’s decision to sell off the office space of its state Capitol complex. It helped lawmakers close a gap in one year’s budget, even though it meant taxpayers would essentially have to pay rent on the property for the next two decades. Now, Arizona’s budget outlook is showing some improvement: For the first time since 2006, the state finished its last fiscal year with a surplus, which came as a surprise to state financial forecasters…”

• Cuts to MaineCare, welfare approved in spring 2011 taking effect, By Kathryn Skelton, January 5, 2012, Lewiston Sun Journal: “Changes in the state budget approved last spring and now in effect include cutting MaineCare coverage for hundreds, stopping food stamps for some and, in two weeks, telling 2,500 people receiving Temporary Assistance for Needy Families: Your time’s up. Also coming soon: new rules that end TANF benefits for some immigrants and a measure to drug-screen TANF recipients with drug-related felonies dating back to 1996. With three of the five changes affecting legal noncitizens who have been in the U.S. fewer than five years, one advocate said Portland and Lewiston will be hardest hit…”
• New study disputes LePage administration on MaineCare’s childless adults, By Jackie Farwell, January 9, 2012, Bangor Daily News: “The childless adults Gov. Paul LePage has proposed dropping from MaineCare are far from young and healthy, despite rhetoric to the contrary, according to a report released Monday by an advocacy group for the poor. More than 40 percent of childless adults covered through MaineCare are older than 45 and many have serious medical conditions, states the report prepared by Maine Equal Justice Partners. Known as ‘noncategoricals’ because they don’t fall under categories of mandatory coverage, the childless adult group consists of beneficiaries ages 21-64 with no dependents in the home who don’t qualify as disabled under federal guidelines…”

Nation’s largest welfare state makes deep cuts, By Sheila V Kumar (AP), December 28, 2011, Sacramento Bee: “Advocates of welfare reform in California often cite one, eye-popping statistic as they have pressed for cuts and changes to the program in recent years: The state has one-eighth of the nation’s population but one-third of all welfare recipients.Yet steps taken in recent years to cut costs and get more recipients back in the workforce have run head-on into the worst economic conditions since the Great Depression. Recipients have been left with fewer training programs, shrinking welfare checks and a shorter period during which they are eligible to receive assistance at a time when employment prospects for even highly qualified job-seekers are dim.That has led to fear and uncertainty among welfare recipients, many of whom have spent a year or more in job-preparation programs without success…”

• State scales back Medicaid shortfall by $300 million, By Jason Stein, January 3, 2012, Milwaukee Journal Sentinel: “In a bit of good news for the state’s strained budget, Gov. Scott Walker’s administration is scaling back by more than $300 million the two-year shortfall projected for state health programs for the poor. But a state health department spokeswoman said that to ensure the state health programs remain affordable, the Walker administration will still seek to proceed with a half-billion dollars in proposed cuts affecting tens of thousands of recipients. In a letter to lawmakers Tuesday, the head of the Department of Health Services said that the shortfall through June 2013 is now expected to be $232 million in state and federal money, down from the $554 million that was projected in September. The change in the projections amounts to about 2% of the funding in the program, Health Services Secretary Dennis Smith wrote in a letter to members of the Joint Finance Committee…”
• Medicaid payment backlog cripples supportive living centers, By Dean Olsen, January 3, 2012, State Journal-Register: “Medicaid payment delays of up to six months are causing fits for supportive living centers throughout Illinois, and some owners are worried they may have to close if the situation doesn’t improve soon. ‘It’s a crisis for us because reserves and lines of credit are being exhausted,’ Wayne Smallwood, executive director of the Springfield-based Affordable Assisted Living Coalition, said last week. ‘This is the worst we’ve seen, and there’s no relief in sight.’ Illinois’ festering budget problems, the sagging economy and the end of the federal economic stimulus program in June have contributed to growing payment delays that also hamstring nursing homes, hospitals, doctors and other medical providers…”
• Nowhere to go, patients linger in hospitals, at a high cost, By Sam Roberts, January 2, 2012, New York Times: “Hundreds of patients have been languishing for months or even years in New York City hospitals, despite being well enough to be sent home or to nursing centers for less-expensive care, because they are illegal immigrants or lack sufficient insurance or appropriate housing. As a result, hospitals are absorbing the bill for millions of dollars in unreimbursed expenses annually while the patients, trapped in bureaucratic limbo, are sometimes deprived of services that could be provided elsewhere at a small fraction of the cost…”

State cuts to Medicaid reduce care for patients, force doctors to reconsider participation, By Shannon McCaffrey (AP), December 27, 2011, Chicago Tribune: “Just as Medicaid prepares for a vast expansion under the federal health care overhaul, the 47-year-old entitlement program for the poor is under increasing pressure as deficit-burdened states chip away at benefits and cut payments to doctors. Nearly every state has proposed or implemented a plan in its current budget to rein in costs, and many are considering additional cuts in the year ahead. For the tens of millions of poor and disabled who rely on the program - approaching nearly one in five Americans - the cuts translate into longer waits for doctors, restrictions on prescription drugs, a halt to vision and dental care, staff cuts at nursing homes and dwindling access to home health care…”

• Private contractors play increasing role in Medicaid, audit finds, By Jason Stein, December 20, 2011, Milwaukee Journal Sentinel: “As the state’s health programs for the poor have ballooned in recent years, the state relied increasingly on private contractors to run its health programs for the poor and completed fewer investigations into potential fraud, a new audit has found. The report released Tuesday by the Legislative Audit Bureau found that as of June there were at least three times as many contract workers working on Medicaid health programs as there were state workers. Over the past four years, payments to private vendors for Medicaid have nearly doubled, the audit found…”
• Utah’s budget debate: transportation and Medicaid, By Kirsten Stewart, December 19, 2011, Salt Lake Tribune: “Unveiling his budget for next year, Utah Gov. Gary Herbert last week bemoaned the growing share flowing to Medicaid. The health insurance program for low-income people consumes 17.6 percent of Utah’s budget, hurting the state’s ability to fund other priorities such as public schools, said Herbert, sounding a theme popular among conservatives. But advocates for the poor say the national strategy of pitting Medicaid against public schools doesn’t reflect reality in Utah. They point to another familiar budget boogeyman: transportation…”

