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SPN Medicaid Exchange - Issue 132

Published on Thursday, March 01, 2012

SPN Medicaid Exchange - Issue 132

What's New in Medicaid And Other Health Care Issues

Expanding Public Insurance Doesn't Increase Access
At his Health Policy Blog, NCPA President and CEO John C. Goodman cites a study that shows expanding public insurance doesn't increase access to care, but paying doctors more does. The implications for ObamaCare are devastating, as millions of newly enrolled Medicaid patients will have less access to care than they had before the reform.

Growth in Medicaid Enrollment Troubling
The Kaiser Family Foundation reports that total Medicaid enrollment is expected to increase by 16 million people, or 27 percent, by 2019. However, John C. Goodman says at his Health Policy Blog that this is not something to get excited about, especially when things like cancer survival rates are much worse for Medicaid patients.

Despite Reforms, Medicaid Expenditures Go Up
According to the Mercatus Center, even though many states have introduced reforms over the last 10 years, combined federal and state Medicaid expenditures have grown from 2.0 percent of gross domestic product (GDP) in 2000 to 2.7 percent of GDP in 2007.

Governors Expect No Action from White House on States' Medicaid Plea
The nation's governors are pessimistic about the Obama administration giving them flexibility on combating Medicaid debt, reports Human Events.

How Many Will Benefit from ObamaCare Coverage Expansion Will Vary Widely
There is wide variation in how many people will benefit from ObamaCare's coverage expansions, ranging from 2 percent to 4 percent of the non-elderly population and as much as 36 percent to 40 percent in parts of Florida, New Mexico, Texas, Louisiana and California. According to a Kaiser Family Foundation analysis, Public Use Microdata Areas in the Miami area, areas northwest of Albuquerque, and Fort Worth might benefit the most.

Medicaid and Medicare

What Was the Impact of States Expanding Eligibility to CHIP?
Evidence that state efforts to reduce the number of uninsured children by expanding Children's Health Insurance Plan eligibility were successful was somewhat ambiguous, according to the Robert Wood Johnson Foundation.

Obama's Budget Could Shift Medicaid Costs to States
Even though President Obama's proposed budget saves billions in Medicare and Medicaid, it could result in greater costs to states. Among the costs are $21.8 billion for limiting the state's ability to use taxes on health care providers to pay a state's share of Medicaid payments, according to

House and Senate Agree to Cut Medicaid, Medicare Payments
Members of the House and Senate have tentatively agreed to cut Medicare and Medicaid payments to hospitals and other providers for things such as bad debt and disproportionate share payments. Kaiser Health News reports that the package would cost about $50 billion over the next decade, with about $20 billion going toward the Medicare doc fix and Medicare extenders package.

Feds Uncover Multimillion Dollar Health Care Fraud
A Texas doctor and five owners of home health care agencies were arrested recently on charges that they fraudulently billed Medicare and Medicaid nearly $375 million. Authorities described it as the largest case of its kind, says the Washington Post.

Medicaid Budget Still Tight in Most States
Despite a better state budget picture, Medicaid budgets have been squeezed lately, reports One study found that states have projected or have addressed shortfalls totaling $47 billion for fiscal year 2013, while state revenues remained 7 percent below pre-recession levels as of the 3rd quarter of 2011.

Supreme Court Sends Back California Medicaid Cuts Case
The Supreme Court sent back to a lower court a case on whether recipients and medical providers can sue California for cutting Medicaid reimbursement rates. At issue, according to Reuters, is a plan by California's lawmakers in 2008 to slash Medicaid payments to doctors, hospitals and other medical providers to help reduce the state's massive budget deficit.

Nursing Homes, Hospitals May Derail Cuts
Complaints from nursing homes and hospitals may derail proposed Medicare and Medicaid cuts, with skilled nursing facilities already absorbing $127 billion in Medicare payment reductions over the next decade, according to Kaiser Health News.

Blue-State Attorneys General File in Support of Medicaid Expansion
Twelve state attorneys general have filed an amicus brief with the Supreme Court in support of the constitutionality of the health reform law to significantly enlarge the Medicaid program and urged the high court to support the new health care law, reports Healthcare Finance News. Supporting the law were attorneys general of California, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maryland, Massachusetts, New Mexico, New York and Vermont, and the governor of Washington.

State News

Arkansas' shortfall in its Medicaid program in 2013 will be higher than officials expected and could hit $400 million.

California's request to charge a variety of copayments, ranging from $3 for prescriptions filled at pharmacies to $100 for inpatient hospital stays, to most of its Medicaid enrollees was denied by federal officials.

Florida's request to expand Medicaid managed care to nearly all of its 3 million enrollees has been sent back by a federal decision preventing the state from requiring its poorer Medicaid enrollees to pay premiums or large copayments.
Georgia state officials have created a third task force to discuss proposals for a revamp of Medicaid and PeachCare services in Georgia.

Illinois Governor Pat Quinn will propose a $33.8 billion spending plan that would cut $2.7 billion from the Medicaid program.
Louisiana Governor Bobby Jindal is unfazed by the potential impact on the state budget of the adjustment in the state's FMAP funding.

Maine spends far more per capita than other states on Medicaid and is far above the national average. Governor Paul LePage is calling for the program to be slashed.
Minnesota: Following word last week of a federal investigation into how Minnesota finances its public health insurance programs, Congresswoman Michele Bachmann called for more audits of the Medicaid program.

Missouri: Some low-income seniors and people with disabilities in Missouri could have to pay more out-of-pocket to qualify for Medicaid coverage.

New Mexico: A proposed overhaul of the state's Medicaid program could force recipients to pay a copay if they go to an emergency room for medical care that's not considered an emergency.

Rhode Island would no longer cover routine dental care for low-income adults under a proposal by Gov. Lincoln Chafee that aims to save the state $2.7 million

Texas: The state legislature has passed regulations barring affiliates of abortion providers from participating in the state's Medicaid program starting March 14.

Washington state's plan to stop paying for certain emergency room visits has met pushback from hospitals and doctors, who say they will be stuck with bills for vital care they often are legally required to provide.

Be Prepared

Order a copy of the NCPA Handbook on State Health Care Reform here.

Sign up for John Goodman's health policy blog at:

Take Advantage of the NCPA's Medicaid Service Center. The Medicaid Service Center can help state-based think tanks with commentaries, policy papers and speakers for briefings. Those interested in exploring further should contact Devon Herrick at (972) 308-6470.

Links of Interest

What the Other Side Says

The NCPA welcomes submissions of Medicaid-related research for inclusion in future editions.


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