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…”

State orders $15 reduction per person in monthly welfare checks, By Erik Larsen, June 30, 2011, Asbury Park Press: “Changes in the state budget for the new fiscal year that begins Friday will result in funding reductions to welfare programs that are administered by New Jersey’s 21 county governments. The reductions had been discussed as a possibility but are now official, according to Mary Fran McFadden, director of the Ocean County Board of Social Services. Letters have been sent to recipients to notify them of the changes. The state Division of Family Development has ordered the counties to make a $15 per person reduction in monthly welfare checks issued to single adults and childless couples…”

For San Diego schools, a fear that larger classes will hinder learning, By Michael Winerip, June 26, 2011, New York Times: “Many in the forefront of what is called the education reform movement - like Bill Gates, the philanthropist, and Arne Duncan, the nation’s education secretary - have attended private schools with small class sizes. Others, like New York’s mayor, Michael R. Bloomberg, and its former schools chancellor Joel I. Klein have sent their children to private schools with small class sizes. Imagine if the poorest public school children had the same opportunity. That is what has been happening for several years in this urban district of 130,000 students. Using state money and federal stimulus dollars, San Diego has held class size to 17 in kindergarten through second grade at its 30 poorest schools. ‘Small class size is the most important priority for us,’ said Richard Barrera, the school board president. ‘These children are behind when they enter kindergarten. If they’re on grade level by third grade, most will be fine.’ Mr. Barrera believes that the rise in the district’s state test scores - to 56 percent proficient in English from 45 percent three years ago - is due, in part, to smaller classes. However, in San Diego, 17 could soon become 30. Federal stimulus money has been spent. California’s governor and Legislature, after several years of budget cuts, are deadlocked over whether to cut again. All around the state, districts have developed worst-case budget plans…”

• Indiana law to cut Planned Parenthood funding is blocked, By Robert Pear, June 24, 2011, New York Times: “A federal judge ruled Friday that the State of Indiana could not cut off money for Planned Parenthood clinics providing health care to low-income women on Medicaid. The judge, Tanya Walton Pratt of the Federal District Court in Indianapolis, blocked provisions of a new state law that penalized Planned Parenthood because some of its clinics performed abortions. The law, she said, conflicts with the federal Medicaid statute, which generally allows Medicaid beneficiaries to choose their health care providers. Planned Parenthood provides services other than abortion, including family planning and screenings for cancer and sexually transmitted diseases. In issuing a preliminary injunction late Friday, Judge Pratt said the state law ‘will exact a devastating financial toll on Planned Parenthood of Indiana and hinder its ability to continue serving patients’ general health needs…’”
• Arizona Medicaid: New attempt made to block cuts, By Mary K. Reinhart, June 28, 2011, Arizona Republic: “Attorneys for low-income Arizonans filed a motion in Maricopa County Superior Court on Monday to stop sweeping cuts to the state’s Medicaid program from taking effect Friday. It may be the last chance for more than 135,000 people expected to lose coverage in the coming year under the Arizona Health Care Cost Containment System, which Gov. Jan Brewer and state lawmakers cut by more than $500 million to balance the budget. Attorneys for three public-interest groups argue that Brewer and lawmakers are violating the state Constitution and the will of voters, who in 2000 agreed to expand AHCCCS and extend health care to everyone earning less than the federal poverty level. The Arizona Supreme Court last Friday declined to accept a similar case, without explanation…”

Job-training programs come under scrutiny in Congress, By Rob Hotakainen, June 27, 2011, Miami Herald: “After working for seven years as a receptionist, Teresa Sawyer knew how to use a typewriter and a photocopier when she got laid off in 2008, but she knew nothing about computers. Sawyer, 60, of Gig Harbor, Wash., sent out hundreds of resumes but didn’t get a single response, leading her to conclude that she was unemployable. But with a little help from a federal job-training program, Sawyer went back to school to learn how to be a medical office professional. After receiving a two-year associate in applied science degree from Tacoma Community College this month, she has no fears of landing a job. ‘None at all, not with the skill that I have. … I never dreamed I would do this,’ she said. Despite their popularity with many members of Congress and their constituents, however, job-training programs have come under increased scrutiny this year on Capitol Hill, and the attention is about to intensify…”

