Medicaid Expansion – Texas

Texas counties consider going it alone on Medicaid expansion, By N.C. Aizenman, August 26, 2012, Washington Post: “Local officials in Texas are discussing whether to band together to expand Medicaid coverage in some of the state’s biggest counties, making an end run around Gov. Rick Perry’s opposition to the expanded program included in President Obama’s health-care law. For years, Texas’s six most populous counties, as well as some smaller localities, have offered free or low-cost health care for uninsured residents with incomes as much as three times the federal poverty level, or about $57,000 for a family of three. The cost of the programs: about $2 billion a year. If some of the patients were enrolled in Medicaid, the state-federal health-care program for the poor, it could be salve for cash-strapped county budgets and a boon for local taxpayers…”

High School Graduation Rate – Texas

Texas’ high school graduation rate reaches record high, By Jennifer Radcliffe, August 3, 2012, Houston Chronicle: “Graduation rates for Texas’ black and Hispanic students topped 80 percent for the first time in state history in 2011, but they still lagged behind the record-setting overall graduation rate of 86 percent, the Texas Education Agency reported Friday. Hispanic graduation rates increased 3 percentage points to 81.8 percent, while black students’ rate increased 2 percentage points to 80.9 percent…”

2012 Kids Count Data Book – Southern States

  • Report says 1 in 4 Kentucky children and 1 in 5 Hoosier kids are mired in child poverty, By Jessie Halladay, July 25, 2012, Louisville Courier-Journal: “One in four Kentucky children lives in poverty, and their numbers have increased starkly since 2005, according to the latest Kids Count report released today by the Annie E. Casey Foundation. Mirroring a national trend, the number of the state’s children living below the poverty line – defined in 2010 as $22,113 for a family of two adults and two children – rose 18 percent between 2005 and 2010, according to the annual report, which provides an annual snapshot of child well-being. In Indiana, one in five children lives in poverty, a 29 percent increase between 2005 and 2010…”
  • Maryland ranks 10th in child well-being, national study says, By Yvonne Wenger, July 25, 2012, Baltimore Sun: “Fewer Maryland children are living in high-poverty neighborhoods than a decade ago, but the lingering economic slump has left more parents without a steady paycheck, the Annie E. Casey Foundation reported Wednesday. The Baltimore-based charity ranks Maryland 10th in the nation for overall child well-being in its 2012 Kids Count Data Book, which analyzed nationwide research and statistics on children’s economic well-being, education, health, family and community…”
  • Study: More SC kids living in poverty, By Gina Smith, July 26, 2012, The State: “South Carolina ranks near the bottom – 43rd among the 50 states – in a ranking of children’s well being. That is according to the newly released Kids Count report, a project of the Annie E. Casey Foundation, that assesses the overall health of the nation’s children, including their economic health, family situation and education. The most-troubling S.C. finding is the number of children living in poverty…”
  • Kids Count report ranks W.Va. as one of worst in education, By Megan Workman, July 24, 2012, Charleston Gazette: “With nearly four out of five eighth-grade students who are not proficient in math, West Virginia received one of the worst education rankings in the country, a national report being released today shows. Nationwide, the percentage of eighth-graders who are not proficient in math decreased from 72 percent in 2005 to 66 percent in 2011, according to the report. West Virginia ranks 47th in the nation in education, according to The Annie E. Casey Foundation’s annual Kids Count Data Book. Arizona, Mississippi, New Mexico and Nevada join West Virginia as the five states ranked weakest for education…”
  • Alabama 45th of 50 for child well-being in 2012 Kids Count Data Book, By Kim Chandler, July 25, 2012, Birmingham News: “Alabama made its best showing ever in an annual ranking of child well-being, but it still came in 45th among the 50 states. The 2012 Kids Count Data Book released today by the Annie E. Casey Foundation showed Alabama made gains in education but continues to struggle with high rates of child poverty. The report ranked Alabama 45th, the state’s best ranking since the Data Book began publication in 1990…”
  • Oklahoma lags in child well-being ranks, By Mike Averill, July 25, 2012, Tulsa World: “Despite slight improvement, Oklahoma remains near the bottom of the country for child well-being, according to a national report that ranks states using an index of 16 indicators in four categories. Oklahoma ranked 40th overall, up from last year’s 43rd spot, according to the 2012 Kids Count Data Book released annually by the Annie E. Casey Foundation…”
  • Texas 44th in children’s well-being, By Melissa Fletcher Stoeltje, July 26, 2012, San Antonio Express-News: “Texas ranks 44th among the states when it comes to the health and well-being of its children, according to a study by a Baltimore nonprofit that advocates for at-risk kids. Using the U.S. Census Bureau and other sources, the study found the child poverty rate in Texas was higher in 2010 than the national rate of 22 percent, with 26 percent living in poverty. Texas was second from the bottom in children who lack health insurance, with an uninsured rate of 14 percent in 2010, although that’s been decreasing…”
  • Report ranks Florida behind most states on child health and education, By Margie Menzel, July 26, 2012, Daytona Beach News-Journal: “A new report Wednesday shows Florida trailing most other states in the health and education of its children — with an especially low ranking in economic well-being. The effects are harmful and could be long-term — not just for the children but for the state, advocates say. The annual Kids Count report from the Annie E. Casey Foundation ranks Florida 44th in the economic well-being of its children, 38th in their health outcomes and 35th in their educational performance. The state ranks 38th overall. The number of Florida children living in poverty is up 28 percent from 2005 to 2010, the last year for which data was included in the study. That measurement considers such factors as whether the parents have secure employment or the ability to cover their housing costs…”

