State legislatures taking aim at Medicaid costs

Plans would cut benefits, threaten health insurance


WASHINGTON - Millions of low-income Americans would face the loss of health insurance or sharp cuts in benefits, such as coverage for prescription drugs and dental care, under proposals moving through state legislatures across the country.

State officials and health policy experts say the cuts will increase the number of uninsured, threaten recent progress in covering children, and impose severe strains on hospitals, doctors and nursing homes.

But those officials, confronting a third straight year of fiscal crisis, say they have no choice but to control Medicaid, the fast-growing program that provides health insurance for 50 million people.

The cost of Medicaid has increased 25 percent in two years and more than 50 percent since 1997.

Many state officials are pleading for federal help as they face an array of painful trade-offs, often pitting the needs of impoverished elderly people for prescription drugs and long-term care against those of low-income families seeking basic health coverage.

The issue is roiling state legislatures. Almost every state has made or is planning cuts in benefits, eligibility or payments to health care providers, according to the National Conference of State Legislatures.

The Center on Budget and Policy Priorities, a liberal research and advocacy group, estimated last month that as many as 1.7 million Americans could lose coverage altogether under proposals advanced by governors or adopted by state legislative committees this year.

In response to the turmoil in the states, moderate Republicans on Capitol Hill have joined Democrats in seeking legislation that would provide additional federal aid for Medicaid, which is financed by the federal government and the states.

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