States Consider Cuts To Health Care Programs As Lawmakers Work To Address Budget Deficits, According To Associated Press Review

Main Category: Public Health
Also Included In: Pediatrics / Children's Health;  Seniors / Aging;  Health Insurance / Medical Insurance
Article Date: 19 Mar 2008 - 11:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

Nearly one-third of state legislatures have approved or are considering cuts to health care programs for low-income children, the elderly, people with disabilities and others to address state budget deficits, according to an Associated Press analysis of all 50 states, the AP/Houston Chronicle reports. According to the AP/Chronicle, nearly two dozen states are considering cuts and taxes to close shortfalls totaling more than $34 billion, and health care "is a choice target" because it is one of the largest state expenditures. In addition, more than 10 million people could lose dental care, access to specialists, brand-name prescription drugs or other benefits, while about 20 million could be affected by further cuts to physician payments. Safety net programs for the elderly, unemployed and people with disabilities also face cuts, "even as the demand for those services is on the rise," according to the analysis.

Diane Rowland, Kaiser Family Foundation executive vice president and executive director of the Foundation's Commission on Medicaid and the Uninsured, said the current economic downturn could be especially difficult because states have not had time since the last downturn to restore previous cuts. She said states have already implemented changes to make programs "more cost-effective," adding, "Now, the only place to cut is at the core."

Cindy Mann, executive director of the Center for Children and Families at Georgetown University, said, "We're at the edge. If the same economic news continues, we're going to see cuts as deep as in the last recession, or worse," adding, "The juxtaposition is that every presidential candidate will now tell you that addressing health care coverage is first and foremost on people's minds. But the first line of defense has to be not letting us go backwards."

State Proposals
According to the analysis, several states are considering tax increases to offset deficits, but many lawmakers "fear such actions would only further stress the economy." Instead, states are looking to increase revenue by increasing lottery ticket sales, promoting gambling at American Indian casinos and increasing taxes on cigarettes and alcohol, although such actions "disproportionately hit the pocketbooks of the same poor and working-class that would be hurt by the spending cuts," according to the AP/Chronicle.

Meanwhile, "governors and lawmakers confront the worst deficits they've faced in a decade or more" by cutting health care and other programs, the AP/Chronicle reports. For example, California lawmakers looking to close a deficit once projected at $16 billion through June 2009 have cut more than $1 billion in physicians' payments for state health care programs, the AP/Chronicle reports. Lawmakers have authorized billions of dollars in bond sales to cut the projected deficit in half. California Gov. Arnold Schwarzenegger (R) also has proposed cutting dental care for three million adult Medicaid beneficiaries, as well as benefits such as foot checkups for diabetes patients that can detect infections to prevent amputations.

New York, which faces a $4.1 billion shortfall, could see state health programs cut by nearly $1 billion. Arizona's fiscal year 2009 budget proposal includes cutting primary care funding for community clinics by one-third, or by about 41,000 patient visits per year. In South Carolina, 70,000 low-income children could be denied regular checkups. The Ohio Department of Job & Family Services also faces cuts, while in Rhode Island, 10% of elderly patients eligible for nursing home care might have to rely on less-costly visiting nurses or family members for care (Davis, AP/Houston Chronicle, 3/18).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.