Medicaid expansion dilemmas: Mental health care demands, impact of managed care, non-expansion states squeezed

The health law built in changes to the system of coverage for lower-income people.

Health News Colorado: Medicaid Expansion Creates Explosion In Demand For Mental Health Care
Mental health centers in Colorado are seeing a surge in new clients seeking services under the state's expansion of Medicaid. And while center officials say they expected an increase, the number of new calls surprised them, so they have ramped up efforts and instituted new programs to meet the demand. As part of the Affordable Care Act, Colorado is among 26 states that expanded Medicaid benefits for adults who earn up to 138 percent of the federal poverty level, ... Mental health leaders say the Medicaid increases point to a huge pent-up demand for services among people with a variety of issues who until now have not been able to get the help they need (Hoback, 8/6).

CQ Roll Call: Boom In Managed Care Alters Medicaid's Calculations
Health insurance companies have not always been eager to cover Medicaid recipients, in part because some low-income people have complex medical needs and don't have all the resources that help wealthier people stay healthy. But that reluctance has turned to enthusiasm in recent years as more states have switched their Medicaid programs to managed care plans, some of which seek to control costs by, among other steps, limiting a patient's choice of physicians and the fees that doctors charge. ... The expansion of Medicaid to many more low-income Americans under the 2010 health care law is making the program even more attractive to insurers (Adams, 8/6). 

The Associated Press: Medicaid Reform Could Cut Deep At Rural Hospitals
Whenever Medicaid cuts filter down from the legislature in Raleigh [N.C.] to small-town and rural hospitals such as Southeastern Regional Medical Center in Lumberton, the pain is acutely felt. Although they disagree on just how to reform North Carolina's Medicaid program, lawmakers know they want to upend the way the state pays for and administers the health insurance program for low-income residents, including the elderly, disabled and children. They talk of contracting with private companies to manage the unpredictable and ever-rising costs of Medicaid (Ferral, 8/6).

The Associated Press: Feds Return Indiana Medicaid Waiver Request
A federal agency has asked the Pence administration to resubmit its proposal for an alternative Medicaid expansion because Indiana's initial application didn't include input from a band of Potawatomi Indians. The Centers for Medicare and Medicaid Services returned the state's proposal last month, two weeks after the state submitted the plan. ... This the second time the CMS returned a waiver request from the Pence administration (LoBianco, 8/5). 

AL.com: On Tour Of Area Hospitals, Congressman Byrne Gets Earful On Obamacare, Medicare Rates
U.S. Rep. Bradley Byrne kicked off a month-long tour of hospitals in southwest Alabama this week, getting an earful about two of their biggest concerns – Obamacare and Medicare. Hospital administrators told Byrne, R-Fairhope, that they are nervous about the impact of looming government cuts in payments to compensate for treating uninsured patients. Congress included the cuts in the Affordable Care Act under the rationale that subsidies combined with expanded Medicaid eligibility would reduce emergency room use by the uninsured. But Alabama has chosen not to expand its Medicaid program (Kirby, 8/7).