States and Medicaid Expansion

  • Working poor stand at center of Medicaid debate, By Juan Carlos Llorca (AP), July 23, 2012, Atlanta Journal-Constitution: “Jose Gallegos’ company eliminated employee health insurance to save money, so when his gut started hurting and his skin took on a yellow tinge, he resisted seeing a doctor. When he finally went to the emergency room, physicians diagnosed stomach cancer. Gallegos made too much money to qualify for Medicaid but not enough to buy his own insurance, so he scraped together what he could, and his wife, Andrea, took on three jobs. Just over a year later, at 41, he died, leaving behind four children. Two years later, it was Andrea’s turn. A crack and sharp pain in her back drove her to the emergency room, where she learned she had breast cancer. It had snapped one of her vertebra. Now 45, she said the cancer remains in several other vertebrae, but at the moment it’s not spreading. Families like the Gallegos stand at the center of a debate over President Barack Obama’s health care overhaul, which could have expanded Medicaid coverage to 1.3 million uninsured Texans. But Republican Gov. Rick Perry has said he will not widen the program because it would cost too much…”
  • Alabama weighs costs, benefits of medicaid expansion under Affordable Care Act, By Kim Chandler, July 22, 2012, Birmingham News: “Alabama could make deep reductions in the number of people who go each day without health insurance if state officials choose to expand Medicaid under the Affordable Care Act. Alabama ranks 14th in the country for the number of people who likely would be added to the Medicaid rolls if the program were expanded, according to estimates from the Henry J. Kaiser Family Foundation. Alabama also is one of five states where more than 60 percent of the state’s uninsured population could become eligible for Medicaid if the expansion were implemented, according to the Urban Institute. But those gains in insurance — while mostly paid for by the federal government — wouldn’t be entirely free to the state. The federal government would pay 100 percent of the cost of services for new enrollees for the first three years, but that eventually would drop to 90 percent…”

State Medicaid Programs – Maine, Texas

  • Maine debate hints at rift on Medicaid after ruling, By Abby Goognough and Robert Pear, July 18, 2012, New York Times: “As some Republican governors declare that they will not expand Medicaid under the national health care law, Gov. Paul R. LePage is going a step further. In what could lead to a direct confrontation with the Obama administration, he is planning to cut thousands of people from Maine’s Medicaid rolls, arguing that the recent Supreme Court ruling on the law gives him license to do so. Mr. LePage, a Republican, says the ruling gave states leeway to tighten eligibility for Medicaid, the joint state-federal program that provides health care to low-income and disabled people. Federal officials insist that while the ruling allowed states to opt out of a planned expansion of Medicaid, it left intact all other aspects of the law affecting the program…”
  • The big push on Medicaid fraud, By Emily Ramshaw, July 19, 2012, New York Times: “When it comes to finding cost savings in the state’s unwieldy Medicaid program, the Office of Inspector General at the Health and Human Services Commission gets high marks. The division, charged with investigating fraud among health care providers paid to treat impoverished children and the disabled, has drastically increased both its caseload and the potential monetary returns associated with it over the last fiscal year. The spike has won glowing reviews from budget-weary state lawmakers and has cast Texas’ innovative enforcement team into the national spotlight. But O.I.G.’s dollar-recovery strategy – which includes an increased reliance on a rule that allows investigators to freeze financing for any health care provider accused of overbilling – has enraged doctors, dentists and other providers who treat Medicaid patients. They say an anonymous call to a fraud hot line or a computer-generated analysis of a handful of billing codes is enough to halt their financing without even a hearing, jeopardizing their practices and employees and leaving thousands of needy patients in a lurch while the state works to prove – or rule out – abuse…”

