Medicaid budget issues mean tough choices across nation

Medicaid programs in Connecticut, Texas, New Jersey and California deal with swelling rolls, tight budgets and reimbursement decisions.

The Associated Press/Wall Street Journal: Medicaid Hits Budget
The larger-than-expected demand for Medicaid health coverage for needy adults, a contributor to Connecticut's latest budget shortfall, is being felt across the state, according to a review of Department of Social Services statistical reports. Average monthly caseloads in cities and towns during the last three years show the state's three largest cities have the greatest jump in numbers of residents seeking coverage under Medicaid for Low Income Adults or LIA (11/23).

The Dallas Morning News: Texas Health Care Facing Big Changes, Tough Spending Decisions
Gov. Rick Perry has promised to fight tooth and nail against implementing the Affordable Care Act. But that doesn't mean big changes aren't coming to Texas health care, and it won't save lawmakers from facing tough spending decisions. … Signs of conflict are already showing. For the 2014-2015 budget cycle, the Texas Health and Human Services Commission that runs the Medicaid program has asked the Legislature for an additional $6.7 billion. Republican leaders, meanwhile, have already pledged to increase the entire state budget by only $7 billion. If they plan to maintain their spending cap, they will need to pare down spending on health care (11/24).

The Record (New Jersey): N.J. Bill Seeks To Limit Cuts By Insurers
One of the four private insurance companies that manage the state's Medicaid program is seeking to cut reimbursement rates for home care to the elderly and the sick, but some lawmakers want to limit their authority to do so. State Sen. Loretta Weinberg, D-Teaneck, said she hopes that the Senate will pass legislation next week to require that managed-care companies get written approval from the Department of Human Services to lower homecare reimbursement rates and that a public hearing be held first. Weinberg introduced the legislation in response to pleas from home-health agencies, which expressed concern in September when Horizon NJ Health -- the largest of the four managed-care companies that administer the state's Medicaid system -- said it would decrease the hourly reimbursement rate for home care from $15.50, to $13.95, a 10 percent drop (Diskin, 11/24).

California Healthline: Letter From Congress Focuses On Healthy Families Transition
California's effort to move approximately 860,000 children from the Healthy Families program has drawn national attention. Twenty-two members of the House of Representatives, including House Speaker Nancy Pelosi (D-San Francisco), last week sent a letter to state health officials, urging caution in the Healthy Families transition to Medi-Cal managed care. The transition is slated to begin Jan. 1 when almost half the Health Families kids -- about 415,000 -- make the switch. The state still needs CMS approval for the plan (Gorn, 11/26).