• TennCare may curtail coverage to reduce costs, By Chas Sisk, November 19, 2009, The Tenneseean: “People covered by TennCare may face new limits on their coverage and reductions in their benefits next year, under a plan unveiled Wednesday to help slice state spending. TennCare officials said that they could impose a new $10,000 annual cap on hospital coverage for the 1.2 million state residents enrolled in the program…”
• NM considers scaling back Medicaid coverage, By Barry Massey (AP), November 20, 2009, Las Cruces Sun-News: “Gov. Bill Richardson’s administration is proposing to overhaul Medicaid and scale back health care services to some lower-income New Mexicans to cope with a projected budget shortfall of $300 million next year in the state’s largest health care program. Human Services Department officials told lawmakers on Thursday that Medicaid benefits and eligibility likely would be limited to minimum federal requirements, such as covering low-income pregnant woman and some children. A package of health care services would be available to other needy individuals-currently covered by Medicaid because the state has expanded eligibility-but they would need to pay premiums and copays. Those fees would vary based on income. The effort to trim Medicaid comes at a difficult financial time. The state faces a half billion budget shortfall next year…”

With aid, Mass. poor cut smoking, By Stephen Smith, November 18, 2009, Boston Globe: “Lower income Massachusetts smokers have dramatically abandoned their habit amid a major state campaign that vigorously promotes and pays for tobacco addiction treatment, according to a report scheduled to be released this morning. Smoking rates among the poor plummeted 26 percent in the first two years of the ongoing state program, a striking result that is already drawing national attention to the effort. Officials targeted a population that historically had the highest smoking rates in Massachusetts. The study, issued by the Department of Public Health, found early indications that the tobacco cessation efforts - aimed at patients enrolled in the state’s medical insurance for the poor, MassHealth - are reaping immediate health benefits…”

House health bill includes Medicaid relief for states, By Aaron C. Davis, November 16, 2009, Washington Post: “Wedged in the House health-care bill is $23.5 billion that looks a lot more like new federal stimulus spending than anything to do with national health-care reform. The barely debated pot of money would allow Congress to continue pumping billions in new short-term aid to states to cover Medicaid costs that have increased with rising unemployment in the past year. The potential impact of the new spending became clear last week when giddy state budget officials in capitals from Annapolis to Sacramento penciled in the revenue, hoping that if health-care legislation survives in the Senate, the states’ bonus might squeak through. Medicaid relief for states comprised one of the biggest pieces of February’s $787 billion federal stimulus package, but that funding will run out next year, halfway through states’ next round of spending plans…”

• Agencies, governments to study who can best deliver social services, By Kevin Bonham, November 14, 2009, Grand Forks Herald: “The North Dakota County Commission Association wants the state to shoulder the responsibility - and a share of the financial burden - of delivering social services, such as federal Medicaid, food stamps and temporary assistance for needy families programs. The resolution, initiated by the nine-county Northeast North Dakota County Commission Association, asks the state Legislature to conduct an interim study of the proposal…”
• Counties propose state delivery of social services, Associated Press, November 16, 2009, Jamestown Sun: “North Dakota county officials want the state to take over the delivery of social services programs, including federal Medicaid and food stamps, saying counties can no longer afford to do it. The North Dakota County Commission Association is seeking a two-year study of the idea starting in 2011, the year of the next legislative session. Its resolution says counties would contribute up to 15 mills of property taxes each…”

• State pushed to restore dental aid, By Kim Kozlowski, November 16, 2009, Detroit News: “Advocates for the disabled, poor and elderly say the state needs to restore Medicaid dental benefits before more people suffer or another person dies. ‘We’ve got to start to thinking about these policy decisions and how they affect real lives, not just what they represent in budget numbers,’ said Sharon Parks, president and CEO of the Michigan League for Human Services. Gov. Jennifer Granholm eliminated dental benefits to adults in July to help shore up the $1.3 billion deficit in last year’s budget. They weren’t restored in this year’s budget, so only emergency dental work is now paid for by Michigan’s Medicaid program, even though advocates argue that dental care is essential to good health. Before the cut, the program paid for routine exams and fillings. Research has shown that dental services are essential to good health…”
• Planned Medicaid cuts hit dental, home care, By Kay Lazar, November 14, 2009, Boston Globe: “More than a million low-income Massachusetts residents covered by Medicaid would be required to pay more for visits to certain doctors and receive prior approval for some expensive psychiatric medications under a plan announced yesterday by the Patrick administration to narrow a $307 million shortfall in the state’s MassHealth program. Some of the biggest changes are in dental care for adults, who would no longer receive dentures or other oral care except for cleanings, X-rays, and emergency services…”

State costs rise with poverty, By Jon Walker, November 15, 2009, Sioux Falls Argus Leader: “A new reality in the shadow of today’s health care debate is that a growing number of South Dakotans live in poverty. Use of Medicaid to pay health care bills jumped the past five years across the state, as did use of food stamps to buy groceries. Both trends indicate that more South Dakotans are low-income, and both show the pain that the recession has caused for individuals and families. But those trends also show that South Dakotans, already below average for wages, are losing ground to what the government defines as a minimum basic income. ‘People making ends meet two years ago and four years ago are not really as able to do that now,’ said Matt Diersen, a South Dakota State University economist. The rise in poverty presents a budgeting headache for politicians and a hard choice for doctors who must decide whether to accept more Medicaid patients at discount rates. But it also pushes more state residents to public health services…”

• 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…”

• State’s poor being shifted to different medical plan, By Chen May Yee, November 10, 2009, Minneapolis-St. Paul Star-Tribune: “The Pawlenty administration, which faced criticism for proposing to eliminate a state health-care program for the indigent, has decided to transfer most of those recipients to a subsidized insurance plan for the working poor. The General Assistance Medical Care (GAMC) program for adults making less than $7,800 a year is scheduled to go away March 1, potentially leaving some 36,000 recipients — many with chronic illnesses and often homeless and mentally ill — without regular access to medical care. Now some 28,000 will be automatically enrolled in MinnesotaCare, a subsidized health insurance plan. The remainder are those whose GAMC eligibility is running out or who already are applying for MinnesotaCare…”
• More Alaska Medicaid kids may get braces, Associated Press, November 10, 2009, Fairbanks Daily News-Miner: “The state of Alaska must pay for braces on the teeth of foster children and young people on Medicaid who need them, a Superior Court judge ruled Monday. Judge William Morse issued an order in a lawsuit brought by an advocacy group for foster children called Facing Foster Care in Alaska. He granted a preliminary injunction against a state rule that limits braces to severe conditions such as cleft palate. The state argued that Facing Foster Care does not have the right to bring a lawsuit. Morse disagreed and ruled the state cannot use its own regulations to limit services that are required by federal code. The braces still have to be medically necessary - not just for the sake of appearance…”
• KidCare numbers drop; Medicaid kids rise, By Bill McCarthy, November 9, 2009, Wyoming Tribune Eagle: “The number of children on Wyoming Kid Care CHIP is declining, but the number of children on Medicaid is going up. Bob Peck, chief financial officer for the Wyoming Department of Health, said one explanation could be that parents are losing their jobs. Formerly working parents who had their children on the Kid Care program for child health insurance may be having to enroll their families directly into Medicaid, he said…”

