Medicaid

Liberal firebrand Bernie Sanders (I-Vt.) released a report Wednesday that concludes America faces a "dental crisis" and urgently needs to boost the number of dentists and dental assistants while expanding Medicaid's dental benefit to cover adults.

According to the report: 

• more than 47 million people live in places where it is difficult to access dental care;

• more than 130 million Americans do not have dental insurance;

• about 17 million low-income children see a dentist less than once a year; and 

• only 45 percent of Americans age 2 and older saw a dental provider in the past 12 months.

A federal judge in California has temporarily blocked a 10 percent cut to California's Medicaid rates that the Obama administration approved in October.

California adopted a budget slashing the payment rates for doctors, pharmacists and other healthcare providers last spring in an effort to close the state's $26.6 billion budget hole, the largest in the nation. But Judge Christina Snyder concluded in a 25-page tentative order Monday that the cuts violate federal law because they put Medicaid beneficiaries' access to care in jeopardy; a final ruling enjoining the cuts is expected shortly.

A wide array of California healthcare groups immediately applauded the judge's decision.

"The court's tentative ruling is encouraging to those of us practicing medicine," James Hay, president of the California Medical Association, said in a statement. "The state's repeated attempt to slash Medi-Cal reimbursement rates is a short-sighted solution that balances the budget on the backs of the poorest and most vulnerable Californians. Rather, we need to be addressing long-term solutions relative to the cost of healthcare."

Healthcare law supporters say the states made significant missteps in their brief on Medicaid expansion filed with the Supreme Court.

The federal government on Tuesday extended a Medicaid waiver in Massachusetts, which was first implemented as part of then-Gov. Mitt Romney's healthcare overhaul.

The waiver will now run through 2014. It is focused primarily on efforts to improve the cost and quality of the Medicaid program and better coordinate care. The waiver provides incentives for hospitals to improve their efforts to integrate their services.

Earlier this year, the Centers for Medicare and Medicaid Services approved a controversial Medicaid waiver for California, which allowed the state to make massive cuts in its payments to doctors. CMS also approved a high-profile Medicaid waiver for Texas, while denying a separate proposal to cut off Medicaid funding to Planned Parenthood.

The Republican senator is taking hits from all sides on a children's healthcare program long touted as his legislative legacy.

Children are much more likely to be uninsured in some states than others, says a new report from the Georgetown Center for Children and Families, with the West and South lagging behind states in the Northeast and Midwest. 

As of 2010, Massachusetts remained far below the national average of 8 percent, with just 1.7 percent of its children uninsured. Nevada, by contrast, lagged behind everyone else, with 17.4 percent of children uninsured. 

Overall, the report concludes, the trend has been positive: The national rate has fallen from 9.3 percent in 2008, while 34 states saw a statistically significant decrease in the rate of uninsured children. This comes as the uninsured rate for adults has grown worse during the recession, from 19.3 percent in 2008 to 21.4 percent in 2010.

The Senate easily cleared a House Republican bill to repeal the 3 percent withholding tax on government contractors.

California requested hundreds of millions of dollars in cuts to Medicaid to shore up its dismal finances.

Medicaid’s burden on the states is swelling rapidly, leaving them scrambling for ways to make cuts.

States are heading into 2012 saddled from all sides with more responsibility for Medicaid, according to a new report from the Kaiser Family Foundation. And states are facing that strain just as the congressional supercommittee is looking to further reduce federal health spending, potentially including Medicaid cuts that could shift even more costs to the states.

The biggest pressure on state spending comes from the federal government. The stimulus provided a temporary increase in the federal government’s share of Medicaid funding, but that boost expired this year. States are expected to spend 28 percent more on Medicaid next year to make up for the lost federal funding, according to the Kaiser report.

It’s “by far the largest increase” in state spending in the history of Medicaid, said Vern Smith, a principal at Health Management Associates.

Passage was made even easier after the Obama administration announced it supported the bill.