• Fewer doctors, longer ER waits are expected, By Ken Alltucker, March 24, 2010, Arizona Republic: “Arizona hospitals say the Legislature’s steep cuts to health-care programs may trigger more hospital cuts and layoffs, longer emergency-room waits and a deepening doctor shortage. The budget cuts will eliminate health insurance for nearly 350,000 low-income adults and children enrolled in the state’s Medicaid program, leaving them few options for care. Hospital executives worry that they will have to absorb the cost and burden of providing treatment for the low-income residents and children until the more generous federal subsidies arrive in 2014 as part of the federal health-reform bill. Hospitals are required to provide care regardless of a patient’s ability to pay…”
• Arizona non-profit clinics fear lost funds, flood of uninsured patients, By Ginger Rough, March 24, 2010, Arizona Republic: “Arizona’s community health centers, a vital safety net for the uninsured and the working poor, are bracing for an onslaught of new patients and preparing to roll back their services after two state health-care programs were killed and the state’s Medicaid spending was slashed. New patients cut off from government insurance programs could flood the centers, and the centers would not have reimbursements from those programs to cover the full cost of providing care. The 16 federally qualified centers, which are non-profits and operate more than 130 clinics in mostly rural and underserved areas, rely mainly on state and federal insurance and federal grants to operate…”

When doctor visits lead to legal help, By Erik Eckholm, March 23, 2010, New York Times: “It was not the normal stuff of a pediatric exam. As a doctor checked the growth of Davon Cade’s 2-month-old son, he also probed about conditions at home, and what he heard raised red flags. Ms. Cade’s apartment had leaky windows and plumbing and was infested with roaches and mold, but the city, she said, had not responded to her complaints. On top of that, the landlord was evicting her for falling behind on the rent. Help came through an unexpected route. The doctor referred Ms. Cade to the legal aid office right inside the pediatric clinic at Children’s Hospital in Cincinnati. Within days, a paralegal had secured an inspection that finally forced the landlord to make repairs, and also got the rent reduced temporarily while Ms. Cade searched for less expensive housing. ‘It got done when the lawyers got involved,’ Ms. Cade said…”

Burden higher for nonprofit hospitals, Illinois Supreme Court says, By Bruce Japsen and Jason Grotto, March 19, 2010, Chicago Tribune: “An Illinois Supreme Court decision Thursday puts nonprofit hospitals on notice that they must provide an adequate amount of charity care to patients or risk losing significant tax exemptions. The decision, closely watched at a time when medical centers and the government are straining to cover health care costs for the poor, is a blow to the state’s hospital industry. It sets the stage for a potential debate about exactly how charitable hospitals must be, with some experts predicting that Springfield could seek to pass a law mandating the amounts. In the meantime, state officials indicated they could incorporate the court ruling into their assessments of whether to renew hospital tax exemptions. In its decision upholding a lower court ruling, the high court found that the Illinois Department of Revenue was correct in withdrawing Provena Covenant Medical Center’s property tax exemption in 2004 because the Urbana hospital failed to justify adequately the exemption through charitable giving…”

Budget cuts could hit low-income NJ residents, By Geoff Mulvihill (AP), March 15, 2010, Philadelphia Inquirer: “New Jersey’s days as a place where the government is unusually generous to the needy may be numbered as a new governor pushes wide-ranging spending cuts to solve a deep budget crisis. Gov. Chris Christie is set to unveil his first spending plan Tuesday after months of preaching shared sacrifice. From what he’s done so far, it’s clear that applies to lower-income people, too, in a state that’s among the most generous in the nation when it comes to unemployment benefits and taxpayer-funded health care for the working poor. Already, he has cut the state’s mass-transit subsidy and stopped enrolling some lower-income adults in a subsidized health insurance program. He’s also proposed reducing weekly unemployment checks and, even before he was sworn in, hinted that food banks could see their state aid cut and told hospitals their reimbursements for treating the indigent will be cut in June…”