Computer issues cause Medicaid payment lags, By Patricia Anstett, November 5, 2009, Detroit Free Press: “Dozens of Michigan nursing homes, hospices, dental offices and hospitals have encountered problems with two new state Medicaid computer programs, including payment errors, lengthy reimbursement lags and delays enrolling patients in the Medicaid program. The problems coincide with large increases in people applying for Medicaid, a program that serves 1.8 million low-income Michigan children and adults…”

Wisconsin failing to approve Medicaid and food stamps applications in timely manner, By Jason Stein, November 2, 2009, Wisconsin State Journal: “Socked by tens of thousands of childless adults applying for a new state health plan, Wisconsin is failing to meet requirements in federal law for timely approvals of applications for both the Medicaid health coverage and food stamps. Since June 15, more than two-thirds of childless applicants with virtually no income - the highest priority cases - haven’t received food stamps within the federally required seven days, state figures show. Nearly two-thirds of all the childless adults seeking food stamps haven’t received them within the required 30 days. The same process is used to check whether applicants are eligible for both Medicaid and the federal FoodShare, or food stamps, program. Officials from the state Department of Health Services met Monday with federal officials to brief them on the delays and said they would seek to resolve the most pressing backlogged food stamp cases by the end of this week…”

• Medicaid plan draws fire, By Marsha Shuler, Baton Rouge Advocate: “A state health agency proposal to scale back rates paid to Medicaid providers drew opposition Monday from nursing home and hospital interests. State Department of Health and Hospitals Undersecretary Charles Castille said reducing the rates to the levels they were three years ago would lower spending by $232 million. The program grew $1 billion in one year and now costs more than $6 billion. State Treasurer John Kennedy, the chairman of a Commission on Streamlining Government advisory group, said cutting the budget across the board, such as this one, is not the way to go. Kennedy asked DHH officials to instead consider prioritizing spending for Medicaid, the health insurance program for the poor…”
• Analysis: Missouri finally produces Medicaid report, By David A. Lieb (AP), St. Louis Post-Dispatch: “After claiming for more than a year that it could not do so, the Missouri Department of Social Services finally has obeyed a state law and published a list of employers whose workers get government-funded Medicaid health care coverage. Yet compliance with the Medicaid reporting law may be only an experiment. Although the list is supposed to be published quarterly, the department says there’s no telling when it will produce the report again. As lawmakers in Washington, D.C., debate a national health-care overhaul, Missouri’s experience shows how slow and difficult it can be for bureaucracies to implement even incremental changes in the health care system. Missouri was one of several states to mandate employer-Medicaid reports in recent years as a way to gauge the extent to which government was picking up the slack for businesses that either didn’t offer their employees affordable health insurance or paid them so little that they qualified for Medicaid…”

• Medicaid, S-CHIP expansion plan could hurt states’ budgets, By Richard Wolf, October 18, 2009, USA Today: “The government programs that provide health care to the poor would expand to cover nearly one in five Americans under health insurance legislation pending in Congress, putting pressure on federal and state budgets. Medicaid, one of the fastest-growing government programs for two decades, and the State Children’s Health Insurance Program would grow from about 50 million people today to more than 60 million in 2019, according to data from the Congressional Budget Office and Kaiser Family Foundation. That would be the biggest single expansion since Medicaid was created in 1965…”
• Medicaid expansion brings pro, con reactions, By Emily Bregel, October 19, 2009, Chattanooga Times Free Press: “Local physicians said health care reform proposals to expand Medicaid coverage drastically, while well-intentioned, are likely unsustainable. ‘Where is the money going to come from to make this happen?’ said Dr. Mack Worthington, a family practice physician in Chattanooga who said almost one-quarter of his patients are on TennCare. ‘I’m all for increasing access, but I just wonder how it’s going to be funded.’ The U.S. Senate Finance Committee last week passed a health reform proposal that would expand Medicaid programs to anyone who earns up to 133 percent of the poverty level, or about $29,000 a year for a family of four…”
• Uninsured & overwhelmed, By Ben Piper, October 18, 2009, Hattiesburg American: “Casey Little finds herself in a health care predicament. Little, 25, of Seminary needs health insurance to be able to afford treatments that could relieve the pain she suffers from fibromyalgia. But the nerve disorder has left her constantly hurting, unable to work - and unable to get insurance…”
• Pressure mounts: 12,000 caught in a backlog, By Andra Bryan Stefanoni, October 19, 2009, Joplin Globe: “When Candice Sinclair was nearing the end of her pregnancy, she applied for Medicaid to cover her expenses and those of her soon-to-be-born son, Jake. That was in June. Their applications still haven’t been processed, meaning Sinclair is left without means to pay an estimated $5,000 hospital bill, and for Jake’s first year of immunizations and checkups…”
• Kansas has backlog of 12,000 Medicaid applications, Associated Press, October 19, 2009, Kansas City Star: “Rising unemployment, the swelling ranks of the uninsured, outdated technology and the state’s budget problems have led to a backlog of 12,000 Medicaid applications in Kansas, health officials said. A contractor that processes applications for the Kansas Health Policy Authority is supposed to complete them in two to six weeks, but has taken up to four months in some cases…”
• Lessons from the Massachusetts healthcare experiment, By James Oliphant and Kim Geiger, October 17, 2009, Los Angeles Times: “Three years ago, Massachusetts passed the most sweeping healthcare bill in the country, adopting a plan that closely resembles the proposals being considered by Congress. It is a plan that now offers powerful lessons for the whole nation. The state’s system, like the proposals moving toward votes in the House and Senate, focused on three goals: making medical insurance almost universal, fostering competition through a regulated insurance exchange, and helping low-income workers pay for coverage. Today, Massachusetts leads the nation with 96% of its residents covered by insurance — an even larger share than some of the plans before Congress would cover. The employer-based insurance system remains intact despite fears that the state’s healthcare overhaul might cause companies to pull back…”