• Bigger share of state cash for Medicaid, By Michael Cooper, December 13, 2011, New York Times: “Medicaid has steadily eaten up a growing share of state budgets over the past three years, while education has been getting a smaller slice of the pie. That is one of the changes that the lingering economic downturn and the changing American economy have wrought on state finances, according to an analysis of state spending over the last few years released Tuesday by the National Association of State Budget Officers…”
• State Medicaid spending soars, By Lisa Lambert, December 14, 2011, Chicago Tribune: “Spending by U.S. states on Medicaid, the healthcare program for the poor, soared last year and will likely continue growing despite measures to contain costs, according to a report released on Tuesday. Total Medicaid spending, excluding administrative costs, likely reached $398.6 billion in fiscal 2011, which ended in June for most states. That was up 10.1 percent from the year before, when spending rose 6 percent, the National Association of State Budget Officers reported. Medicaid was nearly one-quarter of all state expenditures in fiscal 2011, compared to elementary and secondary education, which accounted for 20 percent of all spending…”
• Medicaid money for Texas to jump, By Don Finley, December 13, 2011, San Antonio Express-News: “The federal government Monday granted Texas a waiver that could mean billions more in Medicaid dollars to hospitals over the next few years, in return for having them work together to provide better care for the poor. In Bexar County, that could mean new money to help keep the mentally ill from overusing crowded hospital emergency rooms, among other new services, one local official said. At the same time, federal officials slapped down a request from Texas to deny Medicaid patients access to family planning centers such as Planned Parenthood that also provide abortions - a plan that had drawn the anger of family planning advocates…”
• Medicaid waiver could be boon for Texas hospitals, By Don Finley, December 12, 2011, Houston Chronicle: “The federal government on Monday granted Texas a waiver that could mean billions more in Medicaid dollars to hospitals over the next few years in return for having them work together to provide better care for the poor…”
• Studies point to flaws in Florida’s Medicaid managed care, By Christine Vestal, December 14, 2011, Stateline.org: “Like many other states in fiscal duress, Florida sliced a large portion of its Medicaid budget this fiscal year, primarily by cutting payments to hospitals, nursing homes and other health care providers. Next year, Governor Rick Scott wants to double the size of reductions to the federal-state program - again by cutting provider fees. Within the next two years, however, the Republican governor expects to shave billions from the state budget by letting private health plans take over the care of all of Florida’s Medicaid patients - more than 3 million people. Scott’s plan is a statewide expansion of a controversial five-county managed care pilot started by Republican former Governor Jeb Bush in 2006. The state Medicaid office sought approval for the plan in August and a decision by the U.S. Department of Health and Human Services is expected soon…”
• Gov. Rick Scott’s proposed budget includes $2.1 billion cut in Medicaid, By Matt Dixon, December 12, 2011, Florida Times-Union: “When Gov. Rick Scott unveiled his proposed $66.4 billion budget last week, many people in the capital and around the state cast it as schools versus hospitals. Scott’s spending plan injected public education with a roughly $1 billion increase but cut $2.1 billion in reimbursements for Medicaid. The cut prompted a fast pushback from the Safety Net Alliance of Florida, a lobbying group that represents 15 of the state’s biggest hospitals. It estimates the cuts would cost its members $1.4 billion…”
• Maine Medicaid deficit mainly due to budget miscalculations, By John Richardson, December 13, 2011, Portland Press Herald: “A $120 million budget deficit projected for the fiscal year that began July 1 has set off an ideological debate over the future of Maine’s Medicaid program. The deficit itself, however, is mostly the result of a series of technical budgeting miscalculations, according to a report prepared by the LePage administration. Problems with a new claims processing system, a loss of federal funds that wasn’t accounted for, and a failure to budget for increases in federal Medicare premiums are among the biggest causes…”
• Proposed Medicaid cuts draw big protests in Maine, By John Gramlich, December 15, 2011, Stateline.org: “Earlier this year, it was Arizona that drew national attention for removing tens of thousands of its citizens from the Medicaid rolls. Now, Maine Governor Paul LePage wants to do the same, saying the state-federal health insurance program is becoming unsustainable. LePage is pushing a proposal that would eliminate 65,000 Mainers from Medicaid, as the Bangor Daily News reports. At a hearing on the proposal Wednesday (December 14), hundreds of protesters converged on the State House to voice their disapproval of the plan, which seeks to close a $220 million shortfall in the state health and human services budget…”
• Report on R.I’s Global Medicaid Waiver finds $22M in savings, By Richard Asinof, December 14, 2011, Providence Business News: “The long-awaited report by the Lewin Group on Rhode Island’s Global Medicaid Waiver was released on Dec. 13, finding that some $22.9 million in savings had been created over three years, far below the $100 million in savings claimed by Gary Alexander, former Secretary of the R.I. Office of Health and Human Services under former Gov. Donald L. Carcieri’s administration…”
• Pa.’s drop in Medicaid rolls stirs controversy, By Don Sapatkin, December 15, 2011, Philadelphia Inquirer: “Since August, the Corbett administration has cut off more than 150,000 people - including 43,000 children - from medical assistance in a drive to save costs. That purge far exceeds what any other state has tried, health policy experts say, and officials may be walking a fine line between rooting out waste and erecting barriers to care for the poor and disabled. When most states were experiencing flat or rising Medicaid enrollment from the economic downturn, stepped-up eligibility reviews in Pennsylvania began producing a decline over the summer. The pace of cuts picked up in November, with 90,000 cases, or 4 percent, dropped in a single month. In New Jersey, enrollment increased by 391 the same month…”

• Short-staffed and budget-bare, overwhelmed state agencies are unable to keep up, By Melissa Maynard, December 13, 2011, Stateline.org: “On the face of it, the backlog the Hawaii Public Housing Authority is experiencing seems a simple matter of supply and demand. Some 11,000 families are on the authority’s waiting list, hoping against the odds that they can get one of only 6,295 public housing units. In a state where housing is notoriously expensive, the only people with a real shot at getting a unit are the homeless and survivors of domestic abuse. Even for them, the waiting can take years. ‘The waitlist is so extensive and the homeless problem is so great that a lot of people are getting preference over working families,’ explains Nicholas Birck, chief planner for the Hawaii Public Housing Authority. ‘They never make it to the top.’ But there’s another, hidden problem at play in Hawaii’s housing backlog. Lately, the authority hasn’t had enough employees to manage turnover in vacant units. As a result, 310 homes have been sitting empty, even with all the people languishing in waitlist limbo. For many of the vacant units, all it would take is a few simple repairs and a little bit of administrative work to give a family a home - and get the authority’s backlog shrinking rather than growing…”
• Anatomy of a backlog: How Vermont fell behind on adult protective services, By Melissa Maynard, December 14, 2011, Stateline.org: “Cerebral palsy does not thwart Chris Osborne’s passion for chess and all kinds of music, from hard rock to opera. But Chris, who is 25 and lives near Burlington, does depend on others to dress, feed and bathe him, as well as to clean and change his feeding tube. He can communicate only through a digital device or an eye-gaze board, which allows him to spell words by looking at the letters. Last year, Chris’ mother, Nancy Osborne, and her fiancé, Art Demarais, began to suspect that the professional caretaker living with Chris in his apartment had stopped doing key parts of his job. Sometimes, when Chris came home to visit, Nancy noticed that her son was caked in dirt and covered with rashes. Chris had made multiple trips to the emergency room to treat infections related to improper cleaning of his feeding tube. And he often complained of being hungry: Thin to begin with, Chris lost 23 pounds in six months…”
• Overcoming a backlog: How Texas conquered a mountain of food stamps applications, By Melissa Maynard, December 15, 2011, Stateline.org: “Two years ago, the 316 offices in Texas where people go to sign up for food stamps were the very image of a government backlog. Long lines of frustrated people, many of them hungry, snaked through dingy spaces designed to handle much smaller crowds. The back offices weren’t much better. Desks of state employees were littered with piles of applications - in boxes under workers’ desks and stacked on top of them - that hadn’t yet been entered into the state’s computer systems. Texas was the worst state in the country at performing a straightforward task: giving food stamp applicants a yes or no within 30 days in normal cases and 7 days for emergency cases. That’s the standard set by the federal government, which oversees the state-run program. According to state data, at the height of the backlog in November 2009, Texas processed only 57.5 percent of new applications on time. In reality, the problem was much worse because stacks of pending applications weren’t properly being counted as part of the problem…”