• Medicaid cuts call health care for vulnerable Idahoans into question, By Colleen LaMay, March 3, 2010, Idaho Statesman: “No matter where you cut Medicaid, you are bound to slice into care that matters a great deal to some of the 213,000 people who rely on it for their health care. The Legislature’s Joint Finance-Appropriations Committee on Thursday will consider how to make up a $29 million shortfall in state funding for Medicaid for this year, as well as how and where to curb Medicaid to meet JFAC’s budget goals for 2011. Medicaid started its fiscal year in July with a budget of about $1.5 billion in federal and state funding. That dropped to $1.4 billion as the economic news became more grim…”
• Idaho lawmakers approve budget cuts for Medicaid, By Brian Murphy, March 4, 2010, Idaho Statesman: “Idaho legislative budget writers approved a Medicaid budget Thursday morning that forces the Department of Health and Welfare to finding savings of more than $47 million in the program and gives Gov. Butch Otter the authority to modify state statutes to keep the program in check. The entire Medicaid budget is $1.55 billion dollars, with $298 million coming from the General Fund. More than $1.5 billion of the budget comes from the federal government. Lawmakers expect $25 million to come from the Hospital Assessment Act, a bill that has yet to be introduced this session. Hospitals will pay the state in order to continue to keep its federal match. That still leaves more than $22 million in savings for the department to find…”
• State can’t cut Medi-Cal payments to hospitals, By Bob Egelko, March 4, 2010, San Francisco Chronicle: “A federal appeals court barred California on Wednesday from lowering Medi-Cal payments to doctors and hospitals by 5 percent and from cutting in-home care workers’ wages by nearly 20 percent, saying the state’s budget crisis doesn’t justify violating federal laws that protect the poor and disabled.In four rulings, the Ninth U.S. Circuit Court of Appeals in San Francisco rejected attempts by Gov. Arnold Schwarzenegger and the Legislature to reduce the state’s deficit by paying less to the health professionals who treat 6.6 million low-income Californians, and to hundreds of thousands of workers who care for some of the neediest…”

Bills stalled, hospitals fear rising unpaid care, By Reed Abelson, February 8, 2010, New York Times: “President Obama says he aims to keep trying. But what happens if the health care legislation cannot be revived, and tens of millions of uninsured Americans continue without coverage? For the nation’s hospitals, at least, the cost of doing nothing in Washington translates into tens of billions of dollars each year in medical bills that go unpaid by patients with little or no insurance. Nationwide, the cost of unpaid care for hospitals, which includes charity care as well as money that could not be collected from patients, was around $36 billion in 2008. It is expected to spiral higher. The number of people without insurance in this country could increase to as high as 58 million by 2014, from about 49 million now, according to an estimate by the Urban Institute. No wonder hospital systems like Park Nicollet Health Services near Minneapolis worry about their futures if the health care legislation remains stalled…”

