Arizona's Kids Care program sees enrollment numbers plummet

Arizona's KidsCare program, a state version of the federally sponsored Children's Health Insurance Program, has seen enrollment numbers in August drop to the lowest level since 1999. Enrollment went from a peak of 66,317 in May 2008 to 16,662 in August, while demand for the program is strong. In July, more than 100,000 children were on the waiting list for KidsCare.

More than half of the decline has come since Jan. 1, 2010, when the Arizona Health Care Cost Containment System froze enrollment in KidsCare in response to a lack of funding. State lawmakers have repeatedly cut funding for KidsCare in recent years, from more than $100 million in fiscal 2009 to $36 million this year, fiscal 2012. KidsCare is a premium-based health-care program that covers children whose family income is between one and two times the poverty level, currently $22,350 per year for a family of four. Below that level, a family qualifies for Medicaid.

The freeze raised concerns at the federal Centers for Medicare and Medicaid Services about Arizona's ability to retain children in the program. Since the freeze was enacted, nearly 30,000 children have been dropped. State officials attribute most of the decline to long-standing factors that would have occurred with or without an enrollment freeze, including some families qualifying for Medicaid and others failing to renew their eligibility or pay their premiums

Colorado scaling back Medicaid program after understimating cost

The State of Colorado is scaling back its Medicaid program after extending it to cover poor adults without children two years ago. The state has now found that the number of people eligible for coverage is close to three times as high and the cost of insuring them is almost nine times the first estimated numbers. Original projections were for an additional 49,200 to join the program at a cost of $197.4 million per year, with annual cost per person to be $292 per month. New estimates show that the costs may be $900 per month per individual. The Department of Health Care and Financing will plan to cap the number of people served by the program to just 10,000, with an estimated cost of $190 million in two years.

Arkansas will target nine areas for Medicaid reform

Arkansas officials have selected nine ares that they want to focus on in changing how Medicaid pays for services. The state was provided approval to move forward with plans to switch from a fee-for-service model that Medicaid uses to paying for partnerships of local providers for episodes of care instead of individual treatment. The areas included: pregnancy and neonatal care, ADHD, type 2 diabetes, back pain, cardiovascular disease, upper respiratory infections, developmental disabilities, long term care and prevention. The Arkansas Medicaid program still faces a shortfall of at least $60 million in the budget that begins July, 2012.

Illinois' new managed care program for disabled patients

The Chicago Tribune ran an article about the issues with Illinois' new program of HMO-style care for people with serious disabilities. Many doctors and hospitals are refusing to join the new Medicaid program, which will require patients to break current relationships and find new doctors who will take their coverage. Almost 40,000 adults with disabilities and Medicaid coverage living in suburban Cook, DuPage, Kane, Will, Kankakee and Lake counties are being affected. Those in Chicago are curently excluded but may be included if the pilot program succeeds. The two private HMO- style plans available include Aetna Better Health and the IlliniCare Health Plan.

Cuts in Medicaid payments leave few treatment options for patients

A recent article in the New York Times, describes how some Medicaid patients are finding it difficult to seek treatment for themselves or their children as fewer medical professionals are taking patients covered by the insurance. With the new health law, there will be a temporary two-year increase in Medicaid payments for some primary care services, but not for specialists.

This leaves mothers like Ana Smith in a difficult space as she has found it difficult finding a mental health professional who will take Medicaid to provide care for her young son, Draven. It also has made it difficult for another woman, Nicole Dardeau, who needs surgery to repair three herniated disks in her neck. Unfortunately, Dardeau has not been successful in finding a surgeon who will take her on as a Medicaid patient.

States scrambling to address Medicaid costs due to reduction in federal funding

A recent article on CNNMoney discusses how states are bracing for an impending cut in federal funding for Medicaid. Due to the American Recovery & Reinvestment Act, states received an average of $2.68 for every dollar they spent on Medicaid. This was up from the original funding level of $1.61, according to the figures provided by the Council of State Governments. Federal funding for the program is decreasing incrementally until July 1st, when funding will reach pre-stimulus levels.

With current enrollment rates at nearly 49 million or almost 1 in 6 people, states are looking to address the shortfall by enrolling program participants into managed care programs, eliminating or charging for certain services and slashing rates to providers.

Governors Get Advice for Saving on Medicaid

According to a New York Times article, the Obama administration told governors on Thursday how they can save money on their Medicaid programs by selectively and judiciously reducing benefits, attacking fraud and curbing use of expensive prescriptions.

Ariz. governor signs bill seeking Medicaid waiver

According to a recent article on MSNBC, Arizona governor Jan Brewer has signed an emergency bill allowing the state to seek a federal waiver to temporarily remove nearly 300,000 people from its Medicaid roles in the first such request by a state. If the waiver is granted by the federal government, the state expects to save $541.5 million.