From healthy kids to healthy adults, By Megha Satyanarayana, October 12, 2009, Detroit Free Press: “Jamel Bomer of Redford Township, a Westin Book Cadillac valet, is the father of a 1-year-old on Medicaid. ‘He can go to any doctor that accepts it,’ Bomer said of son Ryan. ‘Without it, we wouldn’t be able to provide him care.’ Even with publicly funded Medicaid, which many doctors don’t take, Bomer and his fiancée are working off a $230 bill for the part of Ryan’s birth that wasn’t covered on Bomer’s $5.15 per hour plus tips. ‘Our income is tight to the penny.’ Although Ryan is covered, neither Bomer nor his fiancée, a TV news intern, have insurance. While Congress and the president debate over comprehensive health care reform, local and national experts say making sure all children have coverage now will mean they have a better chance of growing into healthy adults who will be less of a burden on the health care system…”

• Proposed Medicaid expansion could heap big costs on cash-poor California, By Mike Zapler, October 12, 2009, San Jose Mercury News: “An expansion of Medicaid contemplated by health care reformers in Congress may be good news for the uninsured, but it could be a bitter pill for cash-strapped California that would cost the state hundreds of millions of dollars it doesn’t have. President Barack Obama and Democrats in Congress want to use Medicaid as one of the main vehicles for extending health insurance to many of the 46 million Americans who lack coverage. But because Medicaid costs are split between the federal and state governments, California officials fear that this change would saddle California with a costly mandate at a time when the state can’t afford its existing Medicaid program, called Medi-Cal…”
• Lynch wary of Medicaid reform cost, By Daniel Barrick, October 12, 2009, Concord Monitor: “Gov. John Lynch is one of several governors raising concerns about the health care reform proposals being debated in Congress. Specifically, Lynch is worried that a plan to expand Medicaid, the government-run insurance program for the poor and elderly, will saddle state budgets with hefty costs. Pam Walsh, Lynch’s deputy chief of staff, said the governor supports the larger goal of expanding health care coverage, but he doesn’t think states should be stuck with the bill…”
• Medicaid keeps stretching, By Catherine Candisky, October 11, 2009, Columbus Dispatch: “The recession and continuing job losses are pushing Medicaid enrollment and spending to record levels, raising concerns about how Ohio will continue to meet the soaring demand. Every month, 10,000 to 15,000 Ohioans join the Medicaid rolls, most after losing their job and the employer-provided health insurance that came with it. Over the past 12 months, Ohio’s rolls increased by 154,000, the largest caseload growth in nearly seven years…”
• Expected $1B shortfall looms for Fla. Medicaid, By Lloyd Dunkelberger, October 10, 2009, Ocala Star-Banner: “Florida is heading for a cliff when it comes to Medicaid spending. The federal government has boosted its support for Medicaid, the joint federal-state health care program for the poor and disabled, in Florida during the economic recession. But the extra funding is scheduled to dry up in December 2010, leaving Florida perhaps more than $1 billion short and facing the prospect of having to cut back critical medical services for some of the state’s poorest and sickest residents. Florida isn’t alone. A new report says the states, facing the loss of federal stimulus funding, may experience cuts ‘perhaps on a scale not ever seen in Medicaid…’”

• ‘Shockingly wide’ health gaps among states, By Rita Rubin, October 8, 2009, USA Today: “A new ’scorecard’ lists ’shockingly wide variations’ among the states when it comes to the health of their residents, says the president of the Commonwealth Fund, which compared such factors as access to care, insurance coverage and avoidable hospital admissions. ‘The differences we see among the states translate to real lives and real dollars,’ Karen Davis said Wednesday at a news conference…”
• Report shows healthcare disparities among states, By Andrew Zajac, October 7, 2009, Chicago Tribune: “Even as state and federal initiatives have extended a medical safety net beneath children in recent years, more and more adult Americans have been living without insurance coverage - compounding the already-serious problems of the healthcare system and fueling sharp disparities in the cost and quality of care across the country. Those disparities, graphically documents in state-by-state rankings released Wednesday by the non-partisan Commonwealth Fund, underscored one of the biggest challenges in designing a healthcare overhaul: The nation doesn’t have one system and one reality, it has at least 50 - each with its own economic, social and demographic characteristics…”

• Governor lobbies for Medicaid expansion, By Michelle Saxton, October 6, 2009, Charleston Daily Mail: “A proposed expansion of Medicaid has some governors voicing concern about how states will afford greater coverage in a challenging economy, but Gov. Joe Manchin argues that an expansion focused on prevention will help reduce costs from uncompensated care. ‘You have to expand that to get people more involved in the system,’ Manchin said Monday. ‘We’re paying for them now anyway. People will wait and go to the emergency room when they get deathly ill or seriously ill at the highest cost,’ he said. ‘But if you get them into more of a managed type of care, showing them how to take action on the preventive side, you can really cut down the costs on the most expensive side. That’s the debate that’s going on…’”
• Expansion of Medicaid could impose costs on Ohio, By Jack Torry and Jonathan Riskind, October 7, 2009, Columbus Dispatch: “As Ohio officials try to close an $850 million budget hole, the key U.S. Senate health-care overhaul package could cost Ohio $922 million in additional Medicaid spending in the plan’s first five years. The health-care bill, which is expected to win the Senate Finance Committee’s approval this week, would add nearly 800,000 Ohio residents to the state’s Medicaid roll. The bill would do so by allowing a family of four with an annual income of up to $29,300 to be eligible for Medicaid coverage instead of the current limit of $22,050 for such a family…”
• Levine: Health bill hurts Medicaid, By Gerard Shields, October 7, 2009, Baton Rouge Advocate: “Louisiana’s top health official is criticizing a provision in the U.S. Senate’s health-care bill that would give four states, including that of Senate Majority Leader Harry Reid, of Nevada, full federal funding for increases in the Medicaid rolls. Louisiana would have to pay a 5 percent match for any new federal money for expansion of Medicaid amounting to $614 million over five years, said Alan Levine, secretary of the state Department of Health and Hospitals. ‘The cost to Nevada?’ Levine said. ‘Zero.’ The news of the provision comes at a time when Louisiana is struggling to get control of its Medicaid budget…”