Aid for child care drops when it is needed most, By Sabrina Tavernise, December 13, 2011, New York Times: “With states under pressure to cut their budgets and federal stimulus money gone, low-income working parents are facing a paradox. Just when they have to work longer hours to make ends meet, they are losing access to the thing they need most to stay on the job: a government subsidy that helps pay for child care. The subsidy, a mix of federal and state funds that reimburses child care providers on behalf of families, is critical to the lives of poor women. But it has been eaten away over the years by inflation and growing need and recently by state budget cuts, leaving parents struggling to find other arrangements to stay employed…”

• Maine gov seeks Medicaid cuts to bridge budget gap, By Glenn Adams (AP), December 6, 2011, Boston Globe: “Saying Maine cannot afford one of the country’s most generous Medicaid programs over the long term, Gov. Paul LePage on Tuesday proposed tougher eligibility standards and other changes that would leave more than 60,000 people without coverage they are now receiving. In a news conference Tuesday, LePage said an analysis of state spending in current fiscal year, which ends in June, shows a shortfall of $120 million in Medicaid, known in the state as MaineCare. The shortfall for the 2012-13 fiscal year is an additional $101 million ‘that we know of,’ he said, creating a $221 million gap. The 361,000 people now on Medicaid ‘is pushing one-third of our population,’ said the Republican governor, while the national average is about 20 percent…”
• Medicaid, seniors’ tax break loom over Colorado’s next budget, By Tim Hoover, December 11, 2011, Denver Post: “Gov. John Hickenlooper helped end a standoff over the state budget between Democratic and Republican lawmakers in the last legislative session, but a fiscal fracas shaping up for 2012 may prove much harder to quell. That’s because this time the Democratic governor himself is squarely in the middle of it, recommending a 2012-13 budget that would suspend a property tax break for seniors that would cost the state $98.6 million. The Senior Homestead Exemption allows Coloradans 65 and older who have lived in their homes for at least 10 years to exempt 50 percent of the first $200,000 of the property value of their homes from taxes. But Republicans say they don’t want to delay the tax break for additional years. Instead, they say, Hickenlooper should be trying to seek a federal waiver to trim the cost of Medicaid, the state and federally funded health care program for the poor that takes nearly a third of the state’s general fund…”
• State Medicaid cuts concern clients, By JoAnne Young, December 10, 2011, Lincoln Journal Star: “Ron and Laura Trautman tried to have a baby for 10 years before Christopher and Adam were born May 17, 2007. One of the twins, Christopher, was born with multiple birth defects. His physical problems kept him in Omaha Children’s Hospital for 15 months. So far, he’s had 29 surgeries, with more to come. At 4, he still has a tracheostomy and eats through a gastrostomy button feeding device. He’s about three years behind in development. ‘With all the surgeries he’s had, we’re lucky to have him,’ his dad said. Medicaid helps the Waverly family with nursing care for Christopher so the parents can work and go to school…”

• Budget pressure on help for low income families with heating bills, By Brett Neely, November 30, 2011, Minnesota Public Radio: “A federal program that helps low income families pay their heating bill is coming under intense budget pressure. The Low Income Heating Assistance Program sent Minnesota more than $152 million last year. That money helped 172,000 households, including many seniors, the disabled and the poor, pay their heating bills. The average grant from the LIHEAP program was just over $500 for the winter. But with austerity the new buzzword in Washington, the program’s funding is drying up fast - just as many households prepare for higher heating bills…”
• A costly winter ahead for home heating oil users, By Les Christie, December 1, 2011, CNNMoney.com: “Bill McLaughlin is bracing himself for a tough winter. He and his wife, Cindy, live in Brewer, Maine and neither of them are working. Bill, who’s 59, is disabled and Cindy lost her job more than a year ago. And now the cold is setting in. During any winter in Maine, paying for the oil that heats their home is a big expense. But this winter, it will be especially taxing. The price of heating the average home with oil is expected to jump 10% this year to an average of $2,535 over the winter heating season (October 1 through March 31), according to the U.S. Energy Information Administration (EIA). That’s 45% higher than just two years ago, when the average bill was just $1,752…”

Federal cuts give Maine a chill as winter approaches, By Abby Goodnough, November 27, 2011, New York Times: “Michele Hodges works six days a week but still cannot afford a Maine winter’s worth of heat for her trailer in Corinth, a tiny town where snowmobiles can outnumber cars. Ms. Hodges and her two teenage daughters qualified for federal heating assistance last year, but their luck might have run out. President Obama has proposed sharply cutting the Low Income Home Energy Assistance Program, and Maine is at this point expecting less than half of the $55.6 million that it received last winter, even as more people are applying. The average state benefit last year was about $800 for the season; now it may be closer to $300. Eligibility requirements have tightened too, and with oil prices climbing - the average in Maine was $3.66 a gallon last week, up from $2.87 a year ago - many here are anticipating days or weeks of forgoing heat…”

Texas may cut Medicaid reimbursements to healthcare providers, By Darren Barbee, November 20, 2011, Fort Worth Star-Telegram: “Therapy and physician groups in Texas are alarmed about proposed cuts in government healthcare reimbursement rates that they say would hurt the sickest and poorest Texas patients, most of them children. Therapists stand to lose millions of dollars as Medicaid reimbursement rates for their services are slashed. The average reduction for home health providers, for example, would be 35 percent. All told, the state plan calls for cutting $150 million a year for therapists; that is 19 percent of the $792 million they received last year. The state would save millions more with cuts in co-payments to physicians for people covered by both Medicaid and Medicare. But doctors say the proposed change will further push doctors from wanting to practice in less affluent parts of the state…”

Many states cut Medicaid payments as stimulus ends, By Doug Trapp, November 16, 2011, San Antonio Express-News: “Fourteen states and the District of Columbia cut Medicaid physician pay for fiscal year 2011, down from 20 states in fiscal 2010. But continuing state budget deficits could lead to more new fee cuts than those already adopted for fiscal 2012, according to the Kaiser Family Foundation. The foundation’s 11th annual survey of state Medicaid programs concluded that continued Medicaid budget pressure on many states led them to expand cost-saving measures in 2011 and 2012. These moves included increasing enrollment in Medicaid managed care, reducing or ending optional benefits such as dental care, tightening prescription drug formularies, enacting or hiking co-payments and, most frequently, reducing Medicaid fees to doctors, according to the Kaiser report, released on Oct. 27…”

• Brownback’s administration rolls out Medicaid reform package, November 8, 2011, Wichita Eagle: “Gov. Sam Brownback’s administration unveiled a major Medicaid reform package Tuesday that will shift thousands of disabled, elderly and low-income residents into a managed care system that aims to reduce hospital visits and slow the growth of Medicaid spending over five years without reducing benefits. The ‘person-centered’ integrated care program is called KanCare. It will be managed by three companies that win state-issued three-year contracts. They will be evaluated and paid based on their outcomes, such as reduced emergency room visits…”
• Brownback seeks $850M in Medicaid savings, By Tim Carpenter, November 8, 2011, Topeka Capital-Journal: “Gov. Sam Brownback took a step Tuesday toward formation of a managed-care system for all Kansans on Medicaid that emphasizes coordination of services to improve health outcomes and cut costs by more than $850 million over a five-year period. Brownback said the cornerstone of the overhaul was an integrated care system - to be called KanCare - intended to improve the lives of 350,000 disabled, elderly and low-income Kansas. KanCare would take effect in January 2013 and begin to bend the cost curve of Medicaid down by engaging new partnerships with the state’s Medicaid provider community…”
• Lawmakers OK changes that could drop 65,000 from Medicaid, By Jason Stein, November 10, 2011, Milwaukee Journal Sentinel: “The Legislature’s nonpartisan budget office projects 65,000 people - nearly half of them children - would leave or be turned away from the state’s health programs for the poor, under a proposal passed by lawmakers Thursday. The Joint Finance Committee approved 11-4 a proposal by GOP Gov. Scott Walker’s administration to bridge the final part of a more than half-billion dollar budget gap in the rapidly growing health plans. All Republicans voted in favor and all Democrats against. The proposal must still win federal approval from President Barack Obama’s administration by the end of the year - a significant hurdle. The Medicaid health plans cover about one in five state residents - almost 1.2 million people - and provide everything from doctor visits for poor families to nursing home care for the elderly. To help control rapidly increasing costs in the programs, Walker’s administration wants to decrease benefits for a quarter of a million recipients, increase premiums for tens of thousands of others by up to tenfold, and drop coverage for adults and children for at least a year if the premiums aren’t paid…”

