Clip files / Local news from the states
This column features selected short items about state health care policy.
Missouri Dems stall vote on governor’s cuts
JEFFERSON CITY, MO—While Republican senators supported Gov. Matt Blunt’s plan to revamp the state’s Medicaid program with the initial step of removing more than 100,000 people from the program, Democrats labored in mid-March to delay a vote on the legislation. Mr. Blunt contended the cuts are necessary to boost spending for public schools and balance next year’s budget without raising taxes. But Democrats countered that Republicans are doing things backward by cutting people off Medicaid before waiting for the results of a commission, created under the bill to recommend Medicaid reforms by Jan. 1. They also contended the cuts would raise Missouri’s uninsured and unemployment figures.
The budget proposal would remove about 89,000 of Missouri’s 1 million Medicaid recipients by tightening the eligibility standards for low-income parents, the elderly, and disabled. An additional 13,600 are projected to lose coverage by requiring annual eligibility reviews of recipients. The governor’s plan also would eliminate some Medicaid services such as dental, eye care, wheelchairs, and prosthetics for about 350,000 people — all except children, pregnant women, and the blind. Plus, it would require more Medicaid recipients to make copayments of between 50 cents and $3 each time they visit a doctor or hospital. Republicans contended cuts are necessary to scale back a program that has doubled its rolls in the past dozen years while roughly tripling to a cost of more than $5 billion in state and federal funds. Medicaid consumed 30.7% of Missouri’s total expenditures in the 2004 fiscal year — more than every state except Tennessee, according to the National Association of State Budget Officers.
—St. Louis Post-Dispatch, March 15
Florida plan labels some benefits optional
TALLAHASSEE, FL—Some health care services that Medicaid patients have come to expect would not be covered automatically under Gov. Jeb Bush’s new Medicaid plan. Legislation unveiled in March deemed services such as pharmaceutical benefits, dental, vision care, prenatal and newborn care, chiropractic services, dialysis treatment, children’s hearing service, and hospice care, as "optional benefits" that managed care groups would not be mandated to provide. Medicaid pays for the health care of 2.3 million low-income Floridians, including more than 1 million children. About half of the Medicaid population is in a managed care organization. The governor’s plan is to move all recipients into managed care in hopes of reducing the $15 billion of the state’s $61 billion budget that Medicaid funding requires.
Medicaid recipients from South Florida and the Jacksonville area would be the first state residents to see changes. South Florida, where about half of all Medicaid recipients live, was picked because there are many managed care networks and physician groups that could be ready quickly to take over the program.
Tom Arnold, the state’s Medicaid director, said the governor intends to phase in the changes beginning in April 2006 in Broward, Miami-Dade, and Palm Beach counties, as well as five counties in northeast Florida.
—Orlando Sentinel, March 17
JEFFERSON CITY, MOWhile Republican senators supported Gov. Matt Blunts plan to revamp the states Medicaid program with the initial step of removing more than 100,000 people from the program, Democrats labored in mid-March to delay a vote on the legislation.
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