Many children still don’t get Medicaid dental care, By Ann Sanner (AP), October 7, 2009, Tuscaloosa News: “Two years after a 12-year-old Maryland boy died from an untreated tooth infection, more low-income children are getting dental care under Medicaid but many still don’t ever see a dentist, government investigators said Wednesday. State officials told the Government Accountability Office that a lack of available funding, low provider participation and administrative burdens are some of the barriers to providing dental care to more children through Medicaid…”

• States resist Medicaid growth, By Shailagh Murray, October 5, 2009, Washington Post: “The nation’s governors are emerging as a formidable lobbying force as health-care reform moves through Congress and states overburdened by the recession brace for the daunting prospect of providing coverage to millions of low-income residents. The legislation the Senate Finance Committee is expected to approve this week calls for the biggest expansion of Medicaid since its creation in 1965. Under the Senate bill and a similar House proposal, a patchwork state-federal insurance program targeted mainly at children, pregnant women and disabled people would effectively become a Medicare for the poor, a health-care safety net for all people with an annual income below $14,404. Whether Medicaid can absorb a huge influx of beneficiaries is a matter of grave concern to many governors, who have cut low-income health benefits — along with school funding, prison construction, state jobs and just about everything else — to cope with the most severe economic downturn in decades…”
• Proposed Medicaid Expansion: Plan could be costly to Nevada, By Ed Vogel, October 5, 2009, Las Vegas Journal-Review: “The number of Nevadans receiving free medical care would nearly double by 2015 under provisions of the health care bill being developed in the U.S. Senate Finance Committee. A record 222,022 residents now receive medical care through the state-federal Medicaid program. That total would increase by 217,000 under the national health care bill, according to an analysis done by the state Health Care Financing and Policy Division. The move to expand Medicaid comes at a time when the state can least afford it, although Senate Majority Leader Harry Reid, D-Nev., has proposed an amendment to prevent Nevada from absorbing additional costs under the health care bill. But Charles Duarte, administrator of the division, is not convinced the amendment will be approved. If it fails, then Duarte said Nevada would be responsible for 13 percent to 18 percent of the costs of adding the 217,000 new Medicaid recipients, along with what it already pays for the current recipients. Providing Medicaid to Nevadans already costs the state about $1.5 billion a year, of which $450 million is state funds, Duarte said. Medicaid is the second most costly state government expenditure, trailing only the funding of public education…”

• Reports predict increasing financial burden from health care, By Brian Tumulty, September 30, 2009, Elmira Star-Gazette: “New York’s Medicaid program will experience a financial crisis if Congress doesn’t enact health care legislation, according to two studies released Wednesday. Ten years from now, state officials could face a 93 percent rise in the cost of providing Medicaid services to adults and related health services to children from low-income families, the Robert Wood Johnson Foundation and the Urban Institute predict in one report…”
• Medicaid crisis looms for state, By Jerry Zremski, October 1, 2009, Buffalo News: “New York, which has continued to expand Medicaid while other fiscally pressed states trimmed benefits, now faces a potential double whammy of federal-level changes that could cost the state health care program for the poor nearly $6 billion in 2011 alone. The state’s deficit, projected at $7 billion in the fiscal year beginning next April, is projected to grow to $13 billion a year later…”
• Nearly a quarter of Florida residents have no health insurance, By Drew Harwell and Andy Boyle, October 2, 2009, St. Petersburg Times: “Lawrence Rill, an out-of-work Clearwater tradesman, was preparing to donate plasma when a nurse gave him the news: His blood pressure was dangerously high and his body was in ’stroke mode.’ Rill, 50, needed prompt medical attention. But he hasn’t been able to afford health insurance for 15 years. Even when times were better, and he was working at Home Depot, the weekly $75 premium would have eaten up a fifth of his paycheck. Sound familiar? Florida has the second-lowest rate of health insurance for people younger than 65 in the country, trailing only Texas, a new U.S. Census survey shows. Excluding Medicare-eligible senior citizens, one in four Floridians lives without any form of medical coverage…”

• Rate of enrollment in Medicaid rose rapidly, report says, By Kevin Sack, September 30, 2009, New York Times: “The recession is driving up enrollment in Medicaid at higher than expected rates, threatening gargantuan state budget gaps even as Congress and the White House seek to expand the government health insurance program for the poor and disabled, according to a survey released Wednesday. The annual survey of state Medicaid directors, conducted for the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, found that the program had been spared the worst effects of massive state budget shortfalls because of federal aid in the stimulus package. But it also revealed grave concerns about what will happen when that relief dries up at the close of 2010…”
• 100,000 Ohio workers getting Medicaid, By Catherine Candisky, September 30, 2009, Columbus Dispatch: “They might work for some of Ohio’s largest employers but more than 100,000 low-wage employees rely on taxpayers for their health coverage. Legislation that soon will be introduced in the General Assembly would require the state to publish annually the names of companies with the most employees receiving Medicaid and other government subsidies…”
• Feds may pay for R.I. Medicaid expansion, By Ted Nesi, September 29, 2009, Providence Business Journal: “The federal government would pick up the full cost of expanding Medicaid coverage in Rhode Island for five years under a special provision of the Senate Finance Committee’s health care reform bill. Increasing the number of Americans eligible for Medicaid, the federal health insurance program for the poor, is a key provision of all the various health bills moving through Congress…”
• Medicaid on chopping block, By Chris Christoff, September 29, 2009, Detroit Free Press: “A major hurdle to enacting a new state budget by the Thursday deadline could be resolved this afternoon with expected approval of major cuts in Medicaid and state help for the mentally ill. That will intensify lobbying for a 3% assessment on all Michigan physicians to offset the Medicaid reductions. ..”