Medicaid cost cuts planned, By Guy Boulton, November 6, 2011, Milwaukee Journal Sentinel: “Wisconsin is not alone in dealing with the thorny task of trying to lower the cost of its health care programs for low-income residents. Massachusetts no longer pays for restorative dental care and dentures. Washington no longer covers eyeglasses and hearing aids. Minnesota no long covers chiropractic care. Illinois, Iowa and other states planned to require a $50 co-payment for unnecessary visits to emergency departments. And California has proposed a $50 co-payment for all visits to emergency departments and a co-payment of $100 for hospital stays that last one day and $200 for longer stays. Every state plans to implement at least one policy to control Medicaid spending this fiscal year, according to a survey by the Kaiser Family Foundation. In Wisconsin, the Department of Health Services has proposed dozens of changes in the BadgerCare Plus and Medicaid programs to close a $500 million gap in their budget…”

New attention paid to homeless youth and families, By Meribah Knight, November 3, 2011, New York Times: “More than 10,000 homeless students are enrolled in Chicago’s classrooms this fall, a 16 percent increase over last year and a record high, according to Chicago Public Schools data for September. The school district’s numbers reflect a trend seen by service providers around the city: Chicago’s homeless population is becoming younger. More families are living on the street, and the number of homeless youths on their own has grown exponentially. With a lack of affordable housing, a rising number of foreclosures and a state unemployment rate higher than the national average, the increase in homeless youths and families is putting stress on a social support system that is facing sharp cuts in budgets and programs…”

Families to lose welfare benefits after appeals court overturns Genesee County judge’s ruling, By Kristin Longley, November 4, 2011, Flint Journal: “More than 1,200 families in Genesee County will lose their cash assistance benefits this weekend after the Michigan Court of Appeals on Thursday overturned a local judge’s ruling. Genesee County Circuit Judge Geoffrey L. Neithercut had issued a temporary injunction as part of a lawsuit that argues the state can’t use a five-year time limit based on federal regulations to end benefits for some welfare recipients. But the appeals court reversed that order Thursday, ruling that Neithercut’s ‘issuance of the temporary injunction was inappropriate.’ The cash assistance cutoff will start Saturday, the Department of Human Services said in a statement…”

• U.S. approves managed care for Kentucky Medicaid, By Tom Loftus, October 31, 2011, Lousiville Courier-Journal: “Federal authorities have given final approval to the state’s new Medicaid managed care plans, allowing the program to be launched on Tuesday. The Beshear administration announced Monday that the federal Centers for Medicaid and Medicare Services notified Kentucky Friday that it was satisfied that Kentucky is prepared for the transition…”
• Walker adjusts plan to close $554 million gap in Medicaid programs, By Jason Stein, October 31, 2011, Milwaukee Journal Sentinel: “Gov. Scott Walker’s administration tweaked its proposals Monday to close a half billion-dollar budget hole in the state’s health plans for the poor as a deadline approaches for deciding whether the state will drop the health coverage of tens of thousands of state residents. The state Department of Health Services made the changes in a 238-page plan being sent for review to the Legislature’s budget committee, which is expected to take up the proposal next week. But a Democratic lawmaker said Monday he was concerned that there still wouldn’t be enough time for lawmakers and President Barack Obama’s administration to review the plan - action that is required to keep more than 50,000 state residents from losing their state coverage altogether at the end of the year…”

Genesee County judge halts cash assistance cutoff; State attorney general files appeal, By Kristin Longley, November 1, 2011, Flint Journal: “A Genesee County judge Monday halted the state from cutting some cash assistance benefits, a move that could affect an estimated 1,500 families here and 11,000 families statewide. Circuit Court Judge Geoffrey L. Neithercut granted a temporary injunction that would prevent the Michigan Department of Human Services from using a five-year time limit based on federal regulations to end benefits for some welfare recipients. Benefits would have ended this month for those who received termination notices. The Michigan League for Human Services has said that Genesee County would feel the effects of the assistance cutoff more than almost any other part of the state, since an estimated 13 percent of all families that lost benefits live in the area…”

• California gets OK for large cuts to Medi-Cal, By Anna Gorman, October 28, 2011, Los Angeles Times: “The Obama administration will allow California to cut hundreds of millions of dollars from Medi-Cal, a move doctors and experts say will make it harder for the poor to get medical treatment. California plans to reduce rates by 10% to many providers, including physicians, dentists, clinics, pharmacies and most nursing homes, the Centers for Medicare and Medicaid Services announced Thursday. The cuts ‘will have a real impact on Medi-Cal patients’ because fewer doctors will be willing to see those covered by the program, which serves 7.6 million poor and disabled Californians, said Anthony Wright, executive director of Health Access, a consumer group. The head of the California Medical Assn., which represents doctors, echoed the concern…”
• Medicaid costs balloon for cash-strapped states, By Tami Luhby, October 27, 2011, CNNMoney.com: “As stimulus funds dry up, cash-strapped states are facing steep rises in Medicaid spending, forcing them to slash services and trim costs. States will have to spend another 28.7% on Medicaid this fiscal year — by far the largest increase ever, according to new data released by the Kaiser Family Foundation Thursday. Much of the increase comes from the loss of more than $100 billion in federal stimulus funds, which helped buffer states from the massive jump in Medicaid enrollment during the Great Recession. But those federal funds ran out in June, leaving states to shoulder the burden of covering nearly 60 million people on their own…”
• State spending on Medicaid up sharply, By N.C. Aizenman, October 27, 2011, Washington Post: “The expiration of federal stimulus funding for Medicaid has dealt a blow to states still struggling to recover from the economic downturn, according to figures released Thursday. To compensate for the loss of extra federal Medicaid dollars this June, states have increased their spending on the program by an average of 29 percent in the current fiscal year. Nearly every state also has turned to tough measures to trim Medicaid costs, such as eliminating benefits, reducing payment rates to doctors and hospitals, and increasing the co-payments they charge the poor and disabled served by the program. Even so, more than half of state officials surveyed said there was a 50-50 chance their Medicaid programs - which are financed with a combination of state and federal funds - would face a budget shortfall as enrollment continues to rise…”
• Survey: States counting on lower costs as Medicaid enrollment slows, By Christine Vestal, October 28, 2011, Stateline.org: “As states were drafting their 2012 Medicaid budgets this summer, they faced the biggest leap in general fund spending since the program began - a whopping 29 percent increase. That’s mainly because federal stimulus dollars for the program dried up, leaving states to shoulder their traditional share of the bill - about 50 percent. As a result, state lawmakers authorized only a 2 percent increase in overall spending for the federal-state health insurance program for low-income people - one of the lowest growth rates on record. That’s according to a 50-state survey released Thursday (October 27) by the Kaiser Family Foundation…”