The art of luring ‘poor’ cities into energy-saving projects, By Ellen M. Gilmer, June 27, 2011, New York Times: “The decay of Michigan’s many rusted-out towns doesn’t strike most as fertile ground for any kind of green movement. But entrepreneur Sean Reed sees the state as a prime spot for energy efficiency measures to take root. Through the Clean Energy Coalition, where he is executive director, Reed is aiming to bring those cash-strapped cities into the sustainability fold by making available more clean energy technology in the local building and transportation sectors. Change, though, is not likely to come easily. One CEC project — Cities of Promise — targets municipal energy use in struggling communities, like Flint and Hamtramck. Using a $4.4 million grant issued last year by the Michigan Public Service Commission, CEC has performed energy audits of city-owned and -operated buildings in eight towns…”

What welfare cutbacks say about the wisdom of block grants, By Pamela M. Prah, June 24, 2011, Stateline.org: “Welfare advocates in Oregon were confounded this spring when they discovered that Governor John Kitzhaber wanted to limit to 18 the number of months welfare families could get cash benefits over their lifetimes - a stricter limit than existed anywhere in the country. Part of their disappointment stemmed from the fact that the idea came from Kitzhaber, a Democrat and one-time emergency room physician who had been viewed over two earlier terms as a supporter of generous help for the needy. ‘We were surprised that the governor had such an extreme proposal,’ says Charles Sheketoff, executive director of the Oregon Center for Public Policy. Kitzhaber, in Sheketoff’s view, ‘went after welfare programs with amputation in mind. We are pleased the legislature did more precise surgery and saved limbs.’ As lawmakers in Salem wrap up their session for the year, Oregon is on track to keep its five-year lifetime limit on cash benefits, the maximum allowed under federal law. But the same cannot be said for other states…”

London’s poor facing squeeze amid housing-benefit cuts, By Anthony Faiola, June 20, 2011, Washington Post: “The choice of the London A-list, St. John’s Wood is a neighborhood of ethereal wealth, its leafy avenues lined with the ample mansions of Paul McCartney, Ewan McGregor and Kate Moss. And yet, they share the most unlikely neighbors - the Kastrati family. Poor immigrants struggling to survive in one of the world’s most expensive cities, the family of four nevertheless lives in a sunny, two-bedroom flat in an enclave of urban privilege. Their benefactor: the British government, which covers 85 percent of their $3,600-a-month rent through welfare benefits giving tens of thousands of low-income earners access to even the best neighborhoods. But the clock on such subsidized London lifestyles is suddenly running out. The Conservative-led government is rolling out Britain’s most sweeping welfare reform since the 1940s, taking aim at the ballooning bills in cities such as London, where a few families receive as much as $160,000 a year to ensure economic diversity and quality housing for the poor in some of the priciest districts in the world. Yet as benefits are rolled back, academics are warning of a major side effect: an exodus of the poor from central London in numbers not seen since the demolition of soot-caked Dickensian slums in the 19th century…”

Poor targeted in Pa. budget, By Alfred Lubrano, June 21, 2011, Philadelphia Inquirer: “When Gov. Corbett proposed to balance the budget by cutting hundreds of millions of dollars from universities and public schools, squawks of protest erupted throughout Pennsylvania. Neither deaf nor politically unsavvy, House Republicans listened to the noise, then came up with a new plan to restore nearly $600 million in aid to education. So if schools are, to some extent spared, who will bear the brunt of budget cuts? The House’s Republican majority, elected on pledges of new ideas - smaller government, ethics reform - settled on a not-so-fresh notion: Cut funding for the poor…”

Budget slashed for jobs for older, low-income workers, By Walker Moskop, June 20, 2001, San Antonio Express-News: “Even with the food stamps she received, Sandy Hipp was barely making enough money when she lived on a minimum-wage salary working 24 hours a week at a senior apartment complex in Seguin. Then, in April, Congress slashed the funding for the program paying her wages, and her hours were cut back to 18. Hipp, 58, said she’ll have to find another job soon and will apply to work at a plant nursery in Seguin. For older, low-income jobseekers, the task of landing work is now a greater uphill climb. The Senior Community Service Employment Program, the national program that gives grants to organizations to train workers, connect them with employers and pay their wages, has seen its budget slashed from $825 million for 2010-11 to $450 million for 2011-12 - a 45 percent cut…”

Many needy California schoolchildren not taking part in subsidized summer meal programs, By Alexandra Zavis, June 16, 2011, Los Angeles Times: “Fewer than 1 in 5 of the children who relied on free or reduced-price lunches during the 2009-2010 school year in California received subsidized meals last July, according to a new report. That represents a 15% drop in participation in summer meals programs from the year before at a time when enrollment in other federal nutrition programs is increasing because of the lingering effects of the recession. The report by California Food Policy Advocates blamed cuts to the state’s education budget, which caused many school districts to eliminate summer learning and enrichment programs. That reduced the places where needy students received breakfasts, lunches and snacks during the summer months…”