• Medicaid, while caring for more, faces big budget challenge, By Deborah Yetter, February 9, 2010, Louisville Courier-Journal: “During his 20 years as an electrician, Eric Sachse never sought any type of public assistance. But then Sachse, a 38-year-old single father in Louisville, lost his job - and health insurance for him and his son, 9. So last month, Sachse signed son John up for the Kentucky Children’s Health Insurance Program, a Medicaid program that covers children of low-income parents. Although Sachse doesn’t qualify for Medicaid himself, he said getting coverage for his son is what counts. ‘I was just really fearful of how I was going to take care of any health care situation,’ he said. As the economy has worsened in the past two years, Kentucky’s Medicaid rolls are rising faster than at any other time in the past decade, adding poor, disabled and low-income people at the rate of 3,400 a month…”
• Hawaii may delay payments to Quest health plan, By Derrick DePledge, February 7, 2010, Honolulu Advertiser: “The state Department of Human Services has warned health insurance companies that the state may not make payments for Quest - the state’s health plan for low-income families - for the last quarter of the fiscal year, leaving insurers to absorb about $300 million in medical expenses until at least July. The potential delay in payments has stunned insurers and alarmed health care providers, who worry a delay could jeopardize the ability of insurers to cover claims, which would cause cash flow problems and influence how some providers care for Quest members…”
• Tennessee hospitals push for tax to offset cuts to TennCare, By Chas Sisk, February 9, 2010, The Tennessean: “The Tennessee Hospital Association’s members will push for a temporary tax on their revenues to reduce cuts to the TennCare program proposed last week by Gov. Phil Bredesen. The association’s board voted Monday to approve a one-year ‘coverage fee’ of 1 percent to 2 percent that would raise money for hospital services scheduled to receive less funding from TennCare. The fee likely would go into effect July 1 and would not be passed along to patients, association officials said. The group also will lobby the state to dip further into reserves and to use any additional revenue that comes into the state to reduce TennCare cuts…”
• Medicaid cuts ‘devastating’ to rural hospitals, By Heather Stanek, February 8, 2010, Fond du Lac Reporter: “Rural hospitals around Fond du Lac say a proposed assessment will help them avoid cutting services or raising prices. Ripon Medical Center and Waupun Memorial Hospital are two of the 59 critical-access hospitals across the state dealing with cuts in Medicaid payments. In an effort to slash costs, the state reduced its Medicaid reimbursements by 10 percent, leaving hospitals to pick up heftier bills for caring for low-income patients. Waupun Memorial, part of Agnesian HealthCare, stands to lose $300,000 annually due to Medicaid cuts, said DeAnn Thurmer, WMH chief operating officer. About 10 percent of the hospital’s patients depend on Medicaid. The Wisconsin Hospital Association and Rural Wisconsin Hospital Cooperative are drafting a legislative bill that would help restore federal dollars to rural hospitals…”

• Ease rules for health program for poor, bill urges, By Tony Leys, January 7, 2010, Des Moines Register: “Poor, uninsured adults from throughout Iowa could receive health care at nearby hospitals and clinics, instead of having to travel to Iowa City, under proposed changes to a state health-care program. For most Iowa residents, the IowaCare program pays for medical care only at University of Iowa Hospitals. For Polk County residents, the program also covers care at Broadlawns Medical Center. The rules mean western Iowans must travel hundreds of miles to receive health care under the program. Legislators this spring will consider loosening those rules, but only if federal officials would help pay for the changes. About 33,500 Iowans are covered by the program, which offers basic health care to poor adults who don’t qualify for Medicaid. It was cobbled together in 2005 as a compromise to prevent federal officials from cutting $60 million from the state’s Medicaid program…”
• Medicaid cuts could hurt poor, elderly and children, By Veronica Chufo, December 19, 2009, Daily Press: “Virginia’s Medicaid recipients, hospitals and nursing homes could take a hit under outgoing Gov. Timothy M. Kaine’s proposed budget cuts. The two-year state budget proposal that Kaine unveiled Friday includes a $419 million reduction to Medicaid, which covers health-care costs mostly for residents who are blind or disabled and low-income women and children. It also covers nursing-home stays for the elderly. It’s too early to tell exactly how the reductions will affect health-care systems and long-term care facilities, but health officials say Medicaid reimbursement rates in Virginia are already low…”

• Uninsured trauma patients are much more likely to die, By Karen Kaplan, November 17, 2009, Los Angeles Times: “Patients who lack health insurance are more likely to die from car accidents and other traumatic injuries than people who belong to a health plan — even though emergency rooms are required to care for all comers regardless of ability to pay, according to a study published today. An analysis of 687,091 patients who visited trauma centers nationwide from 2002 to 2006 found that the odds of dying from injuries were almost twice as high for the uninsured than for patients with private insurance, researchers reported in Archives of Surgery. Trauma physicians said they were surprised by the findings, even though a slew of studies had previously documented the ill effects of going without health coverage. Uninsured patients are less likely to be screened for certain cancers or to be admitted to specialty hospitals for procedures such as heart bypass surgery. Overall, about 18,000 deaths each year have been traced to a lack of health insurance…”
• Study: Injured uninsured more likely to die in ER, By Carla K. Johnson (AP), November 16, 2009, Idaho Statesman: “Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study. The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable. ‘This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States,’ said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist…”