Already financially hurting school districts brace for more cuts ahead, Associated Press, October 24, 2011, Washington Post: “Educators are bracing for a tough reality: As difficult as budget cuts have been on schools, more tough times are likely ahead. Even in a best-case scenario that assumes strong economic growth next year, it won’t be until 2013 or later when districts see budget levels return to pre-recession levels, said Daniel Domenech, executive director of the American Association of School Administrators in Arlington, Va. That means more cuts and layoffs are likely ahead. ‘The worst part is that it’s not over,’ Domenech said. Already, an estimated 294,000 jobs in the education sector have been lost since 2008, including those in higher education…”

• Optional Medicaid benefits face state cuts, By Phil Galewitz, October 23, 2011, USA Today: “States are using a variety of strategies to control rising Medicaid costs even as they look ahead to a massive expansion of the state-federal health insurance program for the poor beginning in 2014. The weak economy is driving more jobless Americans into Medicaid, increasing enrollment at the same time that medical costs keep going up. To deal with the higher costs, states are pushing Medicaid recipients into managed-care plans run by private insurers, cutting reimbursement rates to hospitals and doctors and reducing benefits…”
• More states limiting Medicaid hospital stays, By Phil Galewitz, October 23, 2011, USA Today: “A growing number of states are sharply limiting hospital stays under Medicaid to as few as 10 days a year to control rising costs of the health insurance program for the poor and disabled. Advocates for the needy and hospital executives say the moves will restrict access to care, force hospitals to absorb more costs and lead to higher charges for privately insured patients. States defend the actions as a way to balance budgets hammered by the economic downturn and the end of billions of dollars in federal stimulus funds this summer that had helped prop up Medicaid, financed jointly by states and the federal government…”

Growing prison populations hinder budget cuts, By Kevin Johnson, October 20, 2011, USA Today: “The rising number of prisoners serving costly life terms across the country is complicating state officials’ efforts to make dramatic cuts to large prison budgets, lawmakers and criminal justice officials said. From 1984 to 2008, the number of offenders serving life terms quadrupled, from 34,000 to roughly 140,000, according to the most recent count by The Sentencing Project, which advocates alternatives to incarceration. One of the fastest-growing subgroups are inmates serving life without the possibility of parole. Those numbers have jumped from 12,453 in 1992 to 41,095 in 2008 and represent the most costly inmates to house as the aging inmates require increased medical care…”

• Some states seek flexibility to push health-care overhaul further, By Sarah Kliff, October 16, 2011, Washington Post: “As far as health-reform boosters go, Oregon Gov. John Kitzhaber is among the most stalwart. ‘We want to show that health reform is something real, that it actually works,’ he said. ‘Oregon is a place that can actually make it happen.’ His state has aggressively implemented the health overhaul Congress passed last year, taking more than $100 million in federal funding to do so. But at the same time, the health-care law puts Kitzhaber (D) in a bind. This year, Oregon passed its own plan, which starts with changing how it pays doctors and eventually ends with allowing public employees to enroll in Medicaid, the federal insurance program for low-income Americans. There’s just one big obstacle: What Oregon wants to do would require the Obama administration to waive integral pillars of its signature legislative accomplishment…”
• Administration seeks to roll back hospital rules, By Robert Pear, October 18, 2011, New York Times: “The Obama administration moved Tuesday to roll back a number of rules governing hospitals and other health care providers after concluding that the standards were obsolete or overly burdensome to the industry. Among other things, the proposals would allow hospitals to save money by sometimes using qualified nurse practitioners and physician assistants in place of better-paid doctors, allowing doctors to focus more on patients and helping address ‘impending physician shortages.’ Kathleen Sebelius, the secretary of health and human services, said the proposed changes would save providers nearly $1.1 billion a year without creating any ‘consequential risks for patients.’ The proposed rules would apply to more than 6,000 hospitals…”
• ‘Supercommittee’ decision may lead to cuts funding for public health initiatives, By Marilyn Werber Serafini, and Mary Agnes Carey and Kaiser Health News, October 16, 2011, Washington Post: “Federal funding for medical research, disease prevention and a host of public health initiatives could be sharply reduced if the congressional ’supercommittee’ fails to agree on a deficit-reduction package, triggering automatic cuts. Public attention has largely focused on possible cuts to entitlement programs for seniors and the poor, Medicare and Medicaid, but health advocates are raising an alarm about many other smaller programs they say need to be protected…”

• Four-in-10 disabled children ‘in poverty’, By Angela Harrison, October 6, 2011, BBC News: “Four in 10 disabled children in the UK live ‘in poverty’, according to the Children’s Society. In the population as a whole, about one-in-three children lives in poverty. The charity is calling on the government to rethink planned changes to welfare benefits in the UK, saying more than 100,000 disabled children could lose up to £27 a week. The government says the most severely disabled children will receive more money under the changes. Its Welfare Reform Bill is nearing its final stage in parliament before it becomes law. From 2013, it will bring in a single monthly payment - known as a Universal Credit - which will replace a range of benefits…”
• Four in 10 disabled young living in poverty, report says, By Randeep Ramesh, October 6, 2011, The Guardian: “Four in 10 disabled young people in England are living in poverty, amounting to a ’staggering’ 320,000 children. And the figure will rise because of government cuts to welfare payments, according to a report by The Children’s Society. The charity’s analysis looks for the first time at the additional costs of caring for a child who might be paraplegic, infirm or seriously physically incapacitated, and concludes that the official poverty rates understate the number of disabled children in penury by a total of 32,000. Counting on the basis of a disabled child living in a household with a disabled adult, the figure for those existing in poverty rose to 49%. The Children’s Society says that benefit changes in the controversial welfare reform bill, now being considered in the House of Lords, will cause the disability component of child tax-credit to drop from £54 to £27 a week…”

• Delay in welfare cuts could cost Michigan $2.5 million, By Karen Bouffard, October 6, 2011, Detroit News: “The delay in ending welfare to nearly 41,000 Michiganians could cost the state at least $2.5 million. The Department of Human Services must rewrite and resend letters to everyone who was scheduled to lose their cash assistance on Saturday after U.S. District Judge Paul Borman on Tuesday blocked the cutoff of benefits. After the letters are sent, clients have 10 days to appeal the move. ‘We are working diligently to comply with Judge Borman’s order,’ DHS spokeswoman Colleen Rosso said Wednesday. ‘I anticipate that the notices will be mailed in the coming days, but will have a more definitive time frame (today).’ Republicans, who have control of the Legislature and the Governor’s Office, figured savings from the cuts into the budget for the fiscal year that started Oct. 1…”
• Judge delays welfare cuts, says state didn’t follow the rules, By Kathleen Gray, October 4, 2011, Detroit Free Press: “A federal judge ordered the state Tuesday to temporarily stop enforcing a new law ending cash assistance to 11,162 poor Michigan families who have collected welfare for at least 48.months. The state did a poor job of notifying the recipients, giving them less than three weeks to plan for the end of assistance, Borman wrote in his opinion, granting a temporary restraining order against the cuts. The state passed a law in July that capped cash assistance at 48 months during a recipient’s lifetime. It was supposed to take affect Oct. 1, but U.S. District Judge Paul Borman in Detroit delayed the implementation until he ruled. The 11,162 families represent about 40,000 people, two-thirds of whom are children or teenagers…”