Rich schools, poor schools: N.C.’s gap may be growing, By Jane Stancill, June 20, 2011, Charlotte Observer: “North Carolina’s 1.5 million public school children depend on the state to pay the majority of their educational costs, but that long-held tradition may be changing. What started as the state’s promise during the Great Depression has eroded during the Great Recession. Lawmakers, facing gaping state budget shortfalls in the past two years, began to force cuts onto local school districts. That so-called discretionary reduction was $225 million two years ago and $305 million last year, both actions taken by a Democratic-led legislature. Now the state’s budget reduction has grown to $429 million for public schools and charter schools - with the Republican-led legislature cutting another $124 million. The cuts were contained in the budget that passed last week after a lengthy political fight over education spending with Democratic Gov. Bev Perdue. The GOP-controlled legislature overrode the governor’s veto, and the $19.7 billion budget plan became law…”

• States brace for end of extra payments for Medicaid, By Robert Pear, June 15, 2011, New York Times: “Faced with a deepening recession two years ago, the Obama administration injected billions of dollars into Medicaid, the nation’s low-income health program. The money runs out at the end of this month, and benefits are being cut for millions of people, even though unemployment has increased. From New Jersey to California, state officials are bracing for the end to more than $90 billion in federal largess specifically designated for Medicaid. To hold down costs, states are cutting Medicaid payments to doctors and hospitals, limiting benefits for Medicaid recipients, reducing the scope of covered services, requiring beneficiaries to pay larger co-payments and expanding the use of managed care. As a result, costs can be expected to rise in other parts of the health care system. Cuts in Medicaid payments to doctors, for example, make it less likely that they will accept Medicaid patients and more likely that people will turn to hospital emergency rooms for care. Hospitals and other health care providers often try to make up for the loss of Medicaid revenue by increasing charges to other patients, including those with private insurance, experts say…”
• GOP governors push back against Obama on federal Medicaid rules, By Michael A. Fletcher, June 14, 2011, Washington Post: “Faced with severe budget problems, Republican governors are escalating their fight against federal rules requiring states to maintain current levels of health-care coverage for the poor and disabled. The growing resistance to the federal government over the hugely expensive Medicaid program poses a critical test for President Obama, who has the power to relax the rules for states. If he allows states to tighten eligibility requirements, it would outrage many of his core supporters while undermining the central goal of his signature health-care law: expanding health insurance coverage. But if the president turns his back on governors struggling to gain control of their finances by trimming their most costly program, he risks intense criticism just as his administration is locked in a battle with Republicans over the nation’s soaring debt…”

• Christie proposal to slash Medicaid by $540 million puts NJ at center of national debate, By Josh Lederman (AP), June 11, 2011, Washington Post: “As states across the country look for ways to trim billions off their spending on Medicaid, New Jersey is garnering particular attention for a proposal that opponents characterize as an unprecedented and draconian attempt to balance the state’s precarious budget on the backs of society’s most vulnerable populations. The debates taking place in statehouses, clinics and living rooms crystalize the unfortunate truth about economic recessions: Citizens rely most on public services just when the government has the least money to spend on those services. In New Jersey’s case, changes would mean a parent of two earning more than $103 per week would be ineligible…”
• Human Services officials release details on N.J. Medicaid program cuts, changes, By Susan K. Livio, June 10, 2011, Star-Ledger: “The Christie administration released a long-anticipated outline today of how the state proposes to drastically restructure New Jersey’s Medicaid program and cut more than $300 million to help close a deficit. In the most controversial element of the proposal, the Department of Human Services expects to save as much as $32.5 million by sharply limiting who is eligible for coverage. It was the first time that the state disclosed estimates of what each change would save. For instance, parents in a family of three earning more than $422 a month, or $5,000 a year, would be disqualified for earning too much money, according to a document summarizing the proposal. Currently the income cut-off is $24,600 for a family of three…”
• Advocates: ‘glitches’ keep Mass. kids uninsured, By Johanna Kaiser (AP), June 11, 2011, Boston Globe: “Forgotten paperwork, returned mail, and a lack of information are keeping thousands of Massachusetts children from receiving stable health care coverage in a state known for its far-reaching health care initiative. Although Massachusetts has the highest rate of insured children in the county — more than 99 percent — health care advocates and lawmakers say thousands of eligible children still go on and off the state’s Medicaid program, known as MassHealth, during the year because of administrative issues and other paperwork problems…”

