By Charles Wolfe
The Associated Press
FRANKFORT - Medicaid, the state-federal health insurance program for the poor and disabled, figures prominently in Gov. Paul Patton's budget dilemma.
Medicaid now covers one in five Kentuckians - 869,000 in all, of whom 41,000 have become eligible in the current fiscal year.
Medicaid paid for half of the births in Kentucky in fiscal year 2002. It pays 32,000 health care providers of one kind or another. Its budget is $4 billion per year, of which 70 percent comes from the federal government. And it's getting bigger.
Medicaid seems to defy downsizing, Patton said recently. "I've been trying to cut Medicaid for seven years and it went up 63 percent," he said.
For the past year, state health officials have been snipping here and there to keep Medicaid's burgeoning costs under some tenuous control.
The state has imposed co-payments, refused to raise payments to doctors and reduced payments to pharmacists, among other things.
But at current rates, the cost of the program still would have a $216 million overrun during the fiscal year that begins July 1, according to figures from the Cabinet for Health Services.
"Now we're going to cause some real pain," Health Services Secretary Marcia Morgan said last week.
Thousands of people who have been eligible for Medicaid up to now are going to lose that eligibility. They include people in nursing homes or receiving home health services who are considered low-income but still own property and have other finances. "It's our hope homesteads will be sold and other resources will be tapped," Morgan said.
Other Medicaid recipients will have to begin paying nominal fees for an assortment of health services. Hospitals will be paid less for outpatient treatment. Adult day care services will be limited. A moratorium is being placed on new health care projects.
Elsewhere in human services, the administration is laying plans to slash an array of services, from psychiatric treatment to shelters for battered women.
"Our children and families don't go away," Viola Miller, secretary of the Cabinet for Families and Children, told the House and Senate joint budget committee. "They will be somewhere - in hospital emergency rooms, in homeless shelters."
At the same meeting, Shirley Hedges, a foster parent from Madisonville, asked legislators how they thought she and others like her would cope if they got paid less than their current $19.80 per day, which has to cover a child's care and feeding.
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