• High court hears key Medicaid case, By David G. Savage, October 3, 2011, Los Angeles Times: “The Supreme Court justices opened their new term Monday by hearing a major healthcare case that tests whether judges can stop California and other cash-strapped states from cutting their payments to doctors and hospitals who serve low-income patients. The case heard Monday will probably affect how much money is available to pay for medical care for more than 50 million Americans, about half of them children, who depend on Medicaid…”
• For justices’ first day back, a knotty case involving Medicaid cutbacks, By Adam Liptak, October 3, 2011, New York Times: “The Supreme Court started its new term on Monday with arguments in a difficult and consequential case over California’s attempt to cut Medicaid payment rates. The justices were not focused on the ultimate question of whether state officials were entitled to address the budget crisis there by lowering payments to medical providers. Rather, they considered the threshold question of whether the providers and Medicaid recipients were entitled to sue over the move…”

• Heating assistance in jeopardy for low-income families, By Oralandar Brand-Williams and Karen Bouffard, October 1, 2011, Detroit News: “As thousands of state welfare recipients are cut off from cash assistance today, another program to help low-income families pay winter heating bills is in jeopardy. Money for the Low Income Energy Efficiency Fund is tied up in a legal fight challenging the authority of the Michigan Public Service Commission to distribute money to local programs. The news came on the same day a group announced a legal challenge to a new state rule cutting off cash assistance after 48 months. A hearing in federal court is scheduled for Tuesday. The PSC collects the heating aid money from utility companies that funnel a portion of the rate charged to customers into the fund. Agencies such as the Heat and Warmth Fund then draw from the pot of money, which totals about $90 million annually, to help people with their heating and utility bills. Today is the first day of the new fiscal year when the local agencies normally tap the fund, but no money will be available until the court decides the issue…”
• Home heating program may see deep cuts, By Pamela M. Prah, October 3, 2011, Stateline.org: “With Congress in a cutting mood, states are worried they may have to deny home heating help to as many as 2 million families this winter. ‘We’re working against a worst-case scenario and we are very worried,’ Richard Moffi, fuel assistance program chief for the Vermont Department for Children and Families, told The Associated Press. Congress has yet to decide on the funding level for the Low Income Home Energy Assistance Program (LIHEAP) for the coming winter, but ‘all signs point to at least a $1.1 billion cut,” says Mark Wolfe, executive director, of the National Energy Assistance Directors’ Association, an organization that represents state LIHEAP directors. LIHEAP is a federal block grant program that provides grants to states to help low-income families pay their heating and cooling bills…”

• Studies: Medicaid vital to kids, seniors, By David Gulliver, September 28, 2011, Bradenton Herald: “More than a half-million Floridians rely on Medicaid to pay for cancer, diabetes, heart disease and other illnesses, and that federal safety net may be crucial as private health insurance costs rise far faster than wages. That picture comes from a pair of separate studies released Tuesday. Families USA examined Medicaid usage in major states, and found that in Florida, seniors and children are among its biggest recipients. The Kaiser Family Foundation surveyed employers and found that annual premiums for their family health plans increased 9 percent from the prior year, to about $15,073, greatly outpacing the 2.1 percent rise in workers’ pay…”
• State wants to shift some Medicaid recipients to lower-cost plans, By Jason Stein, September 30, 2011, Milwaukee Journal Sentinel: “To help address a half-billion dollar shortfall in the state’s health programs, Gov. Scott Walker’s administration is seeking to shift hundreds of thousands of state residents to lower-cost state plans or to private plans but not to leave them without coverage altogether, officials said. State officials said that there is now a $554 million estimated deficit - $110 million more than previously projected - through June 2013 in state Medicaid health programs, which provide everything from doctor’s visits for poor families to nursing home care for the elderly. That deficit could still grow further going forward, they warned. To close that gap and control fast-growing costs, state Health Services Secretary Dennis Smith said that the state would avoid dropping state residents with no other options for coverage and look instead at efforts like shifting 230,000 state Medicaid recipients into a lower-cost plan with fewer benefits…”

• State decides what’s not an emergency, By Jordan Schrader, September 26, 2011, Tacoma News Tribune: “State government is about to start refusing to pay for repeat visitors to emergency rooms whose conditions don’t truly rise to the level of emergencies. The trouble is all in how you define an emergency. Starting Saturday, Medicaid won’t pay for more than three ER visits in a year for a patient’s nonemergency conditions as defined by the state. A list of more than 700 diagnoses put into that category has drawn fire from hospitals and doctors’ groups over inclusions whose symptoms seem awfully similar to emergencies…”
• Wisconsin starts publishing Medicaid cut proposals, By Scott Bauer (AP), September 27, 2011, Sheboygan Press: “Gov. Scott Walker’s administration unveiled a website Monday that includes a handful of Medicaid cost-savings proposals intended to help it reach required cuts of about $444 million over the next two years. But there’s a long way to go. Most of what was released was either already known about or would make little progress toward what needs to be cut. Only three of the six areas of savings detailed Monday had not been previously announced. Those three total $6 million in savings in state money, just 3 percent of the $181.8 million that must be found under the two-year budget that took effect in July. The total amount of unspecified cuts that must be found, including federal funding and other sources, is $444 million…”

Families feel sharp edge of state budget cuts, By Monica Davey, September 6, 2011, New York Times: “Stretched beyond their limits and searching for new corners of their budgets to find spending cuts, states are now trimming benefits for residents who are in grim financial shape themselves. Some states, including Florida and Missouri, have decided to shrink the duration of state unemployment benefits paid to laid-off workers, while others, including Arizona and California, are creating new restrictions on cash aid for low-income residents. Here in Michigan, more than 11,000 families received letters last week notifying them that in October they will lose the cash assistance they have been provided for years. Next year, people who lose their jobs here will receive fewer weeks of state unemployment benefits, and those making little enough to qualify for the state’s earned income tax credit will see a far smaller benefit from it…”

Number of AZ children enrolled in KidsCare drops, By Max Levy, August 31, 2011, Houston Chronicle: “The number of children enrolled in a state-federal health insurance program for youth on the brink of poverty has plummeted from a peak of 66,317 in May 2008 to 16,662 this month, the lowest level since 1999. The drop comes as demand for the program is going strong: In July, more than 100,000 children were on the waiting list for KidsCare, the state’s version of the federally sponsored Children’s Health Insurance Program. More than half of the decline has come since Jan. 1, 2010, when the Arizona Health Care Cost Containment System froze enrollment in KidsCare in response to a lack of funding, according to its website…”