• State’s social services suffering, panel learns, By Mary Beth Schneider, September 25, 2009, Indianapolis Star: “Too many errors and delays and too little face-to-face contact with clients are hampering Indiana’s privatized welfare delivery service, the state acknowledged Friday to lawmakers. Despite those persistent problems, Anne Murphy, secretary of the Family and Social Services Administration, told the bipartisan State Budget Committee that no decision has been made on whether to end the $1.34 billion, 10-year contract that Indiana has with an IBM-led group to manage food stamps, Medicaid and the Temporary Assistance for Needy Families program…”
• Indiana welfare problems linger, budget committee told, By Lesley Stedman Weidenbener, September 25, 2009, Louisville Courier-Journal: “Significant problems remain in Indiana’s welfare application system, and no decision has been made about whether to sever a controversial contract with the private firm handling the work, a key state official told lawmakers Friday. Some parts of the system have improved since Gov. Mitch Daniels ordered the private consortium - which includes IBM and Affiliated Computer Services - to fix problems or face losing a 10-year, $1.3 billion contract, said Anne Murphy, secretary of the state Family and Social Services Administration…”
• Political, geographical lines divide welfare solutions, By Eric Bradner, September 26, 2009, Evansville Courier and Press: “Gov. Mitch Daniels’ administration is working to improve its human services agency’s troubled attempt to modernize, and state lawmakers are grappling with how and where their pressure can be applied best. But geographic and political differences have made it impossible for all parties to agree on an approach that is suitable statewide. In some pockets, such as Evansville, frustration with the new system has reached a boiling point. Some lawmakers say the project is hopeless and the best choice is to cut losses and abandon it. In other places, such as Indianapolis, the changes have not been rolled out yet. In other areas, the new system is working relatively well, according to Indiana Family and Social Services Administration officials…”

More Nevadans will need help as economic storm worsens, By J. Patrick Coolican and David McGrath Schwartz, September 27, 2009, Las Vegas Sun: “The parking lot at Catholic Charities, which shares space with a state welfare office, is packed these days. That’s a new thing. In the past, clients were the type to take the bus or walk to the service center on Las Vegas Boulevard in North Las Vegas. Now it’s the middle and working classes driving here, desperate for help. Same at the Women, Infants, and Children program offices at Flamingo Road and Torrey Pines Drive, its waiting room teeming with young, weary mothers who need nutrition assistance for their toddlers. Nevada’s spiking unemployment rate, which officially hit 13.2 percent recently, is forcing the newly destitute to seek help from the state as unemployment checks stop coming, savings accounts run dry and there are no jobs to be had. This spreading pain is measured in the ballooning number of Nevadans receiving government help - food, medical care, cash assistance. In June, for example, the number of residents on food stamps rose 45 percent compared with a year earlier. That was the second-fastest rise in the nation, behind Utah’s, according to the Kaiser Family Foundation…”

Utah’s Medicaid wants a big boost, By Lisa Rosetta, September 28, 2009, Salt Lake Tribune: “With its enrollment fast approaching 200,000 Utahns — an all-time high — the state’s Medicaid program is poised to ask the Legislature for $17 million in additional funding to keep it afloat through fiscal 2010. But it’s a request that may fall on unsympathetic ears. Alarmed by an audit that said Medicaid’s Bureau of Program Integrity could save as much as $20 million if it more scrupulously examined bills and claims for services, House Speaker Dave Clark said the public health insurance program is going to have to find those savings and plug its own funding hole…”

Texas got less stimulus money per resident than almost every other state, By Dave Michaels, September 28, 2009, Dallas Morning News: “Texas has received less funding per resident from the stimulus package so far than almost any other state, according to a Dallas Morning News analysis of federal grants and contracts. Texas lawmakers have long complained about one reason for the disparity: Federal funding formulas, often written by small-state lawmakers, disadvantage big states like Texas. But Texas is also a victim of its own thrift: With fewer research universities, less subsidized housing, and a smaller contribution to programs like Medicaid and unemployment insurance, it stands to receive less emergency funds than if it spent more of its own money on the programs…”

Michigan struggles to insure kids, By Kim Kozlowski, September 15, 2009, Detroit News: “Michigan’s budget crisis is expected to prevent expansion of children’s health insurance coverage because the state can’t afford to match an extra $100 million in federal funds. Michigan has to come up with a 26 percent match, or about $33 million, for its MIChild program to get federal funds from the recently renewed Children’s Health Insurance Program, state health officials say. But the need comes as lawmakers scramble to close a $2.8 billion deficit for the fiscal year that begins Oct. 1. Democratic and Republican lawmakers agree it is unlikely the state can come up with the $33 million at a time when budget talks are focused on cuts, and millions of federal dollars for other health programs have been bypassed due to cuts made earlier this year…”

• Medicaid expansion stalls health talks, By Jennifer Haberkorn and Ralph Z. Hallow, September 15, 2009, Washington Times: “A proposed expansion of Medicaid, the health care program for lower-income Americans, has emerged as one of the last sticking points in the Senate Finance Committee’s health care reform bill, with governors and state legislatures around the country worried they’re going to get left with the tab. Proposals in the House and Senate would expand Medicaid eligibility to 133 percent of the federal poverty level, potentially putting millions of new people on the public health program for the poor younger than 65…”
• Congressional health plans could break state budget, By Lesley Stedman Weidenbener, September 12, 2009, Louisville Courier-Journal: “Gov. Mitch Daniels last week weighed into the national health care debate with a letter to Indiana’s congressional delegation that opposed the insurance reform plans currently under consideration. ‘There is no disputing the fact that aspects of American health care, such (as) access and affordability, truly do need to be restructured and improved,’ Daniels wrote. ‘Yet, I have serious concerns about Congress’ proposed solutions to these problems. In fact, I fear the current rush to overhaul the system will ultimately do more damage than good and create far more problems than it solves.’ But as described in his letter, Daniels’ opposition has as much to do with protecting the state’s finances as it does with political philosophy. In fact, Daniels is part of a group of governors and other state government leaders across the country who are trying to draw attention to a part of the health care debate that has been largely ignored – an expansion of Medicaid…”
• Congress should extend help with Medicaid, Editorial, September 15, 2009, Des Moines Register: “Billions in federal economic-stimulus dollars rescued state governments this year. The influx of money - about $2 billion in Iowa - helped this state avoid laying off workers and cutting vital programs. But another fiscal year is coming. Iowa was not among the states that raised taxes to generate revenue, and the federal stimulus money is almost gone. This state is facing a shortfall of between $900 million and $1 billion for the next budget year, and has about $133 million left in stimulus money. Everyone knew the federal help was temporary, and there is likely little political will in Washington for passing another stimulus package…”

