Poor people face more health care cuts

Medical services for the poor may be in jeopardy as the state starts to look for millions in Medicaid cuts on top of the $354 million cut in the state budget.

The state legislature set an aggressive target for savings in the government insurance program for the poor and disabled, one the state Medicaid office will likely not be able to meet without a plan for more widespread reductions.

"The challenges of the Medicaid budget this time are probably more significant than we've faced before," said Lanier Cansler, secretary of the state Department of Health and Human Services.

Medicaid is a state and federal program, and the state needs federal approval before it trims or eliminates patient services or changes provider pay rates.

The Medicaid budget is $12.8 billion this year, though the federal government picks up most of the cost. The state pays about $3 billion.

The state Medicaid office won't have federal approval in time for the dozens of rate and service cuts needed to meet the state budget timetable, so Cansler has to make plans for deeper cuts, which could include paying medical providers less, and cutting or eliminating medical services.

He's asking the Medical Advisory Committee, a federally-required group, to step up its meeting schedule through October so it can offer guidance.

The committee will begin its task tomorrow.

Sen. Stan Bingham, a Davidson County Republican who helped write the DHHS budget, said legislators discussed the possibility that Cansler would have to make cuts beyond those laid out in the budget, and they were worried about it.

The Senate version of the budget specified optional services that would go, but the final decision was to put the onus on Cansler to make more cuts, if needed.

Bingham said he thought it best to give Cansler the authority because he has more knowledge and advisers to help him with specifics. "We kind of grieved over this, trying to do as little damage as we could," Bingham said.