Aging

"The state's effort to rein in Medicaid costs has created deep friction between small businesses that deliver behavioral-health services to Medicaid patients and a new contractor hired to manage them. Service providers across Idaho have raised complaints over the last 11 months that the contractor, Optum Idaho, a unit of United Behavioral Health, has created red tape and cut services needed by at-risk patients. Now providers in the Treasure Valley have raised another complaint: Optum isn't paying them promptly, putting their businesses' survival and employees' jobs at risk. Optum says it has fixed a glitch that resulted in tiny claims payments to the companies, which provide counseling and other behavioral health services to low-income and disabled adults and children on Medicaid."

"Many low-income Californians who became eligible for Medi-Cal, the state's version of Medicaid, under the Affordable Care Act were happy to get free health care. But for those 55 and older, it came with a booby trap. When they die, the state will attempt to recover anything it spent on their health care from their estates, including their home. This so-called estate recovery program has been a feature of Medi-Cal for many years, but the act allowed California to expand Medi-Cal coverage to a much larger group of people, including those with low incomes but unlimited assets. Some who are 55-plus are deeply concerned about asset recovery, because the rules are confusing and it's hard to know how much of their estate is at risk."

"Utah's top health official said Thursday he is optimistic about the prospects of gaining federal approval for a state-tailored private expansion of Medicaid, but some strides still need to be made. David Patton, director of the Utah Department of Health, met privately with elected officials and other community leaders during a visit to Washington County, part of a campaign to gather support for Gov. Gary Herbert's Healthy Utah Plan, proposed as a compromised alternative to a full Medicaid expansion under the Obama Administration's Affordable Care Act."

"Fewer low-income children and adults are filing for federal disability benefits in Arkansas this year, according to the state's Social Security disability determination agency. Physically or mentally disabled people up to age 64 who have little or no Social Security trust funds are eligible for Supplemental Security Income, SSI. Those approved for the federal program, which is funded through general tax revenue, are automatically enrolled in Medicaid. The 19 percent drop - from 17,497 first-time SSI applications to 14,160 applications from Oct. 1 to Tuesday - is the largest seen by the agency since 2006."

"Buckling from more than $140 million in losses racked up since the start of the year, the companies that contract with the state to insure Medicaid patients are pressing the Patrick administration to boost health payments for low-income residents. The health insurers' losses are tied to a high-cost hepatitis C drug approved by federal regulators last December and a surge of nearly 190,000 new members, many with expensive medical needs, assigned by MassHealth, the state Medicaid program. State funding budgeted for the current year falls far short of covering these costs, the insurers say."

"The developer behind a project that replaced 127 housing units occupied mostly by low-income seniors with luxury apartments in downtown Detroit said the experience could be used to aid future transitions. More than 100 low-income seniors, many with disabilities, were given in March 2013 one year to vacate 1214 Griswold, as Broder & Sachse Real Estate Services moved forward on plans to convert the Albert Kahn-designed building into luxury apartments known as The Albert."

"Health insurers that cover low-income residents are reacting in different ways to financial struggles brought on by the health care overhaul and expensive drugs, with some turning to new markets while others petition the state for help. Many insurers that cover Medicaid populations, and those that offer the fee-per-member model for Medicaid clients known as Managed Medicaid,' have seen drastic operating losses in the last several months."

"New Jersey Gov. Chris Christie's decision to expand Medicaid under Obamacare puts him alone among Republican governors vying for the 2016 presidential nomination, and could come back to haunt him among primary voters. Some of his potential rivals who are also governors have sought ways to leverage federal money, and others have spurned the Medicaid expansion altogether. Mr. Christie, however, embraced President Obama's vision of expanding the federal-state health care program for the poor to those with incomes up to 138 percent of the poverty level."

"Kentucky showed one of the largest drops in the percentage of uninsured adults since expanded Medicaid went into effect last January, according to a recent Gallup-Healthways Well-Being Index poll. The latest state figures show that 512,000 Kentuckians were newly enrolled in health coverage, with nearly three-fourths of them qualifying under Medicaid expansion that happened as part of the Affordable Care Act. One-fourth purchased private insurance through the state-based marketplace, kynect."