In dour economy, more indigent burials get public funds, By Laurel Walker, September 8, 2009, Milwaukee Journal Sentinel: “Recent elaborate funeral services for the likes of Sen. Edward Kennedy or Michael Jackson may grab the public’s attention. But among the ranks of the impoverished, the number of indigents who need publicly financed burials has been quietly growing. The Wisconsin Department of Health Services has recorded a nearly 15% increase in indigent burials qualifying for public subsidy between 2006 and 2008, when the number jumped from 3,169 to 3,629. Department spokeswoman Stephanie Smiley said the state spent just over $6.1 million in general purpose funds in 2006 to reimburse funeral homes and cemeteries for those services. The figure grew to $7.4 million last year. Through August of this year, the total is $6.1 million. Anecdotal evidence from news stories around the country, from California to West Virginia, suggests a common theme - that more people are needing government help to bury their loved ones…”

Governors worry federal health reform could strain budgets in states with many poor, jobless, By Emily Wagster Pettus (AP), September 14, 2009, Los Angeles Times: “States with high levels of poverty and unemployment have been struggling with growing Medicaid budgets during the recession, and some governors worry their financial burdens could get worse as Congress works on a comprehensive health care bill. They’re especially worried about possible expansion of Medicaid, the federal-state health insurance program for the needy and disabled…”

• Federal Katrina dollars can impact Louisiana’s Medicaid benefits, By Matthew Hamilton, September 7, 2009, Monroe News-Star: “G.B. Cooley chief executive officer Ben Pitts and ARCO executive director Roma Kidd refer to it as Louisiana’s ‘Medicaid cliff.’ In January 2011, a little-known formula will prompt the federal government to slash $1 billion in health care spending for the poorest residents of one of the poorest states in the country. Unless legislators make tough political choices to close the gap, the Louisiana Department of Health and Hospitals and Medicaid providers like Pitts and Kidd fear a devastating economic blow and the loss of health care for thousands across the state. The seeds of the crisis were planted in the wake of Hurricane Katrina. After the storm, the federal government pumped billions of dollars into the state, including $5.4 billion in Road Home subsidies. According to the DHH, the cash infusion spiked Louisiana’s per-capita income growth more than 42 percent in Louisiana…”
• Alabama Medicaid rolls jump by 50,000 over two year span, By Kim Chandler, September 7, 2009, Birmingham News: “Alabama Medicaid enrollment jumped by nearly 50,000 people in the past two years, with the largest increase coming in the number of children, teens and pregnant women enrolled. ‘When we’re at double-digit unemployment, it has an effect on the entire safety net,’ said Sen. Roger Bedford, chairman of the Senate General Fund budget committee and a Democrat from Russellville. ‘You see it not only in Medicaid, but also in food stamps.’ Alabama Medicaid Agency spokeswoman Robin Rawls said agency officials believe the economy is likely the cause, and the largest increase is in the program most likely to include working families…”

A Milwaukee clinic fills a need but faces failure, By Kevin Sack, September 1, 2009, New York Times: “Like many low-income neighborhoods, the north side of Milwaukee has seen a gradual depletion of its primary care doctors over the last two decades. One by one, they have retired or surrendered to financial reality, rarely to be replaced. At the few remaining practices, the wait for an appointment can make it almost purposeless to seek one. When Martha Brown’s 3-year-old daughter, Loverree, woke up with a runny nose last Thursday, her doctor’s office told her it would be a week. ‘I couldn’t wait,’ Ms. Brown said. ‘I had to see what was wrong with my baby. I think she’s got an infection.’ Rather than heading to an emergency room, Ms. Brown took her three children to the Milwaukee Immediate Care Center, a small nonprofit clinic that has treated the north side’s largely African-American community since 1986. The clinic, which keeps hours at night and on weekends, is the only full-time operation in the neighborhood that provides urgent care, luring patients with a sign that reads, ‘When You Need a Doctor Today…’”

Healthy Indiana Plan to reopen to childless adults, By Ken Kusmer (AP), September 1, 2009, Indianapolis Star: “Indiana wants to enroll more childless adults in its state-funded medical savings account program and will reopen enrollment for them in the future, a state consultant told lawmakers Tuesday. The federal government, when it approved the Healthy Indiana Plan, said the state could enroll no more than 34,000 childless adults, consultant Seema Verma told the Medicaid Oversight Commission. However, HIP has proven most popular among such non-caretaker adults, and the Family and Social Services Administration closed the program to that group in March. At the end of July, they made up more than 26,000 of the nearly 46,000 people enrolled, Verma said. The program, partially funded by the Medicaid program for needy and disabled people and a state cigarette tax increase, was designed to enroll a total of 130,000 people, mostly parents…”

Arizona faces ‘financial tsunami’ over Medicaid, by Jeff Brady, September 1, 2009, National Public Radio: “Arizona has one of the highest Medicaid rates in the country. About 1 out of every 5 residents is covered by the program for the poor and disabled. That doesn’t include illegal immigrants, who are barred from receiving state services. And the Medicaid rolls there are increasing rapidly in this economy, primarily due to slumps in the construction and service industries…”

Debit cards reward Medicaid patients for care, By Tom Murphy (AP), August 31, 2009, Washington Post: “Some Indiana Medicaid patients can now earn money to spend on health care simply by visiting the doctor or seeking routine preventive care. Managed Health Services on Monday announced a new debit card program that rewards patients for making regular trips to the doctor, taking their babies in for checkups and getting screened for several conditions. Participants can earn between $10 and $20 on their cards for each visit or screening. They can then use the funds to buy health-related items like cough syrup or thermometers…”

Advocates push to include the homeless in Medicaid, By Pam Fessler, August 25, 2009, National Public Radio: “Most homeless people in America are too poor to buy their own health coverage, but many also don’t qualify for Medicaid, the government-run health program for the poor. Medicaid is mainly for people who have children or a disability, and most homeless people are childless adults. So, like 63-year-old Walter Brooks of Baltimore, they make do without insurance coverage…”

