Growing pressure on Medicaid programmes

Medicaid programs could face a revenue crunch that hurts programs and provider reimbursement in fiscal 2011 after federal stimulus money dries up, said a survey released Wednesday.

The state-administered programs saw bigger-than-expected jumps in enrollment and spending during fiscal 2009, but money from the American Recovery and Reinvestment Act helped soften that burden, according to a study from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.

Medicaid is a state-federal program that covers health care for the needy, the elderly and people with disabilities.

The federal government will provide about $87 billion to states through the stimulus funding, but that ends Dec. 31, 2010, or in the middle of most states’ 2011 fiscal year. Medicaid programs then may have to consider “previously unthinkable eligibility and benefit reductions,” according to the study.

New York, for instance, may consider cuts for its home care or personal care services, which could push patients into even more expensive nursing home and institutionalized care, said state Medicaid director Deborah Bachrach during a Wednesday afternoon teleconference.

Nevada expects a $240 million revenue shortfall when the federal funding ends, and it may consider changes to program eligibility, said Charles Duarte of the state’s Department of Health and Human Services.

Duarte said his state also may have to cut reimbursement to providers, a move that could lead to fewer doctors accepting Medicaid.

The recession helped drive Medicaid enrollment up 5.4 percent on average in fiscal 2009, the highest rate of increase in six years, the study said. Meanwhile, spending growth on the programs averaged nearly 8 percent, the highest rate in five years.

Both increases exceeded expectations.

A total of 29 states said they would have cut eligibility without the stimulus help, and 36 said the money helped them avoid benefits cuts, the survey said.

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