Health reform changes could increase costs to states

Today's state news round-up includes the cost of health reform to New York, immigrants in California, a possible new mental health overhaul in Arizona and a delay in expanding the children's health program in Iowa.

New York: "The Paterson administration is raising alarms that health care legislation taking shape in Washington could drive up deficits and punish New York and other states that have expanded Medicaid coverage on their own," The New York Times reports. "New York's warning is almost certain to be echoed by governors across the country as Democrats in Congress work to complete major health care legislation that will require states to pay part of the cost of a broad expansion of Medicaid, the federal-state insurance program for the poor" (Hakim and Herszenhorn, 10/21).

California: "A new statewide study has found that a federal requirement to check the citizenship of all Medi-Cal applicants has imposed significant burdens on California's 58 counties but that officials have not reported any cases of existing recipients who had falsely claimed U.S. citizenship," The Los Angeles Times reports. "The study by the California Endowment and the California Healthcare Foundation, released this week, found that the requirement in particular made it harder for the homeless, mentally ill, people born outside California and children over age 16 to access public healthcare. That's because such groups had a more difficult time finding birth certificates, passports, driver's licenses and other documents needed to prove U.S. citizenship and identity" (Watanabe, 10/22).

Arizona: "Gov. Jan Brewer has proposed a sweeping overhaul of Arizona's mental-health system that would give [Arizona Health Care Cost Containment System, the state's Medicaid program] responsibility for tens of thousands of new patients while creating a pilot program to address people with serious mental illnesses," The Arizona Republic reports. "Brewer's six-page proposal, which arrived Tuesday after months of delays, suggests integrating physical and mental health care for people with basic mental-health and substance-abuse issues" (Newton, 10/21).

Iowa: "Iowa doctors and nursing homes would receive less money when they care for poor people, if the governor approves the plan the Department of Human Services submitted. And the state might have to delay its goal to provide health insurance to all children," The Des Moines Register reports. "Most health care providers would lose 5 percent of their pay from Medicaid, a state and federal program that covers poor people. Many providers already have complained for years that they lose money on every Medicaid patient they treat because the pay rates are so low" (Leys and Jacobs, 10/22).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.