• Indiana trims Medicaid payments to hospitals, By Mary Beth Schneider, November 10, 2009, Indianapolis Star: “Hospitals would get 5 percent less money from the state for caring for Medicaid patients under cuts announced today by the state. Gov. Mitch Daniels last week called for emergency budget cuts as the state’s revenue continues to fall short of projections. State tax collections already are a half-billion dollars short of what was collected at this time last year. To make the cuts, Daniels said state employees would not be getting pay raises, and asked agencies to come up with cuts, including the Family and Social Services Administration which administers Medicaid in Indiana…”
• Pain of budget cuts is hitting home, By Mary Beth Schneider, November 11, 2009, Indianapolis Star: “State budget cuts will begin to take a tangible toll on Hoosiers, from the pay in prison guards’ pockets to possibly the level of service people receive at hospitals. Faced with withering revenues, Gov. Mitch Daniels last week ordered state agencies to slash their expenses by 10 percent this fiscal year, on top of 10 percent cuts made last year. On Tuesday, the Family and Social Services Administration announced that it will reach some of its goal by cutting the amount it pays hospitals for caring for Medicaid patients by 5 percent beginning Jan. 1, a move that will save the state $10.6 million in this fiscal year…”
• Ind. budget cuts include $34 million in social services, By Ken Kusmer (AP), November 10, 2009, Louisville Courier-Journal: “Indiana’s human services agency said Tuesday it will slice $34 million from its budget by paying hospitals less to treat Medicaid patients, renegotiating contracts with most of its vendors, moving some offices and leaving about 400 jobs unfilled. However, the Family and Social Services administration will not reduce its Medicaid payments to doctors or cut ‘vital services’ to the young, elderly, disabled and needy Indiana residents who receive social safety-net benefits, agency officials said…”

Hospitals cite worry on fees in health bill, By Anemona Hartocollis, November 2, 2009, New York Times: “As Congress struggles to rein in health care costs as part of its sweeping reform efforts, hospitals in New York City and other urban areas that provide some of the most expensive care are among the primary targets. The issue pits hospitals in more rural states like Iowa and Minnesota, where spending tends to be lower, against those in areas like New York and Los Angeles, and revolves around a question that has bedeviled the medical establishment for decades: How much money do hospitals need to provide adequate care for patients, especially poor people who have not had regular access to health care…”

Will safety net hospitals survive health reform?, By Carla K. Johnson (AP), September 3, 2009, San Jose Mercury News: “Janie Johnson has no health insurance, so when she cut her toe while giving herself a pedicure, she limped to the emergency room at one of Chicago’s safety net hospitals and waited her turn. ‘I’m 44, but I probably look about 55 right now,’ Johnson joked in Stroger Hospital’s emergency department where more than 100 patients sat waiting. Urgent cases, from chest pains to gunshot wounds, are rushed to doctors first. Johnson was glad to have somewhere to go for health care. ‘I don’t know what I would do’ without the hospital, she said. ‘My health would probably get worse.’ To all the knotty issues involved in health care overhaul, add one more: The proposals in Congress may threaten the funding and future of the nation’s already-struggling safety net hospitals…”

La. Health department cuts Medicaid providers, By Melinda Deslatte (AP), August 3, 2009, Baton Rouge Advocate: “Louisiana will start paying less money Tuesday to many private health care providers for taking care of Medicaid patients, a move the state health department estimates will save $86 million this year.  Health and Hospitals Secretary Alan Levine said he also is weighing whether to require adults in the Medicaid program to pay a ‘very small co-pay’ if they use emergency rooms for non-emergency care…”