States are cutting Medicaid provider payments long before Trump cuts hit : Shots

Every day for almost 18 years, Alessandra Fabrello was a medical guardian for her son, as well as his mother.

“It is almost impossible to explain what is needed to keep the child alive, who should be dead,” said Fabrello, whose son, Isador Maclacoff, experienced a rare condition of the brain, called acute necrotic encephalopathy at 9 months.

Thanks to the Medicaid program in North Carolin, Maklakoff is entitled to most of the medical care in the family of the family in Chapel -Hill. Fabrello said that she works with personnel agencies to organize services. She also learned to provide assistance, usually performed by a doctor qualified by a nurse or a highly qualified therapist, because she often cannot get help.

Now, wide abbreviations in North Carolin Medicaid make it difficult to search and pay for medical care. Medicaid is state medical insurance for people with low incomes or disabled people, and state and federal dollars pay for the program.

Throughout the country, the states are trying to close the budget deficit and look after Medicaid, as a rule, one of the largest states-even costs before the legislation of President Donald Trump for tax and expenses reduces federal expenses for Medicaid approximately 1 trillion dollars Over the next decade.

North Carolina and Idaho have already announced plans to reduce Medicaid payments for medical suppliers, including hospitals, doctors and persons who care.

In Michigan and Pennsylvania, where lawmakers have not yet accepted budgets this year, the costs of Medicaid are part of these debates. IN WashingtonLegislators approved a reduction in a program that will not affect who has the right, said Hayden Makli, a representative of the State Administration of Financial Administration.

NC Cuts continues

The Medicaid agency in North Carolina established Minimum decrease by 3% According to the Department of Health and Social Services of North Carolina, in payment for all suppliers who treat patients with Medicaid on October 1. Primary medical care doctors are faced with 8% and specialized doctors by 10% of payments.

Fabrello said that her son’s dentist had already called to say that the office would not accept patients with Medicaid, which will appear in November. Fabrello is afraid of dental work will become another service for which her son is qualified, but cannot get it, because there are not enough suppliers who accept the Medicaid coating.

According to her, professional therapy, care for patients and breaks are difficult or impossible to get. Over a good week, her son will receive 50 hours of qualified care for sick care for 112 hours, to which he has the right.

“When you say:“ We simply reduce the bets of suppliers, ”you actually reduce it for all his needs,” Fabrello said.

Shannon Dawler, a former Medicaid Medical Director in North Carolin, said that a decrease in payments for dentists and other suppliers would reduce the number of suppliers on the Medicaid network in the state and will lead to “immediate loss of access to medical care, worse results and will lead to higher costs for subsequent losses”.

According to Dawler, the reduction in North Carolin “has nothing to do” with the new federal law, which reduces financing Medicaid.

“It looks like layers of onion,” she said. “We are harmful to ourselves in North Carolin, ahead of the game, long before we need it.” It is predicted that only North Carolina To lose about 23 billion dollars In federal dollars Medicaid over the next decade.

More than 3 million northern Carolines are enrolled in Medicaid. The state lawmakers in dead ends agreed to the mini -budget in July to continue financing state programs that gave Medicaid to 319 million dollars less than he asked. According to Douler, legislators can restore financing for Medicaid in this financial year.

“We all hope that this will change,” said Dowler, adding that if this is not so: you will see that practice drops the coating of Medicaid members. ”

Complex options

Each year, at least since 2019, the Medicaid agency in North Carolin asked for more money than it received from the state legislative body. Various federal resources, including the money provided to the States during the Covid-19 pandemic, helped to overcome the gap.

But these funds disappeared this year, leaving the agency with a choice: to exclude some additional parts of the program or force each supplier who accepts state insurance to reduce salaries. The state chose mainly for the latter.

“This is a difficult moment for North Carolina,” said Jay Lyudlam, deputy secretary of Medicaid in North Carolin. Permission in the budget is “an absolutely opposite direction of where we really want to go, we need to go, goes as a state.”

For Anita, the case, which leads a small group of medical clinics in North Carolin, the abbreviations make it difficult to take care of “the most vulnerable in our community.”

Three clinics in public public health services of Western Northern Carolina serve about 15,000 patients in Ashville and its environs, including many non -English tourist workers. Case said that she would consider staff, services and contracts to find places for trim.

Hospitals at risk of closing in Aidaho

About 350,000 people are registered in Aidahoid in Medicaid. This month, state leaders reacted to the state budget in the amount of 80 million US dollars, reducing Medicaid payment rates 4% in all directionsField

Wide contractions caused a negative reaction from the operators of the nursing home and patient protection groups. The leaders of one house in the house have written in Recent article In the state newspaper of Aidaho, that from 75 to 100% of financing at their institutions comes from Medicaid, and reductions will force them to “reduce personnel or accept less residents.”

The representative of the Ministry of Health and Social Security of Aj Mcwhort said that the state was faced with a tough choice. This is predicted 19% growth In Medicaid Proting this year.

Tony Lawson from the Audaho Hospital Association said that the financial stress would be the largest in two dozen small hospitals – with 25 or less beds – which dotting the staff. Lawson, the main lawyer of the organization, said that one leader’s leader said that they had less than two days of money to receive wages. Others reported 30 cash days or less, she said.

“We hope that none of them will close,” Lawson said, adding that she expects that the employment units, as well as the behavioral health that often lose money, will be the first to leave this last reduction in state payments. According to her, several hospitals mainly in the rural areas of the state closed their units for labor and delivery.

Most of the state budgets

According to Brian Sigrits, director of state state financial research for the National Association of State Budget Employees of the State Fund, on average Medicaid is an average of 19% of the expenses for general state funds, second only to expenses on K-12.

The states, as a rule, had a strong increase in income in 2021 and 2022 from economic growth, which included federal assistance to stimulate the economy. Since then, the growth of revenue has slowed down, and some states have reduced income and property taxes.

Meanwhile, the costs of Medicaid, housing, education and response to natural disasters have increased, Sigrithz said.

In North Carolina, Fabrello could not work out of caring for her son. According to Fabrello, her savings were practically exhausted, and she was on the verge of financial destruction, until the state began to allow her parents to compensate for care. She received this income for about a year, she said. Without this, she was worried about losing her house.

Now, with a reduction in conditions, she is faced with a reduction in salary.

“As parents, we are an indispensable life for our children, and we are struggling to fight for our own survival, not,” said Fabrello.

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