SNAP Enrollment Among Seniors – Texas

More Texas seniors relying on food stamps, By Cindy Horswell and Renèe C. Lee, July 15, 2012, San Antonio Express-News: “At age 64, Paulette Lanius is a ‘Golden Boomer’ – one of the 76 million American babies born after World War II, a legacy of the legions of men and women described as the Greatest Generation. But the future for this Houston woman and thousands of other seniors appears to be far from great. The fastest-growing group of Texans receiving food stamps is the 60-64 age bracket. In the past six years, the number of those residents receiving food assistance – now issued in the form of a benefit debit card – has jumped by 106 percent to 85,000 as of this month, according to the Texas Health and Human Services Commission. The total number of recipients from all age groups has increased 58 percent…”

Medicaid Errors and Fraud – Arizona, Texas

  • New report: State Medicaid program pays $50M annually on care for ineligible patients, By Howard Fischer, June 8, 2012, East Valley Tribune: “Arizona’s Medicaid program is paying out up to an extra $50 million a year to provide care for those who are ineligible, a new report says. The study done by the state Auditor General’s Office finds a 1.1 percent error rate in cases where people were determined to qualify for the free care. Auditor General Debbie Davenport acknowledged that appears to be half of what federal officials found for Arizona in 2008, the last time the Centers for Medicare and Medicaid Services did its own report on the Arizona Health Care Cost Containment System. That same year, Davenport said, the average error rate of the 17 states studied was 6.7 percent. But Davenport said Arizona’s 1.1 percent rate still translates to real money…”
  • Medicaid fraud busters learn from experience, By Christine Vestal, June 4, 2012, Stateline: “Texas had an unusually high Medicaid orthodontics bill in 2010. At $185 million, the state was reportedly spending more than the other 49 states combined. Claims data showed that it had led the nation for three consecutive years in total dollars spent to help children with crooked teeth. Or at least that’s what state and federal regulators thought. As it turns out, Texas did not have a higher percentage of children with orthodontic needs. Nor was the Medicaid program doing a better than average job of providing dental care for the poor. Instead, a handful of orthodontists were bilking Medicaid by putting braces on thousands of children who did not require them. They were also tweaking the braces more often than recommended and keeping them on much longer than was normal…”

Foster Care System – Texas

Travis County foster care system is among the most efficient in Texas, report finds, By Tara Merrigan, June 6, 2012, Austin American-Statesman: “Associate Judge John Hathaway, who presides over most of Travis County’s foster care cases, says he sometimes feels more like a parent in his courtroom. ‘I feel like I’ve been raising some of these kids,’ Hathaway said. ‘I’m happy when they leave the system, but I also feel a loss with that loss of personal connection. I always tell them to come back and see me.’ This familiarity, engendered by a number of changes to the Travis County juvenile justice system in recent years, has helped make Travis County’s foster care system one of the most effective in Texas, according to a new report set to be released today. The report’s findings could help the state improve its struggling foster care system in a time of government cutbacks. The study, by Texas Appleseed, an Austin-based nonprofit legal group focused on social justice issues, found that a jurisdiction’s ability to place foster children in permanent homes was more closely tied to courtroom procedures than spending…”

