Kaiser Daily Health Policy Report Highlights State Medicaid Developments
Summaries of developments related to state Medicaid programs appear below.
- Florida: The state could lose $300 million in federal Medicaid funding if lawmakers do not expand a pilot program statewide by fiscal year 2011, Health News Florida reports. Under the pilot program, which former Gov. Jeb Bush (R) initiated in 2005, the state receives $1 billion annually for providing no-cost care to uninsured residents. However, the program also includes the penalty clause for reduced federal funds if it is not expanded by 2011. According to Health News Florida, previous attempts to expand the program have been defeated by the state Legislature over the past two years, and some lawmakers this session have indicated that they do not plan on approving an expansion (Jordan Sexton, Health News Florida, 5/1). Legislative leaders only recently learned of the penalty and "now are scrambling in the waning days of the lawmaking session" to approve special budget language requesting additional time from the federal government, the St. Petersburg Times reports. They also must decide what to do with about $246 million in surplus funds, which some public hospital executives say should be used to close the $300 million shortfall if the penalty takes effect or any other funding deficits in the future (Caputo, St. Petersburg Times, 5/2). Others say that the excess funds -- part of the state's share from the federal economic stimulus package -- should be distributed and spent now (Health News Florida, 5/1). Some lawmakers want Medicaid reform scrapped altogether. State Senate Committee on Health and Human Services Appropriations Chair Durell Peaden (R), said, "We've done the experiment. It has failed," adding, "The reports are unsettling. People couldn't get to specialists, couldn't get adequate care. And they couldn't do it cheaply" (St. Petersburg Times, 5/2).
- Louisiana: The state Department of Health and Hospitals on Friday issued emergency rules that cut Medicaid provider payments by 7% as part of an effort to reduce the department's proposed fiscal year 2010 budget by $445 million, the Baton Rouge Advocate reports. The cuts took effect immediately; however, they will have to be approved by the state Legislature to remain in effect for FY 2010, which begins July 1. DHH undersecretary Charles Castille said, "If we started rules after the legislative session, it would take several months to put these rules in place and we would only be able to get eight months of cuts." According to Castille, if the state Legislature does not approve the cuts, DHH would "simply pull back and redo on whatever rules are cut or adjusted." Louisiana Hospital Association President John Matessino said, "I am extremely disappointed in the administration's decision to further reduce hospital reimbursement, which continues to weaken our hospitals' ability to serve their communities" (Shuler, Baton Rouge Advocate, 5/2).
- Texas: Texas officials on Tuesday said that increased Medicaid enrollment and growing health care costs will require state lawmakers to provide an additional $1 billion in funding for Medicaid over the next two years, the Dallas Morning News reports (Garrett, Dallas Morning News, 5/6). State officials said that amid job losses and the economic recession, more people now qualify for the program. Lt. Gov. David Dewhurst (R) said, "We weren't expecting this big of an increase" (Root, AP/Houston Chronicle, 5/5). The budget being negotiated by the state Senate and House already projects spending all the general revenue that the state comptroller said is available to lawmakers. Therefore, unless the comptroller increases its revenue estimates, the projected Medicaid increase could force lawmakers to cut more than 1% from the budget. Dewhurst said that the $1 billion needed for Medicaid would diminish the likelihood of new programs being established this year (Dallas Morning News, 5/6). State Sen. Steve Ogden (R), chair of the Texas Senate Finance Committee, said, "We're going to be able to get it done, but at the end of the day there is less money today than we thought there was available a week ago for new stuff." He said that the new enrollment rates also will require additional funds to be appropriated in a separate emergency spending bill that covers the current fiscal year (AP/Houston Chronicle, 5/5).