States Cutting Medicaid

Jul 24, 2012

<< Main Story: 13 States Cut Medicaid To Balance Budgets

To help balance their budgets, 13 states are cutting Medicaid either by lowering fees paid to medical providers, reducing benefits, or tightening eligibility for the health insurance program for the poor and disabled. Most changes went into effect July 1, though some take effect later this year and some are pending federal approval. Kaiser Health News surveyed the 50 state Medicaid programs:

Provider Cuts
State Detail of Provider, Benefit or Eligibility Cuts
Alabama Cut fees to doctors and dentists by 10 percent. Eliminated eyeglass coverage; limited brand name drugs for most adults to one drug a month (exempted are long-term-care patients and HIV and psychiatric drugs) through July 31, after which the limit will be four brand-name drugs a month; cut routine eye exams from once every two years to once every three.
California Cut payments to private hospitals by $150 million; froze rates for payments to nursing homes; cut fees to clinical laboratories by 10 percent. Added $15 co-pay for non-emergency ER use and $1 and $3 co-pays for certain drugs. (Source: California 2012-13 State Budget)
Colorado Cut nursing home rates by 1.5 percent. Limited orthodontics coverage, added some co-pays and enrollment fees to its Children’s Health Insurance Program based on family income. (Source: Colo. Dept. of Health Care Policy & Financing)
Connecticut Preparing to seek federal approval to eliminate coverage for adults with assets exceeding $10,000 (excludes home and one car), and to count parental income and assets for adult children aged 19 to 25 who live with their parents.
Florida Cut hospital rates by 5.6 percent, and nursing home rates by 1.3 percent. Seeking federal approval to limit home health visits for non-pregnant adults to no more than three per day, primary care visits to no more than two per month and ER coverage to a maximum of six visits per year.
Hawaii Reduced eligibility for non-pregnant adults from 200 percent of poverty level ($46,100 for family of four) to 133 percent ($30,656 for family of four)..
Illinois Cut fees to health providers, except physicians and dentists, by 2.7 percent. Cut payments to non-safety net hospitals by 3.5 percent. Reduced parents’ eligibility from 185 percent of federal poverty level ($42,642 for family of four) to 133 percent ($30,656 for family of four) to eliminate more than 25,000 people from the program; increased co-pays for drugs; limited prescriptions to four a month, with state permission needed for more; added a $3.65 fee for nonemergency ER use; eliminated chiropractic coverage and regular dental care for adults. Pregnant women are exempt from co-pays. (Source: Ill. Dept. of Healthcare & Family Services)
Louisiana Cut fees to doctors (primary care excluded) by 3.4 percent, cut fees to dentists by 3.7 percent, cut mental health providers by 1.9 percent and cut fees to dialysis centers by 3.7 percent.
Maine Planning to seek federal approval to eliminate coverage for 19- and 20-year-olds and to reduce eligibility for parents from 200 percent of poverty level ($46,100 for family of four) to 100 percent of poverty level (23,050 for family of four). Also eliminated coverage for ambulatory surgery centers, sexually transmitted disease clinics and coverage of smoking cessation products, except for pregnant women.
Maryland Cut fees to nursing homes by 2 percent and to hospitals by 1 percent.
New Hampshire Cut payments to hospitals by $160 million.
South Dakota Added a $1,000 annual limit for non-emergency dental services for adults. Implemented a $1 co-pay for generic drugs and increased co-pays for brand name drugs to $3.30.
Wisconsin Eliminated coverage for non-pregnant adults over 133 percent of the federal poverty level ($30,656 for family of four) if they are offered affordable coverage by their employers; added or increased monthly premiums for some non-pregnant adults; eliminated presumptive eligibility for adults. (Sources: Wis. Dept. Of Health Services news release and update)
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