• The other healthcare lawsuit: California Medicaid (aka Medi-Cal) case headed to Supreme Court, By Marilyn Chase, June 6, 2011, Los Angeles Times: “With valet parking for patients, video-conferencing for parents of premature babies and a healing garden abloom with azaleas, Santa Rosa Memorial Hospital tries to maintain the amenities of a thriving community hospital. But chief financial officer Mich Riccioni is focused on the fiscal strains Memorial is facing. Nearly a quarter of the hospital’s patients are on California’s Medicaid program, known as Medi-Cal, and the state has been trying for years to cut its reimbursement rates for hospitals and other healthcare providers. Memorial, a 278-bed hospital in this city 55 miles north of San Francisco, sued California to try to stop the payment reductions. Now it is part of a case before the U.S. Supreme Court that could redefine states’ responsibilities on Medicaid services and ultimately determine whether Democratic Gov. Jerry Brown can go forward with cuts he says are vital to closing the state’s budget gap. The court is likely to hear arguments in the fall and render a decision by next spring…”
• Texas House approves Medicaid changes, By Chris Tomlinson (AP), June 8, 2011, Houston Chronicle: “Texas lawmakers passed major changes to Medicaid on Wednesday that would privatize the health program in South Texas and allow the formation of health care cooperatives. The 142-page measure is part of a special legislative session. The Legislative Budget Board says it could save the state $467 million, almost two-thirds of that from Medic­aid savings. Medic­aid is a joint state and federal health insurance program for the poor and disabled…”

• Improved tax collections can’t keep pace with states’ fiscal needs, survey finds, By Michael Cooper, June 2, 2011, New York Times: “Half the states plan to cut spending on higher education, and nearly a third plan cuts to elementary and high schools. Public assistance and transportation face cuts. Eighteen states have proposed slashing aid to struggling cities and local governments. Some states will raise taxes or fees. Others plan to lay off workers, or cut their salaries or benefits. Although state tax collections are picking up after several brutal years, a new survey by the National Governors Association and the National Association of State Budget Officers found that states still expect to collect less tax revenue and spend less money in the coming fiscal year than they did before the Great Recession began. At the same time the cost of Medicaid, the biggest single portion of state spending, has been rising, driven up by higher enrollment as many people have lost their jobs and their health insurance…”
• Education, social services are big losers in state budget, By Ray Long and Monique Garcia, May 31, 2011, Chicago Tribune: “Education and social services are the losers under a state budget lawmakers put the finishing touches on Tuesday. The $33.2 billion spending plan is about $2 billion less than what Democratic Gov. Pat Quinn wanted. Spending less was on the minds of many lawmakers after they approved a 67 percent increase in the income tax rate in January that was billed as mostly temporary…”

For states, a glimmer of hope on deficits, By Michael Cooper, May 17, 2011, New York Times: “From stronger-than-expected tax collections in deficit-ridden California to projected surpluses in struggling states like Michigan and Pennsylvania, a growing number of recession-weary states are finally announcing a bit of good budget news for the first time since the downturn began. But it would probably be premature to pop the Champagne, or even the prosecco - or to otherwise declare the fiscal crisis that has hammered states to be over. ‘If the question is ‘Are we out of the woods?,’ I think the answer is probably no,’ said Donald J. Boyd, a senior fellow at the Nelson A. Rockefeller Institute of Government in Albany, which closely tracks state tax collections. ‘We’re closer to the edge. But there are still so many things that states and localities need to worry about…’”

2 Illinois hospitals on brink of closure illustrate pressures on US health care safety net, By Carla K. Johnson (AP), May 9, 2011, Washington Post: “Two charity hospitals in Illinois are facing a life-or-death decision. There’s not much left of either of them - one in Chicago’s south suburbs, the other in impoverished East St. Louis - aside from emergency rooms crowded with patients seeking free care. Now they would like the state’s permission to shut down. The institutions, which have served low-income people in the state for more than 100 years, represent a significant development that’s gone largely unnoticed as the nation climbs out of the recession. Many charity hospitals, already struggling with rising costs, are on the brink of failure because of looming budget cuts, increasing numbers of uninsured patients and a slow economic recovery…”

Plan would trade Medicaid funds for flexibility, By Julie Rovner, May 5, 2011, National Public Radio: “Most of the debate about the budget plan passed by House Republicans last month centers on the dramatic changes it would make to the Medicare health program for seniors. But the proposal calls for potentially even bigger changes to the Medicaid program for the poor. Medicaid actually covers more people than Medicare. In 2010, according to the most recent estimates from the Department of Health and Human Services, Medicaid covered 53.9 million people, compared with Medicare’s 47.3 million. Medicaid’s patients are also among the most vulnerable in society…”