Homelessness and Housing – Texas, Florida

  • Decline in homelessness spurs effort to build long-term housing, By Renée C. Lee, May 6, 2012, Houston Chronicle: “Houston’s homeless population declined by 5 percent this year, creating a positive backdrop for a new collaborative effort aimed at moving more people off the streets and into long-term housing. The number of sheltered and unsheltered homeless dropped from 8,242 counted in January 2011, to 7,830 counted in January 2012, according to the annual tally by the Coalition for the Homeless of Houston/Fort Bend County. In addition, the number of people in permanent housing with additional services, known as permanent supportive housing, increased slightly, suggesting the concept might be a promising approach to reducing homelessness in Houston…”
  • For homeless kids, school can be a struggle, By Tasnim Shamma, May 8, 2012, Miami Herald: “Students wondering where they’re going to sleep at night may have trouble paying attention in class. In Miami-Dade County, the number of kids without a home is in the thousands and growing. The county school district counted more than 4,406 students who were homeless in the 2010-11 academic year. Eleven-year-old David Thomas and his eight siblings used to be included in those statistics…”

Medicaid Spending – Texas

Medicaid spending growing faster than Texas taxes, By Chris Tomlinson (AP), May 7, 2012, Houston Chronicle: “Texas’ share for providing health care to poor children, the impoverished elderly and the disabled is growing faster than tax revenues to pay for services, creating another state budget challenge next year, top agency officials told lawmakers Monday. Texas’ Medicaid director Billy Millwee told lawmakers that his program will likely achieve only 88 percent of the cost savings forecast in the current budget. Experts had warned lawmakers last year that they were underfunding the Medicaid program by $4.8 billion, an amount lawmakers will have to make up when they meet again next year. Agency officials told the House Appropriation Subcommittee that the number of people qualifying for the Medicaid program nearly doubled between 2000 and 2011, and the number of poor children grew more than 10 percent in 2010 alone. The Medicaid population grows an average of 6.3 percent a year…”

Affordable Housing – Colorado, Texas

  • Report: Low-income Coloradans priced out of rentals, By Howard Pankratz, April 23, 2012, Denver Post: “People with the lowest incomes in Colorado are being priced out of rental properties, a report issued Monday by the Colorado Division of Housing said. ‘Rental housing in general since 2009 has become more scarce for many households as vacancies fall and rents rise,’ said Ryan McMaken, a spokesman for the Colorado Division of Housing. ‘But when one is at the lowest income levels, the impact of the growing demand for rentals can be especially severe as once-affordable units are priced out of range.’ The report said that among households with the lowest incomes, there are twice as many households as there are affordable rentals units in Colorado…”
  • Affordable housing fenced into poor areas, By Karisa King and Ryan Murphy, April 23, 2012, San Antonio Express-News: “Plans to build an affordable apartment complex for seniors in one of San Antonio’s most fashionable neighborhoods had been posted for barely a week in January when the fury hit. Residents feared the 68 apartments, which were competing for funding with federal tax credits, would spoil the affluent Stone Oak neighborhood. In a storm of emails, calls and letters to local and state officials, they predicted bitter results: damaged property values, more traffic and an increase in crime. ‘It just didn’t fit with us,’ said Francisco Martinez, president of the Mount Arrowhead Homeowners Association, one of about a dozen groups that opposed the apartments. ‘These are single-family homes. Anything that takes away from that takes away from why we bought into it.’ By March, the neighbors had prevailed. The project and any chance of public funding this year were dead. In Texas, where tax-credit proposals often need community support to survive, the project’s demise illustrates how the largest national program to create affordable housing pushes low-income developments away from desirable neighborhoods…”

Low-Income Residents – Austin, TX

Report: 2 in 5 Austinites are considered low-income, By Juan Castillo, April 12, 2012, Austin American-Statesman: “Hardly what you would call Austin slackers, Jerry Sanchez and his wife, Lisa, embrace the work ethic with sleeves rolled up and arms wide open. Jerry Sanchez, 41, works full time at his stepfather’s Estrada’s Cleaners in East Austin and does odd jobs – building decks, installing fences – for extra cash. Lisa Sanchez works as a day care teacher. Yet, despite all that sweat equity, the Sanchezes, who have five children, sometimes struggle financially. ‘Sometimes you’re frustrated. You’re not making ends meet; you’re playing catch up,’ Jerry Sanchez said. ‘It’s one thing after another.’ The Sanchezes are not alone. A report released Thursday by the Community Action Network shows that 2 in 5 Austin residents were low-income in 2010, meaning they earned less than 200 percent of the federal poverty level, which translates to about $44,000 a year for a family of four. The finding is contained in the network’s ‘Community Dashboard 2012’ report of 16 key socioeconomic indicators for Austin and Travis County…”

