States Cutting Medicaid Coverage for Hospital Stays, Other Care

While the weak economy pushes more people into Medicaid, the government health insurance program for the poor and disabled, a growing number of financially squeezed states are moving to cut back the coverage.

As a story by Kaiser Health News and USA Today points out, one focus of the cost-cutters has been hospital stays.

Arizona, which last year stopped coverage of certain transplants for several months, hopes to start limiting adult Medicaid recipients to 25 days of hospital coverage a year beginning the end of this month. In April, Hawaii plans to cut its Medicaid hospital coverage to 10 days a year, the fewest of any state.

Both efforts await federal approval — Medicaid is operated with both state and federal money — but Arizona and Hawaii officials expect to get the green light because several other states already restrict hospital coverage. They include Alabama (a 16-day limit), Massachusetts (20 days), Arkansas (24 days), Mississippi (30 days) and Florida (45 days).

Critics say the moves will reduce or delay care for some people who can’t afford it, while also leading to higher charges for privately insured patients and imposing more costs on hospitals.

While the hospital stay limits should affect only a small percentage of Medicaid patients, they often are the sickest. About 4,000 of Arizona’s 1.3 million Medicaid recipients were in hospitals for more than 25 days from July, 2009 to July, 2010.

However, a spokesman for the Arizona Hospital and Healthcare Association, an industry group, said that medical centers in the state won’t turn away patients who need to be there. “Hospitals will get stuck with the bill,” he said.

The federal health care overhaul legislation passed last year requires states to maintain Medicaid eligibility and enrollment standards until 2014, when the program is to begin covering millions of uninsured Americans. Still, this year many states, to hold down their costs, have reduced benefits considered optional by the federal government.

Just this month, North Carolina ended vision coverage for adults on Medicaid and Nebraska began limiting the number of adult diapers it pays for to 180 a month. In July, Colorado stopped covering circumcisions and Tennessee ended coverage of adult acne medicine.

source