Experts: Half-day kindergarten a ‘disaster’, By Alfred Lubrano, May 1, 2011, Philadelphia Inquirer: “The Philadelphia School District’s plan to cut full-day kindergarten to help balance its budget is being decried by national education experts as a ‘disaster’ and a ‘very bad decision’ that could harm the development of thousands of children - especially the poor. At the same time, many Philadelphia parents are angered and worried that half-day kindergarten would force them to choose between quitting work to be home for their children or placing them in questionable or costly day care. And local child advocates warn that community child-care centers could not handle the tidal wave of 12,700 kindergartners likely to need placement in some kind of program…”

Budget cuts could give Oregon the shortest time line in the nation for cash assistance program, By Michelle Cole, April 27, 2011, The Oregonian: “Oregon lawmakers are considering budget cuts that would kick families off welfare cash assistance after 18 months. If approved, the proposal, which is also included in the governor’s budget, would leave Oregon with the shortest time limit in the nation. Currently, families may receive government cash assistance for as long as five years. Shortening to an 18-month, lifetime limit would save Oregon $11.6 million over two years. State officials estimate the change could affect 7,500 families. Neither Democrats nor Republicans like the idea but they say there’s no way to protect Oregon’s social safety net completely in light of the state’s $3.5 billion budget hole and the end to federal stimulus dollars…”

Child nutrition program faces cuts, By David Abel, April 16, 2011, Boston Globe: “Governor Deval Patrick and state lawmakers are proposing to slash more than 20 percent of state money from a decades-old program that helps thousands of low-income mothers afford formula and other basic foods for their children. The Women, Infants, and Children program, widely known as WIC, is regarded as a pillar of the social safety net, providing 130,000 low-income women in Massachusetts who are pregnant, breast-feeding, or raising young children with supplemental food, health care referrals, and nutrition education. Despite concerns raised by advocates for the poor, state officials said they have no choice but to make the cuts because of the state’s budget crunch…”

Job cuts puts seniors in jeopardy, By Shaya Tayefe Mohajer (AP), April 17, 2011, Contra Costa Times: “For $700 a month, 65-year-old Esmeralda Calderon cares for children part time through a federal community service job that’s in jeopardy because of cuts to the proposed federal budget for 2011. It’s the only source of income for a woman who has no one to rely on and lives alone in public housing in a gritty Hollywood neighborhood. Under the Department of Labor’s Senior Community Service Employment Program, more than 75,000 elderly Americans living in poverty in all 50 states earn their keep by the slimmest of margins. To qualify, participants must be over 55 and earning less than 125 percent of the federal poverty level - $13,600 a year. In the budget bill signed Friday by President Barack Obama, the program was slashed by 45 percent, from $825 million to $450 million a year. Advocates say it could mean as many as 58,000 fewer jobs if states or national groups are forced to discontinue the program because of the reductions…”

Republicans revive 1990s-era welfare debate over food stamps, suggest overhauling program, Associated Press, April 18, 2011, Washington Post: “House Republicans resurrected a 1990s-era fight over food stamps in their budget approved last week, arguing that any serious attempt to cut spending must include an overhaul of government programs that help needy families pay for food. Congress already has started cutting some food programs, including reducing the Women, Infants and Children Program by $500 million as part of a deal on this year’s budget. And last year, more than $2 billion in future funding for food stamps was redirected to other programs. On Friday, the House approved a Republican proposal to overhaul the $65 billion food stamp program - known officially as the Supplemental Nutrition Assistance Program, or SNAP - by replacing it with capped block grants to states, which would pay for the aid but make it contingent on work or job training. That proposal was included in a 2012 budget plan put forward by Budget Committee Chairman Rep. Paul Ryan, R-Wis…”

Federal Medicaid teams deployed to help states cut costs get mixed reviews, By Christopher Weaver, April 13, 2011, Kaiser Health News: “Earlier this year, governors — both Republicans and Democrats — asked the federal Department of Health and Human Services for greater freedom in bending Medicaid rules to make it easier to narrow gaping state budget deficits. The department demurred, but offered the states teams of experts to search for savings within the current rules. The teams, HHS said at the time, would be deployed to states that asked for help on Medicaid, the state-federal program for the poor and disabled. Nearly half the states took HHS up on its offer, according to newly released information from HHS…”