Kids Count Report – Texas

1.2 million Texas children still without insurance, Associated Press, April 8, 2012, Houston Chronicle: “More than 1 million Texas children remain without health insurance, and those kids are not getting the care they need. The startling condition of the state’s children came into vivid focus last week with the release of the annual Kids Count survey. The analysis of official state and federal data by the non-partisan Center for Public Policy Priorities found that 1.2 million Texas children have neither private nor public health insurance. Almost 40 percent of Texas mothers received little or no prenatal care and one in seven babies were born premature, statistics show. The difference between being insured and uninsured is stark: 90 percent of insured kids are healthy, while only 58 percent of kids without insurance are considered healthy. It comes as no surprise that the percentage of children covered by health care is directly related to the employment rate and the parent’s economic status…”

Kids Count Report – Texas

Quarter of Texas children live in poverty, By Chris Tomlinson (AP), April 5, 2012, Lubbock Avalanche-Journal: “Texas has the second-highest birth rate in the nation and more than 25 percent of those children live in poverty, according to the annual Kids Count survey released Wednesday. The number of children in Texas rose by nearly 1 million between 2000 and 2010, and accounted for more than half the U.S. child population growth. But 39 percent of Texas mothers received no, or very late, prenatal care and the percentage of babies born underweight jumped 13 percent during that same period, according the Texas survey, conducted every year by the Austin-based Center for Public Policy Priorities and funded by Methodist Healthcare Ministries and the Annie E. Casey Foundation…”

State Medicaid Cuts – Wisconsin, Texas

  • Lawmakers approve Medicaid cuts, By Jason Stein, March 14, 2012, Milwaukee Journal Sentinel: “An estimated 22,800 people would leave or be turned away from the state’s health programs for the poor, under a cost-cutting proposal revised by a legislative committee Wednesday. The Joint Finance Committee approved the revised Medicaid cuts on a 12-4 vote, with all Republicans voting in favor and all Democrats voting against. The number of people expected to lose or drop their coverage was about one-third the number that would have lost it under the original proposal put forward by Gov. Scott Walker’s administration, which would have affected 64,800 people. The number of children losing their coverage fell even more sharply to 2,900 from the original proposal of 29,100 children. The proposal also would save less state money – $36.5 million through June 2013 instead of $90.2 million…”
  • Doctors, their oldest patients starting to smart from new state health cuts, By Tim Eaton, March 14, 2012, Austin American-Statesman: “About 10 percent of patients seen by Bruce Malone, an Austin orthopedic surgeon, are referred to in medical circles as ‘dual-eligibles.’ They are the state’s oldest and poorest: the patients who can receive benefits from both Medicare and Medicaid. They have also been targeted by legislative budget writers. When state legislators tried to close the gaping, multibillion-dollar budget deficit last year, deep cuts needed to be made. And publicly funded medical care – like just about every other portion of the budget – was going to take a hit. Now, the consequences of cuts to Medicaid, the federal-state health insurance program for low-income people and people with disabilities, are coming to light, and some doctors and medical organizations say new regulations threaten the practices of some Texas doctors by reducing their payments…”