• TennCare could take big hit, By Chas Sisk, August 31, 2011, The Tennessean: “Health care, children’s services and unemployment offices could bear the brunt of expected cuts in federal spending in Tennessee, according to planning documents released Tuesday. Spending on TennCare could be reduced by as much as 25 percent, and local health departments could lose as many as 278 jobs across Tennessee under a worst-case scenario prepared for state finance officials. Tennessee also may have to close as many 36 career centers, and reduce staffing for child welfare by nearly 700 people, if the federal government presses ahead with deep cuts to Tennessee. The planning documents give some insight into how sharp reductions in federal spending might affect Tennessee. About 40 percent of the state’s $30 billion budget comes from the federal government, which intends to reduce its spending by at least $1.2 trillion in a bid to reduce the national debt…”
• Colorado scaling back Medicaid after drastically underestimating numbers, cost, By Tim Hoover, August 31, 2011, Denver Post: “Two years after lawmakers expanded Medicaid to cover poor adults without children, the state is vastly scaling back the program because the number of people eligible for coverage is nearly three times as high as first projected and the cost of insuring them is almost nine times original estimates. The new coverage followed the 2009 passage of major health care legislation that allowed the state to impose a fee on hospitals while drawing down matching federal money to expand Medi caid coverage. House Bill 1293 was estimated to generate about $1.2 billion for Medicaid programs when fully phased in, and the measure called for expanding eligibility levels. A new eligibility class was created for adults without dependent children and whose income was up to 100 percent of the federal poverty level, or $10,890 per year for an individual…”

Wave of Medicaid cuts to begin, By Lynn Bonner, August 28, 2011, News and Observer: “New cuts to health services for the poor take hold in October, with the elimination of eye exams and glasses for adults on Medicaid. Medicaid recipients are receiving notices about reductions, eliminations or other changes to an array of health services in the next few months. The $354 million Medicaid cut in the state budget includes limits and other changes to services totaling $16.5 million. In addition to getting rid of routine adult eye care and glasses, the state plans to limit payments for deep cleaning dental treatments for people who have gum disease to once every two years from once a year. Outpatient physical therapy, occupational therapy and speech therapy for adults will be limited to three visits a year…”

Legal aid programs for poor deal with deep cuts, By Elizabeth Crisp, August 29, 2011, USA Today: “Programs that provide free legal aid to the poor are laying off employees, cutting services and increasingly turning away people who need assistance, as slashed budgets face deeper cuts. ‘It’s a really dire situation,’ said Rebekah Diller, deputy director of the justice program at the Brennan Center for Justice at New York University School of Law. ‘Courts around the country are struggling right now with massive amounts of people who have no legal representation.’ Legal aid programs provide representation in civil cases related to domestic violence, foreclosures, child custody issues and similar matters. The Constitution guarantees legal representation if a person cannot afford to hire a lawyer in criminal cases, but in civil cases, people are on their own…”

State officials identify priorities for Medicaid reform, By John Lyon, August 22, 2011, Arkansas News: “State officials working on revamping Arkansas’ Medicaid program have identified nine priority areas for reform. In an Aug. 10 letter to U.S. Department of Health and Human Services Secretary Kathleen Sibelius, Gov. Mike Beebe said the nine areas ‘appear to hold significant potential for early success and impact in moving from fee-for-service to episodic payments,’ or payments based on an entire course of treatment for a single health issue. The areas are pregnancy and neonatal care; attention deficit hyperactivity disorder; type 2 diabetes; back pain; cardiovascular disease; upper respiratory infections; developmental disabilities; long-term care; and prevention…”

Democrats challenging administration on Medicaid, By Robert Pear, August 8, 2011, New York Times: “In an unusual break with the White House, the Democratic leaders of Congress told the Supreme Court on Monday that President Obama was pursuing a misguided interpretation of federal Medicaid law that made it more difficult for low-income people to obtain health care. The Democratic leaders said Medicaid beneficiaries must be allowed to file suit to enforce their right to care - and to challenge Medicaid cuts being made by states around the country. The Obama administration maintains that beneficiaries and health care providers cannot sue state officials to challenge cuts in Medicaid payment rates, even if such cuts compromise access to care for the poor…”

• Education takes a beating nationwide, By Stephen Ceasar and Teresa Watanabe, July 31, 2011, Los Angeles Times: “After a particularly brutal budgeting season this summer, states and school districts across the country have fired thousands of teachers, raised college tuition, relaxed standards, slashed days off the academic calendar and gutted pre-kindergarten and summer school programs. Slashed budgets are nothing new for educators, but experts say this year stands out. Last year, K-12 budgets were cut $1.8 billion nationwide. According to estimates by the National Assn. of State Budget Officers, cuts to K-12 for the new fiscal year may reach $2.5 billion. A year ago, higher-education budgets across the nation were trimmed $1.2 billion. The expected cuts this year: $5 billion…”
• Poor schools hit hardest by budget cuts in Pennsylvania, Associated Press, August 7, 2011, Patriot-News: “Cutbacks in state aid for public schools hit Pennsylvania’s poorer school districts the hardest, slashing nearly three times as many dollars in aid per student compared with wealthier districts, according to an analysis of state data. All told, the poorest 150 school districts, or 30 percent of the state’s total, lost $537.5 million in five key program lines. That works out to $581 per student, the analysis found. The wealthiest 150 school districts, as measured by the number of children who qualify for subsidized school lunches, lost $123 million, or $214 per student. Of the remaining money in the programs, almost $3 per student went to the 150 poorest districts for every $1 per student that went to the 150 wealthiest…”

Deep Medicaid cuts suddenly on table in N.C., By Lynn Bonner, August 5, 2011, News and Observer: “The legislature set an aggressive target to cut more than $350 million from the state’s share of Medicaid spending this year, but chances for meeting the goal with the plan legislators approved were slim. It takes time to get federal approval for any changes in Medicaid services, so the state won’t see the impact of the legislature’s cuts for months. Under orders from the legislature to manage Medicaid with the money budgeted, Lanier Cansler, secretary of health and human services, has to squeeze more savings into less time. So Medicaid cuts may be deeper than anyone thought just a month ago…”

• With debt deal, states brace for cuts in federal aid, By Michael A. Fletcher, August 2, 2011, Washington Post: “The domestic spending cuts contemplated in the debt-ceiling deal are sure to compound the dire fiscal situation confronting the states, which already are reducing jobs and slashing once-untouchable programs to balance their budgets. The measure that President Obama signed into law on Tuesday does not lay out specific reductions, but with federal dollars accounting for a third of state revenue, analysts said steep cuts will be unavoidable…”
• Fewer cops, more potholes: How debt deal could hit states hardest, By Patrick Wall, August 2, 2011, Christian Science Monitor: “The debt-and-deficit bill signed into law on Tuesday forestalled a dangerous federal government default. But it will also slash aid to states already reeling from the recession, almost certainly forcing them to curtail services and raise revenues to pay for programs once bankrolled by Congress. The bill, which the Senate approved and President Obama signed into law Tuesday, will eventually raise the government’s debt limit by more than $2 trillion in exchange for equivalent savings. Congress will achieve nearly $1 trillion of those savings by cutting domestic discretionary spending - including funds for education, health care, job training - to its lowest level in over half a century, as a share of the GDP…”
• For states, debt deal is short on details, By John Gramlich and Melissa Maynard, August 2, 2011, Stateline.org: “As state officials begin to decipher Washington’s spending reduction deal, it’s clear that federal aid to states for certain programs will take a hit over the next decade. But it will be a while before they know exactly which programs and how big a hit. That’s because the deal, which the U.S. House passed Monday night (August 1), leaves a lot of choices hanging into the future. It calls for $917 billion in deficit reduction over 10 years by setting caps on discretionary spending. But exactly how to meet those caps - and what funds to states might be cut - is a question for Washington to answer another day. Also undetermined is how much a joint congressional committee charged with finding another $1.5 trillion in deficit savings would cut from aid to states. So for states, which have been waiting anxiously to see whether the federal government would soon begin defaulting on its payments, there is relief - but also more waiting ahead…”

