Although the contents of a budget proposal Gov. Norm Bangerter will make to the Legislature in January are largely unknown, Utah Health Department officials are drawing up a list of programs that may have to be cut or eliminated from the Medicaid program.
The Health Department was told during budget hearings in November that its budget would receive about $3 million in new monies. Now indications are the amount may be as high as $10 million. But it's still not enough to cover the cost of programs recently mandated by the federal government.Since those are required, the money may have to come from other programs, said Dr. Suzanne Dandoy, Health Department director. "We're having trouble funding everything that needs to be funded. It's a big jump from $3 million to $10 million and we're pleased about that. But there are still needs that won't cover.
"It's not a uniquely Utah problem," she said Friday to a joint meeting of Utah Issues and the Health Department. "All of the states are finding the mandates a very difficult area to fund."
She said the cuts the department may have to enact include eliminating people from programs, narrowing the scope of the services provided to participants and reducing payments for services rendered.
Medicaid is a categorical program (you have to be low-income and blind, elderly, disabled or receive public assistance to participate) that provides limited health care.
Rod Betit, director of Health Care Financing, which administers Medicaid, predicted that the state would have to find ways to cut about $3 million from its Medicaid budget. Since Utah receives $3 for every $1 in state funds spent, that would mean a $12 million cut from the program.
He predicted that the following cuts would have to be made if additional funding isn't found:
- - Because Primary Children's Medical Center has such a high Medicaid caseload, it has been reimbursed at a slightly higher rate than other Utah hospitals. That rate differential would be reduced by 2 percent.
- - Eliminate all organ transplants for adults, except cornea transplants. Six Utahns who are now saved each year by a Medicaid-funded transplant would die.
- Stop waivered case management that helps children with chronic illness and disability tie into programs and services that can effectively help them.
- Reduce the income eligibility level from $350 a month to $310 for participation in the Medically Needy program. People could still participate, but it would cost them $40 more.
- Reduce the scope of Medically Needy services. This would affect about 3,000 participants.
- Change Utah Medical Assistance Program income eligibility from $337 a month to $289. The level was raised just this year. Reducing it would eliminate 350 people from the program.
- Take 3,000 people off the Medicaid roles by eliminating the Aid to Families with Dependent Children-Medical Assistance Only option. The program provides Medicaid to people who also qualify for welfare grants but have chosen not to receive them.
- Eliminate all dental services for adults, except temporary fillings and extractions. This cut could affect 12,200 people, Betit said.
Joe Duke-Rosati of the Community Action Program said he thought the budget would be better than people anticipate. "I want to see how much money's available and where it's being put. I don't think we'll see cuts of the magnitude" being predicted.