Break­ing the sys­tem: Bud­get bat­tles gut health­care for most vul­ner­a­ble

Modern Healthcare - - NEWS - By Shan­non Much­more

Even as the White House touts the Af­ford­able Care Act’s suc­cess­ful cov­er­age of nearly 20 mil­lion peo­ple, res­i­dents across the country are strug­gling to ac­cess and af­ford health­care and so­cial ser­vice pro­grams.

State leg­is­la­tures are see­ing shrink­ing rev­enue be­cause of tax cuts and low en­ergy prices. North Dakota and Texas, which rely on oil tax rev­enue, are fac­ing huge bud­get short­falls.

Jesse Cross-Call, a pol­icy an­a­lyst for the non­par­ti­san Cen­ter on Bud­get and Pol­icy Pri­or­i­ties, said Med­i­caid, a large part of most state bud­gets, is one of the first places to make cuts. But Med­i­caid is a blunt in­stru­ment, he said.

Now, af­ter years of threat­en­ing to do so, health and so­cial ser­vice pro­grams are cut­ting ser­vices or fold­ing out­right. Med­i­caid pro­grams are see­ing month­s­long de­lays in ap­prov­ing ben­e­fi­cia­ries.

Doc­tors in Ok­la­homa will see cuts to Med­i­caid provider rates in June. Kansas res­i­dents must wait months for Med­i­caid ap­proval. Con­necti­cut has sus­pended about $140 mil­lion in pay­ments to acute-care hos­pi­tals. The state hospi­tal as­so­ci­a­tion said the move is “break­ing the health­care sys­tem.”

Some of the states af­fected al­ready rank in the bot­tom half for over­all health, with Ok­la­homa and Louisiana among the worst five states, ac­cord­ing to Amer­ica’s Health Rank­ings. So how is this play­ing out, where and why?

Protesters rally in sup­port of law­mak­ers end­ing the state bud­get im­passe at the Illi­nois state Capi­tol in Spring­field.

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