State shaves funds for health, social services, By Alexandra Zavis, July 30, 2011, Los Angeles Times: “Cynde Soto dreads the arrival of yet another benefit notice. Her cash assistance has been cut four times in two years. State medical coverage is getting more expensive and no longer includes dental care or podiatry. And the in-home help she needs to take care of basics has been cut by about 20 minutes a day. ‘That doesn’t sound like a lot to people but … I’m a quadriplegic,’ said the 54-year-old Long Beach resident. ‘I can’t even scratch my own nose.’ Faced with years of recession-driven budget shortfalls, state lawmakers have made deep cuts to health and social services. The reductions, including a round that took effect this month, translate into sizable state savings but are sharply scaling back the safety net for California’s most vulnerable residents: the elderly, the disabled and the poor…”

• Health care providers, advocates feel budget sting, By Madeleine Baran, July 21, 2011, Minnesota Public Radio: “Advocates, nonprofits and health care providers continue to scrutinize a state Health and Human Services budget that could restructure social services and public healthcare in Minnesota for years to come. Gov. Mark Dayton signed the department’s $11.4 billion budget into law Wednesday along with other bills that ended the state government shutdown. The budget bill that emerged Wednesday preserved health insurance coverage for the state’s poorest residents. It made slight cuts in welfare spending and services for people with disabilities. And it cut payments for health care providers and created incentives for hospitals to reduce emergency room visits and readmissions…”
• Budget deal means big changes for schools, health, By Baird Helgeson, Mike Kaszuba and Eric Roper, July 21, 2011, Minneapolis-St. Paul Star Tribune: “Minnesotans awoke Wednesday to a new state budget that clamps down on spending, makes big changes in education and health care, and borrows heavily to make ends meet. The $35.7 billion budget ends a nearly three-week state government shutdown and sends 22,000 laid-off workers back to their jobs, where today they will begin reopening state offices and digging through the backlog of work. They will return to an operation transformed by changes forced largely by sagging revenues, as the state finds itself still trying to emerge from the worst economy in decades…”

As budgets are trimmed, time in class is shortened, By Sam Dillon, July 5, 2011, New York Times: “After several years of state and local budget cuts, thousands of school districts across the nation are gutting summer-school programs, cramming classes into four-day weeks or lopping days off the school year, even though virtually everyone involved in education agrees that American students need more instruction time. Los Angeles slashed its budget for summer classes to $3 million from $18 million last year, while Philadelphia, Milwaukee and half the school districts in North Carolina have deeply cut their programs or zeroed them out. A scattering of rural districts in New Mexico, Idaho and other states will be closed on Fridays or Mondays come September. And in California, where some 600 of the 1,100 local districts have shortened the calendar by up to five days over the past two years, lawmakers last week authorized them to cut seven days more if budgets get tighter…”

• Medicaid payments go under the knife, By Phil Galewitz, July 5, 2011, USA Today: “To curb rising Medicaid costs, about a dozen states are starting a new budget year by reducing payments to doctors, hospitals and other health care providers that treat the poor. Some health care experts say the cuts, most of which went into effect July 1 or will later this month, could add to a shortage of physicians and other providers participating in Medicaid. ‘Further depressing payment rates can only worsen the situation,’ says Sara Rosenbaum, chair of the health policy department at George Washington University. She says some states cutting rates - such as South Carolina- already have severe Medicaid physician shortages. Insurers and employers have their own concerns about the payment cuts. They say trimming the rates will prompt providers to raise their prices for patients who have private insurance…”
• Latest S.C. Medicaid cuts raise access fears, By Phil Galewitz, July 5, 2011, USA Today: “Medicaid patients in Spartanburg, S.C., face long odds in finding a new doctor. Most specialists in the city don’t see Medicaid patients, and primary care physicians generally will see only one new Medicaid patient a month, says Fran Kunda, a Spartanburg family doctor and chairwoman of the South Carolina Academy of Family Physicians. As the latest round of Medicaid cuts on doctors goes into effect Friday, Kunda fears access problems will only worsen in Spartanburg and other parts of the state. South Carolina, which reduced reimbursement rates to all Medicaid providers by 3% in April, is imposing an additional 2% cut on all doctors except obstetricians and neonatologists. It is one of nearly a dozen states that have opted to cut the Medicaid rates this month to doctors, hospitals and other providers to help limit spending in the federal-state health program for low-income and disabled residents…”
• Doctors shun Medicaid, By Kristen Consillio, July 5, 2011, Honolulu Star-Advertiser: “Hawaii’s chance to get a handle on the number of publicly insured residents denied access to primary care slipped away last week when the Obama administration shelved a plan for a mystery shopper program to measure access to medical services. A common complaint among patients covered by government health plans such as Medicaid is the difficulty in finding primary care doctors willing to accept public insurance, though there is no hard evidence to gauge the scope of the problem. The mystery shopper program, scrapped after doctors and politicians criticized it as government snooping, would have measured the level of access for patients insured in a public program versus higher-paying private insurance offered by companies such as Hawaii Medical Service Association. Local health care providers had hoped the short-lived proposal to survey difficulties in accessing care here and in eight other states - through people posing as patients with different kinds of insurance coverage seeking primary-care appointments - would have prompted government action, making it less burdensome for doctors to accept publicly insured patients…”

• Criticism for cuts to programs that help people get off welfare, By Alfred Lubrano, July 4, 2011, Philadelphia Inquirer: “In a GED classroom emptied by state budget cuts last Thursday, instructor Marylou Fusco began removing paper cutouts that her students - single mothers working to get off welfare - had made of their own hands that were tacked to a bulletin board. On the palms of the hands, the women had written their life goals: ‘Get off welfare.’ ‘Go to college.’ ‘Get my own place for me and my kids.’ After 15 years, the GED classes were quickly ended to reflect the new reality dictated by state budget line No. 5297.55: Cut the welfare-to-work program by $17 million - nearly 48 percent. The new reality postpones or ends the hopes and wishes scrawled across the women’s palms. Still more cuts were made in other programs meant to help the poor in a budget process that saw the Corbett administration push through a controversial last-minute Senate measure that shifts control of welfare funding from the legislature to his administration…”
• NJ reverses order to cut $15 from welfare checks, By Erik Larsen, July 6, 2011, Asbury Park Press: “The state of New Jersey has reversed an order to its 21 counties to make a $15 per person reduction in monthly welfare checks issued to single adults and childless couples. Mary Fran McFadden, director of the Ocean County Board of Social Services, said Tuesday that anyone affected by the change before the order was rescinded will be reimbursed. The benefits change was to begin last Friday, the start of the state’s new fiscal year. There are more than 3,100 county residents on General Assistance who stood to be impacted by the change…”

Administration offers health care cuts as part of budget negotiations, By Robert Pear, July 4, 2011, New York Times: “Obama administration officials are offering to cut tens of billions of dollars from Medicare and Medicaid in negotiations to reduce the federal budget deficit, but the depth of the cuts depends on whether Republicans are willing to accept any increases in tax revenues. Administration officials and Republican negotiators say the money can be taken from health care providers like hospitals and nursing homes without directly imposing new costs on needy beneficiaries or radically restructuring either program…”