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Sunday, February 21, 2010

Virginia, Nevada, Louisiana, Arkansas Continue Medicaid Cut Struggles

Another set of massive budget cuts by the House

Another set of massive budget cuts were proposed today, this time by the House of Delegates to close Virginia’s $4 billion shortfall.

And a lot of it will sound familiar.

The reason: the House plan is largely in line with the cuts proposed by Governor Bob McDonnell.

The major differences are:

The house plan rejects McDonnell’s suggestion of 10 furlough days over two years for most state workers, it spares further cuts to higher ed, it kills a proposed out-of-pocket employee retirement contribution, and it provides a 2011 Christmas bonus.

For more, see

Nevada in Budget Squeeze

Nevada's $887 million deficit is puny compared with California's $20 billion hole.

But in a state that operates one of the leanest budgets in the nation, that amounts to a 22% shortfall, a gap that has some worried that the state might fall further behind in such areas as education and health care, where it already lags behind other states. Others sense an opening to chart a new course in small government.

"We are working on solutions to turn this recession into an opportunity to reinvent our state's government," Republican Gov. Jim Gibbons said in an emergency State of the State address this month. "We may never have an opportunity like this again," he said. Mr. Gibbons faces a tough primary battle this year and has had low approval ratings.

For more, see

La. budget cuts outlined

Mid-article: Many agencies still will have to make do with less money in the upcoming budget year.

In health care:

• The more than $6 billion Medicaid program would get $350 million less than what was initially authorized in the current fiscal year.

The reduction translates into an average 3 percent cut in the reimbursement that doctors, hospitals and other Medicaid providers receive for treating the poor. The practical effect is that Medicaid program enrollees may have a tougher time finding someone to care for them.

State Health Secretary Alan Levine said he has not decided yet how to distribute the rate cuts. Some providers may get a larger percentage cut than others.

• In mental health services, the Jindal administration replaced only $30.9 million of a $42.9 million reduction in federal funding.

Levine said the administration wants to save money by caring for more of the mentally ill in the community rather than in institutions. He said institutions are more expensive than contracting for private beds in patients’ communities.

The state operates mental health institutions in Pineville, Jackson and Mandeville.

Levine characterized the shift as a reform rather than a reduction — a shift away from locking people in a mental hospital when they may not need that level of treatment.

However, the closure of beds in state institutions likely will mean a loss of jobs if workers cannot find employment with a private company or simply cannot relocate.

Levine said he is trying to prevent the reduction in federal money from causing a reduction in mental health services.

“Let’s catch our breath. Let’s try to make structural changes,” he said.

For more, see:

Arkansas lawmakers fret over Medicaid budget cuts

Arkansas lawmakers on Tuesday told the state's Human Services chief they want more influence over how the state will reduce the cost of Medicaid programs by $400 million.

Arkansas Department of Human Services Director John Selig told lawmakers the department plans to keep next year's budget for the program at the same level as this year. But Selig says that means cutting $400 million in the program because of increasing costs and more clients.

For more, see:


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