We have been reading these tea leaves for awhile. The Medicaid noose is beginning to tighten and the picture is not pretty. Thirteen states are moving to cut Medicaid by reducing benefits, paying health providers less or tightening eligibility, even as the federal government prepares to expand the insurance program for the poor to as many as 17 million more people.
States routinely trim the program as tough times drive up enrollment and costs. But the latest reductions – which follow more extensive cuts last year -- threaten to limit access to care for some of its 60 million recipients.
"With more people on Medicaid, states will have to continue to ratchet down payments and limit services," says Nina Owcharenko, director of the center for health policy studies at the conservative Heritage Foundation.
Some worry the cuts to doctors and hospitals could make it more difficult to expand the state-federal program in 2014, as called for by the federal health law. "Some providers may be unwilling to accept new Medicaid patients," says former New York Medicaid Director Deborah Bachrach.