• State safety net makes up 46 percent of budget, By Cynthia Needham, August 20, 2009, Providence Journal: “State-funded safety net programs for the poor have grown into an expensive and sometimes chaotic system that doesn’t always effectively serve the neediest residents, according to a report to be released Thursday by the Rhode Island Public Expenditures Council and the United Way. The result of a year-long study, the report combines data with analysis by an advisory council made up of anti-poverty advocates, union officials, clergy and members of the business community, who see first-hand the effects of these programs. Rhode Island, that data suggests, spends an a steadily increasing amount of money on its safety net programs — 46 percent of total spending in the current year’s budget…”
• Study: R.I. social safety net ill-managed, By Chris Barrett, August 20, 2009, Providence Business News: “Rhode Island’s social safety net is expensive and splintered, according to a report released jointly today by United Way of Rhode Island and the R.I. Public Expenditure Council. The 58-page report details federal and state programs that provide assistance to the state’s poor, unemployed and disabled residents. It comes as the state’s economy continues to struggle and state agencies deal with an influx of residents seeking social services. The report found that 46 percent of all spending in this year’s enacted state budget flows to grants and benefits for programs such as Medicaid, medical assistance programs, child care subsidies and unemployment benefits…”

Minus Medicaid, homeless youths hurting, By Jennifer Brown, August 20, 2009, Denver Post: “LeeLee Hanley, 19, plunks down in a chair in the makeshift health clinic and asks for a pregnancy test. She also needs a new asthma inhaler because her ex-boyfriend has hers. And she wants a tuberculosis test so she can move back into this youth homeless shelter, Urban Peak. Hanley, who lost her Medicaid coverage when she turned 19, has no money and no home. When she needs a doctor, she goes to a hospital emergency room or the physicians who spend a few hours each week at the homeless shelter, in central Denver. About 75 percent of the more than 3 million American adults who spent some part of the last year homeless have no insurance, according to the National Health Care for the Homeless Council. Under the radar of the town-hall shouting matches on health reform, advocates for the homeless are pushing to get them on the rolls of the insured.

• Auditors warn Utah Medicaid is likely wasting millions of taxpayer dollars, By Heather May, August 18, 2009, Salt Lake Tribune: ” Millions of tax dollars are likely being wasted in Utah’s Medicaid program on procedures — including a breast augmentation and nose jobs — that aren’t covered by the government insurance program, according to a scathing legislative audit released Tuesday. Millions more are lost because the Medicaid department isn’t adequately going after providers who submit fraudulent bills. And while there are three sets of internal auditors charged with overseeing the department and its $1.7 billion budget, none are independent enough to do their jobs appropriately, the report says…”
• Audit says Utah losing millions to Medicaid fraud, waste, By Lana Groves, August 18, 2009, Deseret News: “Legislators are appalled over the results of an audit reporting the state Medicaid system is losing millions because of an outdated system. The state audit released Tuesday found that the Utah Department of Health’s Bureau of Program Integrity, which checks for fraud, waste and abuse within the state Medicaid program, is mismanaged and failed on several occasions to follow policy regarding cost-saving methods…”

Companies face heat on welfare modernization, By Eric Bradner, August 12, 2009, Evansville Courier and Press: “Southwestern Indiana lawmakers, hospitals and social services agencies ramped up the pressure on the companies hired to modernize Indiana’s welfare agency during a closed-door meeting earlier this week. Family and Social Services Administration Secretary Anne Murphy brought officials from IBM Corp. and Affiliated Computer Services Inc., the companies working on a 10-year contract that now tops $1.3 billion, to Tuesday’s meeting so they could hear from those who are affected by the problems plaguing the new system…”

Homeless would benefit from health care reform, By Wayne Parry (AP), August 13, 2009, Idaho Statesman: “Victor Rozanski’s wife gave him an ultimatum: It’s either me or the bottle. He chose the bottle. The drinking wrecked his marriage. The 47-year-old lost his job as a printer, and hopped on a bus to Atlantic City, where his life’s savings of $1,500 vanished in two days of drinking and gambling. While sleeping in an alley one night, he nearly lost a leg to a cut that became infected and infested with maggots. His hernia and psychiatric disorders went untreated for years as he bounced from one casino bus lounge to the next, getting rousted every hour or so. People like Rozanski, who is trying get off the street with the help of a homeless shelter detox program, have gotten scant attention in the contentious national debate over whether and how to reform the nation’s health care system. Among the nearly 50 million Americans who don’t have health coverage are an unknown number of homeless adults, who would become eligible for Medicaid under proposals being considered in Congress…”

Alabama Medicaid could add 237,000 to rolls, but money an issue, By Sean Reilly, August 13, 2009, Mobile Press-Register: “At least 237,000 Alabamians could gain health coverage through the state Medicaid program under legislation now moving through Congress, according to an official agency estimate, and the expanded rolls could end up costing state taxpayers tens of millions of dollars a year. The estimate, provided at the Press-Register’s request, is based on raising the state’s stringent income eligibility cutoffs to match the federal poverty level, now $18,310 a year for a family of three…”

Glitches mar Indiana’s effort to outsource social services, By William M. Bulkeley, August 12, 2009, Wall Street Journal: “Processing of welfare, food-stamp and Medicaid claims in Indiana was plagued with difficulties when the state outsourced the system to International Business Machines Corp. and Affiliated Computer Services Inc. two years ago. The problem hasn’t been resolved since then. ‘There’s a myriad of problems,’ said Anne Murphy, secretary of the state’s Family and Social Services Administration. ‘Error rates are too high. We’re not processing claims within federal guidelines.’ Naomi Mundy, a 59-year-old homemaker, said it took 15 months after she developed melanoma to get Indiana to pay her health-care benefits under Medicaid because of outsourcing snafus…”

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…”

• Holes in the safety net: Medicaid falls short just as some need it most, By Tom Curry and JoNel Aleccia, July 27, 2009, MSNBC.com: “Doctors at the Maple City Health Care Center, a neighborhood clinic where the toddler’s family receives most care, couldn’t diagnose the problem. The child needed to see a specialist, but no local dermatologist would agree to accept Medicaid, the government’s safety net plan. Instead, Antonia Mejorado, 33, has to drive nearly two hours to see a dermatologist willing to treat her daughter’s potentially serious illness…”
• Colorado Medicaid list swells to record, By Tim Hoover, July 28, 2009, Denver Post: “Colorado had a 14 percent spike in Medicaid enrollment in the budget year that ended in June, a record-setting rate that capped a year with the largest-ever number of people in the health insurance program. As of June 30, there were 467,556 Coloradans on Medicaid. That’s 79,488, or 20.5 percent, more than in the same month a year before. The June figure represented the highest total in the 40 years Colorado has been participating in the state and federally funded program, which covers low-income pregnant women, children, the elderly and the disabled. Nearly 10 percent of the state’s residents are now enrolled in Medicaid…”

