By Julian Pecquet
The Obama administration on Thursday approved hundreds of millions of dollars in cuts to California’s Medicaid program that the state had requested to shore up its dismal finances.
The state’s Democratic governor, Jerry Brown, this summer requested the authority to slash Medicaid payments to providers by 10 percent to save $623 million this year and next. Cindy Mann, director of the federal Center for Medicaid and State Operations, said Thursday that the Centers for Medicare and Medicaid Services has partially approved the request while rejecting cuts that would have affected beneficiaries’ access to care.
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Brown put the administration in a tight spot with his
request to slash the state’s Medicaid budget by $1.4 billion to help plug a $26.6 billion budget gap, the worst of the 50 states.
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The request has sparked opposition from California’s Democratic congressional delegation. More than a dozen members met with Centers for Medicare and Medicaid Services Administrator Donald Berwick last month to share their concerns.
moreWhy is Jerry Brown cutting Medicaid?
State spending on Medicaid up sharplyThe expiration of federal stimulus funding for Medicaid has dealt a blow to states still struggling to recover from the economic downturn, according to figures released Thursday.
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Nearly every state also has turned to tough measures to trim Medicaid costs, such as eliminating benefits, reducing payment rates to doctors and hospitals, and increasing the co-payments they charge the poor and disabled served by the program.
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The 2010 health-care overhaul law bars states from tightening their eligibility rules for Medicaid through 2014, when the program will be expanded to cover a larger share of the poor, almost entirely at the federal government’s expense.
All
29 Republican governors have written to President Obama and Congress pleading for relief from this “maintenance of effort” requirement.
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(June):
WASHINGTON — The Obama administration injected billions of dollars into Medicaid, the nation’s low-income health program, as the recession deepened two years ago. The money runs out at the end of this month, and benefits are being cut for millions of people, even though unemployment has increased.
From New Jersey to California, state officials are bracing for the end to more than $90 billion in federal largess specifically designated for Medicaid. To hold down costs, states are cutting Medicaid payments to doctors and hospitals, limiting benefits for Medicaid recipients, reducing the scope of covered services, requiring beneficiaries to pay larger co-payments and expanding the use of managed care.
As a result, costs can be expected to rise in other parts of the health care system. Cuts in Medicaid payments to doctors, for example, make it less likely that they will accept Medicaid patients and more likely that people will turn to hospital emergency rooms for care. Hospitals and other health care providers often try to make up for the loss of Medicaid revenue by increasing charges to other patients, including those with private insurance, experts say.
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The aid ending next month increased the federal share of Medicaid spending in all states, with additional help for states where unemployment rates had risen sharply. The extra aid was scheduled to expire last December, but Congress extended it for six months at the urging of the White House and state officials.
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No one seemed to care when this program was extended, and it expired with little notice in June. Now states are cutting Medicaid, Republicans are demanding help (though they don't want to admit it), and no one is moving to address this. The program should have been extended.
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