KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Medicaid Costs Pose Coverage Challenges, State Budget Struggles

Kaiser Health News: "About 100,000 people -- mostly elderly or disabled residents -- have been dropped [from Tennessee's Medicaid program] since January 2009, including approximately 37,000 who had relied on the state program for all their health care needs. Coverage for 8,000 children was also reassessed, but a TennCare spokeswoman said the number of children ultimately cut from the program could not be verified. The state's actions follow the resolution of a long-running court case involving people who receive Supplemental Security Income (SSI), a federal assistance program for low-income residents who are aged, blind or disabled and some infants hospitalized for long periods with major medical problems. SSI recipients are automatically eligible for TennCare, but the state had sought to discontinue coverage for those who lost the SSI benefits."

"Some enrollees sued, arguing that the state was not taking into consideration whether they qualified on their own for TennCare. In 1987, they got a federal court injunction that prohibited the state from denying benefits to anyone who had ever qualified for SSI. As the case languished for two decades, the number of people affected grew to more than 150,000, about 13 percent of all TennCare enrollees. The group became known as the 'Daniels class,' named for Cluster Daniels -- one of the original participants in the lawsuit -- who has since died. In January 2009, a federal district court rescinded the injunction after the state argued that its new process for determining Medicaid eligibility had been approved by federal officials. The court action cleared the way for an evaluation of the Daniels class of recipients" (Wadhwani, 4/8). 

Baltimore Business Journal: Maryland "hospitals and health insurers Tuesday finally put to rest their own budget battle. But it could come at a cost to Maryland's employers and their workers next year. In a special meeting held by the state agency that sets hospitals' rates, hospital and health insurance leaders agreed to split a looming $123 million cut to Maryland's Medicaid budget into thirds. Hospitals will pay out of their pockets almost one-third - about $37 million - while insurers will generate 70 percent of the fiscal 2011 cut by increasing by nearly 1 percent the amount hospitals can charge patients for care" (Graham, 4/7).

The Atlanta Journal Constitution: In Georgia, the number of people "receiving Medicaid and food stamps has skyrocketed over the past year, stressing a social service system that is facing budget cuts at a time of increasing need. More and more of these new cases involve people and families that haven't sought public assistance before, say workers who help people apply for these benefits." Among the first-time applicants are "formerly stable working-class families laid low by long-term job loss and home foreclosures. ... But even as the numbers grow, state officials plan to cut 137 of the workers who process applications for Medicaid and food stamps. That has alarmed advocates, who say they are already seeing the increasing numbers cause delays in approvals, lost paperwork and cases falling through the cracks. The planned cuts for fiscal 2011 -- which still must be approved by the Legislature -- come in the wake of 57,282 new Medicaid cases between December 2008 and December 2009, a 9 percent increase to a total of 705,042 cases, according to the state Department of Human Services" (Schneider, 4/8).

The Associated Press/Seattle Times: "The Washington Department of Social and Health Services will be mailing 1 million plastic ID cards this month to Medicaid clients in the state. The services cards are part of the change to the ProviderOne payment system. The department says the cards are more convenient than paper coupons. Doctors will use them to verify eligibility" (4/7).

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