State Medicaid Programs

  • State cuts squeezing the elderly poor and their doctors, By Thanh Tan, March 8, 2012, New York Times: “After Dr. Javier Saenz completed his family-medicine residency in 1985, he returned home to the Rio Grande Valley to open a practice in the impoverished town of La Joya. Today, Saenz Medical Center treats up to 150 patients a day. Dr. Saenz is the volunteer physician for the local high schools and their football teams. A middle school is named after him. Despite his success, Dr. Saenz, 56, said he feels nothing like a hero these days. His practice, he said, is hanging by a thread. His troubles reflect a statewide problem for doctors who treat a disproportionately high number of the reported 320,000 low-income Texans who are dually eligible for Medicare, the federal insurer of the elderly, and Medicaid, the joint state-federal health care program for indigent children, disabled people and the very poor. On Jan. 1, the state reduced its share of co-payments for such patients. Physicians who treat them are seeing less revenue. Many, like Dr. Saenz, are not sure they can make enough money to stay in business…”
  • TennCare hospital reimbursements vary widely, By Tom Wilemon, March 9, 2012, The Tennessean: “Some Tennessee hospitals are questioning why they should continue paying a self-imposed tax to prop up the state’s Medicaid program because competitors are getting back much more in reimbursements while they lose money treating TennCare patients. Hospital executives were shocked to learn that insurance contractors for TennCare, the state health-care program for the poor, were paying more than four times as much to some hospitals as to others for outpatient procedures. In some cases, the disparities amounted to millions of dollars – enough to make or break a hospital’s budget…”
  • Last-minute plan would let FSSA cut Medicaid, By Chris Sikich, March 9, 2012, Indianapolis Star: “As today’s adjournment for the General Assembly quickly approaches, lawmakers are debating a last-minute plan to give the Family and Social Services Administration broad powers to reduce Medicaid spending. In 2011, the General Assembly approved a measure to help the agency cut $212 million from Medicaid to balance spending. The FSSA was granted emergency powers to quickly cut funding or alter or eliminate certain Medicaid programs. The action allowed the agency to bypass public hearings and legislative oversight. Just how long those powers should last has been a matter of debate…”
  • Medicaid cut would hit Florida’s poorest patients, hospitals, By Mary Shedden, March 8, 2012, Tampa Tribune: “Doctors and hospitals treating Florida’s poorest patients face significant pay cuts in the state’s nearly final budget. Legislators will vote by Friday on a $70 billion budget that includes $304 million less to reimburse hospitals. A Florida Hospital Association analysis released Wednesday projects the state’s hospitals will receive $642.8 million less for treating poor children, pregnant women and disabled adults in 2013. This second consecutive year of Medicaid cuts will force hospitals to quickly decide what services to reduce or eliminate, said Kimberly Guy, chief operating officer at St. Joseph’s hospitals for women and children, where the cuts could total $7.3 million…”

Homelessness Programs – Texas, Washington DC

  • Texas funding cut leaves local agencies scrambling to continue services for homeless, By Alex Branch, March 3, 2012, Fort Worth Star-Telegram: “The impact of state budget cuts on homeless programs is evident on the calendar pages inside Larry Beasely’s personal planner. Last year, full hours were blocked off and highlighted for one-on-one assessments that Beasely, a case manager, conducted with people staying at the Salvation Army’s emergency shelter in Fort Worth. This year, each line is crammed with the names of people he assessed in hurried 15-minute meetings. The shelter reduced its case managers from four to one after the state eliminated funding for a $20 million state homeless housing and services program last year. Other programs affected by the cuts include an employment program, street outreach and rental assistance…”
  • Montgomery County grapples with chronic homelessness, By Victor Zapana, March 5, 2012, Washington Post: “On the streets of Bethesda, the hard-core homeless live mostly in the shadows. Many of them steer clear of the main thoroughfares. Few venture into shelters. But amid a downturn that has cut social-services spending and forced officials to make the most of government funds, Montgomery County says it is focusing more of its homelessness efforts on the people with some of the most complicated needs. The chronically homeless are often on the streets for at least a year and face not only economic hardships but also problems such as mental illness and addiction that can make housing them a significant challenge. County officials began targeting such people last year, setting aside housing vouchers to get them a roof over their heads before grappling with underlying issues…”

Poor Children and Dental Disease

‘Silent epidemic’ of dental disease threatens poor kids’ health, By Renée C. Lee, March 4, 2012, Houston Chronicle: “Every time Dr. Martee Engel treats a young patient whose teeth have brown or white chalky spots, she’s reminded of an acute problem affecting children – particularly poor children. Engel sees more than her share of early childhood tooth decay as dental director at Denver Harbor Clinic in northeast Houston. The clinic treats mostly poor children who are twice as likely as more affluent children to have untreated tooth decay, studies show. While overall oral health care for adults and children has improved, tooth decay continues to be the most common chronic disease among children. It can have serious social and health consequences when untreated and, in rare cases, can be fatal…”

State Medicaid Programs

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

States and Medicaid

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