• Massachusetts, home of nation’s most ambitious health care law, offers reform ‘dos and don’ts’, By Steve LeBlanc (AP), July 24, 2009, Chicago Tribune: “Three years into its experiment with near-universal health care, Massachusetts has some ‘dos and don’ts’ for the nation as it grapples with the best way to cover tens of millions of uninsured Americans.  Do require that virtually everyone have health insurance, the overriding goal in Massachusetts. Don’t ignore rising costs, the single greatest threat to the law’s long-term affordability…”
• Texas Medicaid program likely to surge under health care proposals, By Dave Michaels, July 24, 2009, Dallas Morning News: “The effort to insure tens of millions of uncovered Americans will almost certainly involve a sweeping expansion of Medicaid – with Texas probably feeling the impact more than any other state.  State lawmakers have for years limited Medicaid’s reach to low-income adults, who under Texas rules don’t qualify for the joint state-federal program. One proposal by U.S. House lawmakers would provide federal funding to extend Medicaid to about 1 million Texas adults, according to the Austin-based Center for Public Policy Priorities – a massive jump from the 38,000 who qualify today…”

• Joy, skepticism greet IBM’s plan, By Angela Mapes Turner, July 24, 2009, Fort Wayne Journal Gazette: “State lawmakers and social service providers welcome Indiana’s extensive plan to correct its failing welfare system.  But they aren’t convinced it provides the right guidance for private welfare vendor IBM Corp. to resolve widespread problems…”
• IBM to add humanity to welfare, By Ken Kusmer (AP), July 24, 2009, Evansville Courier and Press: “IBM Corp.’s 362-page plan to fix problems with Indiana’s privately run welfare system calls for providing more face-to-face help and no longer “forcing clients to self-service channels” such as telephone call centers and online applications.  The plan, obtained by The Associated Press, also describes myriad mechanical and human errors such as an automatic call distributor that “inappropriately fails” about twice a month, losing all telephone calls in progress and infighting within IBM’s coalition of partners…”

Medicaid and the states: Health-care reform’s next hurdle, By Karen Tumulty, July 21, 2009, Time Magazine: “Until the nation’s governors staged a public revolt last weekend, few people were paying attention to one of the most far-reaching proposals being considered as part of overhauling the health-care system: a dramatic expansion and redefinition of the Medicaid program. Redefining who is eligible for Medicaid would be one of the major means by which lawmakers hope to achieve universal health coverage — which is one of the reasons that governors, whose budgets are already straining under the program’s growing costs, are so wary of the idea…”

• State plugs budget hole with Medicaid money, By Beth Musgrave, July 21, 2009, Lexington Herald-Leader: “The state was in the black for the fiscal year that ended June 30, but only because it received a loan from the Medicaid program, which had additional money from the federal stimulus program. Now state officials are trying to determine how much money state agencies will have to cut from this year’s budget, which began July 1…”
• CalWORKS: Is it costing too much?, By Steve Wiegand, July 19, 2009, Sacramento Bee: “It’s the kind of statistic that makes radio talk show hosts drool: California is home to about 12 percent of all Americans – and more than 30 percent of all Americans on welfare. Critics of the state’s welfare program, called CalWORKs, say it’s clear proof that the system is flabby and overly beneficent, particularly as compared to other states…”
• Governor, legislative leaders begin building support for their budget pact, By Evan Halper and Shane Goldmacher, July 21, 2009, Los Angeles Times: “Gov. Arnold Schwarzenegger and legislative leaders will begin working today to line up votes for the budget agreement they reached Monday evening to close a $26.3-billion deficit and allow the state to begin paying all of its bills again…”
• Budget breakthrough solves California’s long fiscal nightmare, By Steven Harmon, July 20, 2009, Contra Costa Times: “A tense, months-long standoff over ever-shrinking resources gave way Monday to a deal to bridge California’s $26.3 billion deficit…”

Privatizing welfare means more fall through cracks, critics say, By Will Higgins, July 20, 2009, Indianapolis Star: “Omega Young lay in her hospital bed, her body wracked with disease. The cancer that started in her ovaries had spread to her kidneys, breast and liver. She’d lost her appetite to the chemotherapy; she weighed 98 pounds. Then came more bad news: After a botched round of telephone tag with welfare officials, the state of Indiana pulled the plug on her Medicaid benefits and food stamps…”

• Defying slump, 13 states insure more children, By Kevin Sack, July 18, 2009, New York Times: “Despite budgets ravaged by the recession, at least 13 states have invested millions of dollars this year to cover 250,000 more children with subsidized government health insurance…”
• Governors fear Medicaid costs in health plan, By Kevin Sack and Robert Pear, July 19, 2009, New York Times: “The nation’s governors, Democrats as well as Republicans, voiced deep concern Sunday about the shape of the health care plan emerging from Congress, fearing that Washington was about to hand them expensive new Medicaid obligations without money to pay for them…”
• More uninsured patients cause struggle for local hospitals, By Sarah Tompkins, July 19, 2009, Munster Times: “While about 700 working Hoosiers each week lose health insurance during the declining economy, local hospitals and doctors are left to figure out how they can continue to treat more and more uninsured…”
• Millions more lacking insurance, By Mark Johnson, July 19, 2009, Milwaukee Journal Sentinel: “This month, Pierre Aterianus is due back at the doctor for twice-a-year tests of his high cholesterol, but he may stay home and simply hope he isn’t heading toward a heart attack or stroke. Aterianus, who is 57 and lives in Whitefish Bay with his 23-year-old daughter, was laid off in January from his engineering job…”
• Healthy Kids expansion to take time, By Margot Sanger-Katz, July 17, 2009, Concord Monitor: “Gov. John Lynch signed a bill yesterday that will allow young adults to purchase low-cost health insurance from a state plan originally designed for low-income children…”

Schwarzenegger proposes private, centralized system for public assistance eligibility, By Michael Rothfield, July 16, 2009, Los Angeles Times: A proposal that Gov. Arnold Schwarzenegger has been pushing in closed-door budget talks would tie the state, with little oversight or review, into a multibillion-dollar computer system likely to be run by the private sector to enroll low-income Californians in welfare, food stamp and healthcare programs.  A draft of the plan obtained by The Times shows that Schwarzenegger would replace existing county-run processes, which use four different computer systems across the state, with a single one. Administration officials say the new Internet-based system would allow them to save money on overhead and spend more on recipients…”