The National Health Law Project offers a review of "2005 State Medicaid Eligibility Cutbacks: Proposed & Recently Enacted." (Compiled by Thomas P. McCormack.) Go there to find out which poor kids, disabled people, and sick old folks are getting screwed in your state so that rich people don't have to pay taxes and we can pay for getting rid of all those Weapons of Mass Destruction™ in Iraq.
- California: new red tape and a reduced income level will take 200,000 parents off the roles. The legislature rejected almost all of Gov. [Gropenator's] proposed cuts for Crippled Children's, ADAP and MediCal, but in early 2005, he proposed premiums for patients with incomes over 100% [of poverty] or the $812 SSI/SSP level,*, forced enrollment of the aged and disabled into HMOs, and an annual patient cap of $1,000 for dental care.
- Connecticut: . . . Governor Rell (R ) . . . may again attempt to raise family Medicaid and CHIP premiums to between $10 and $50 monthly, after an earlier attempted increase fizzled. The state already added co-pays of $1 to $3 for doctors; raised Medicaid’s $1 Rx co-pay to $1.50 and $3; upped SPAP premiums from $25 to $30 and its co-pays from $12/$15 to $16.25; imposed a $100,000 SPAP liquid asset test; and required recoveries of SPAP costs from estates of the deceased. It dropped legal aliens from welfare, Medicaid, CHIP and SAGA (state-funded welfare and medical programs). SAGA welfare was reduced from $350 a month to $200; its patients are being forced into HMOs; and its medical budget was capped. The state ended coverage of chiropractic; naturopathy, occupational, physical and speech therapy; and psychology services for adults... .
- District of Columbia---the local, DC-funded Health Alliance still covers all uninsured persons under 200% except for Medicare and Medicaid eligibles; yet free city TB and STD clinics remain closed; and city low income clinics no longer give free Rx’s to the needy aged and disabled (who instead must be under 100% to get drugs from Medicaid). The DC Rx Access law offers discounts to those over 62 with incomes under 200% and to others under 350%; but eligibility, provider, delivery and cost-sharing details must still be worked out.
- Georgia: the state . . . lowered the CHIP income level from 235% to 200%; and stopped CHIP coverage of dental and vision care. It lowered the Medicaid and WIC level for pregnant women and infants from 235% to 185%, raised CHIP premiums from $10 monthly to $35, ended adult coverage for emergency dental care and artificial limbs and will force 800,000+ patients (including children, the aged and the disabled) into HMOs. The state had already stopped covering adult dental care, orthotics, prosthetics and hospice care; planned time limits on eligibility for patients in the breast/cervical cancer category; capped HCB expenses and CHIP enrollment; and added cost-sharing fees to Katie Beckett waiver care. By May, 2005—when over 45,000 children had lost CHIP---Gov. Pedue (R ) sought CMS approval for a HIFA** waiver to reduce nursing home access, raise Rx and other co-pays (even for children and nursing home patients), add more managed care and health savings account features to Medicaid and other economies in exchange for extra current funding (but which would bring federal matching fund caps that could cut future program funds).
- Mississippi: the state, over big protests, lowered its aged and disabled Medicaid level from 135% ($1,068 monthly for one) to $579---causing 65,000 aged and disabled to lose Medicaid; and reduced monthly Rx’s from 7 to 4 brand names plus unlimited generics. The state says it has a waiver to keep using the old, higher aged/disabled level for transplant, dialysis, chemo and mental patients, plus about 7,000 non-Medicare-qualified disabled clients, but it has no ADAP or other funding for the 2,000+ disabled HIV patients losing Medicaid.
And on and on it goes. The news is better in a few states, including:
Massachusetts: almost all of Gov. Romney’s (R ) health cut proposals failed or were reversed by the Democratic legislature. (The state still offers the most generous eligibility in the nation.) For details see “Funding Cuts in Massachusetts..” at www.sihp.brandeis.edu/mhpf. By 2005, even Gov. Romney proposed moving toward universal health coverage by voluntarily urging purchase of cheap, limited benefit, high cost-sharing policies by the uninsured and more enrollment in Medicaid by all those eligible. He even wants a higher minimum wage for firms that don’t offer health insurance
Not that Romney's proposals are good, actually, but at least he can't get away with that Bushit here in the People's Republic. What are they getting away with in your state?
*SSI, supplemental security income, is the last resort safety net for elderly or disabled people who don't have enough earnings history to qualify for full social security benefits.
** "HIFA" refers to the Health Insurance Flexibility and Accountability demonstration initiative. Basically it means that states can apply to CMS (the federal agency that administers Medicare and Medicaid) for permission to violate the usual standards for Medicaid benefits in order to cover more people, but give them worse insurance. That basic concept is all the rage these days amongst the Republican champions of the Culture of Life.