NCPA - National Center for Policy Analysis

Optional Medicaid Benefits Face State Cuts

October 31, 2011

States are using a variety of strategies to control rising Medicaid costs as they look ahead to a massive expansion of the state-federal health insurance program for the poor beginning in 2014.  The pressure placed on states to fund Medicaid is threefold, says USA Today.

  • First, almost all states are already implementing significant measures to cut spending within their budgets in response to recession-depressed revenues.
  • Second, the economic downturn is creating a larger segment of the population that is jobless and is forced to enroll in Medicaid for medical needs.
  • Third, rising costs already make providing health care significantly more expensive than it was in years past.

Facing these challenges, states across the country are implementing their own methods of cost-cutting within the Medicaid program.

  • Nebraska has begun limiting how many adult diapers it pays for to 180 a month.
  • In July, Colorado stopped covering circumcisions.
  • Tennessee has ended coverage for adult acne medicine.
  • California plans to eliminate adult day care coverage and limit Medicaid patients to seven doctor visits a year.
  • North Carolina stopped covering regular eye examinations and eye glasses for adults.
  • Connecticut cut the number of dental exams covered for adults from twice a year to once a year.
  • Pennsylvania began requiring adult Medicaid patients to get state permission for crowns and certain other dental procedures.

Regulations from the federal government limit the ability of states to cut essential services, yet this does not preclude cuts to portions of Medicaid that are considered optional.  With 16 million more people set to enter the program in 2014 with the initiation of the new federal health law, additional cuts are likely to take place.

Source: Phil Galewitz, "Optional Medicaid Benefits Face State Cuts," USA Today, October 24, 2011.

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