- Medicaid managed care programs grow; so do issues, By Phil Galewitz, November 12, 2010, USA Today: “After Tonya Bauserman slipped in a grocery store and hurt her right knee last July, an emergency room doctor prescribed painkillers and told her to see an orthopedic surgeon. But Bauserman, 27, who’s insured by a Medicaid managed health care plan called HealthCare USA, says she had trouble finding an orthopedist in her plan who would see her. Finally, she drove 2½ hours to Columbia from her home in a northwestern suburb here to see a physician, who fitted her for a brace and recommended physical therapy. HealthCare USA later said it wouldn’t pay for the brace. Furious, Bauserman says her experience was ‘crazy.’ But it’s not uncommon. Primary care physicians in the area say a shortage of specialists in Medicaid managed-care networks makes it difficult sometimes to refer patients…”
- Battle lines drawn over Medicaid in Texas, By Emily Ramshaw and Marilyn Serafini, November 11, 2010, New York Times: “A week after newly emboldened Republicans in the Texas Legislature floated a radical cost-saving proposal – opting out of the federal Medicaid program – health care experts, economists and think tanks are trying to determine just how serious they are, and if it would even be possible. The answer? It is complicated. But that is not stopping some conservative lawmakers in nearly a dozen other states, frantic over budget shortfalls and anticipating new costs from the federal health care overhaul, from exploring it. ‘States feel like their backs are against the wall, so this is the nuclear option for them,’ said Christie Herrera, director of the health and human services task force for the American Legislative Exchange Council, an association for conservative state lawmakers. ‘I’m hearing below-the-radar chatter from legislators around the country from states considering this option…'”
Day: November 12, 2010
Poverty in the Suburbs – Washington, DC
Amid Montgomery’s affluence, plight of suburban poor worsens in downturn, By Annie Gowen, November 12, 2010, Washington Post: “Their numbers are growing, but the suburban poor can be tough to spot amid the affluence that sometimes surrounds them. In few places is that more true than Tobytown, a tiny enclave in Potomac still occupied by the descendants of former slaves who founded it in 1875. The neighborhood off River Road, hidden from view on a woodsy stretch of Pennyfield Lock Road near the C&O Canal, is almost jarringly out of place. It nestles in the midst of great opulence – homes guarded by stone lions with lawns big enough for their own soccer fields. Tobytown’s 60 or so residents have struggled to break free of poverty for generations, and their circumstances have worsened in the recession. People have lost jobs and face more difficulty finding transportation in and out of the neighborhood, which is so remote it has no bus service. At the same, Montgomery County has cut funds for a taxi voucher program and an after-school program for kids…”