Cash-strapped States rethink how much coverage of health care, they can afford to provide their neediest residents. Governor of New Jersey Chris Christie wants to cut the $ 500 million in Medicaid expenses - in part by freezing more of 20,000 residents of the State of the program. Critics say that cuts would be detrimental to those who can do less.
For years, in New Jersey expanded the coverage of health care for low-income residents - people like Deborah Shupenko of Passaic, New Jersey. But last month, after 10 years of health insurance financed by the State, Shupenko received a letter by mail.
"It is expected that my last day of the family of New Jersey coverage will be July 31, 2011," she said.
Shupenko says that she had no idea this was happening.
"I was shocked", she said. "I was floored.
Shupenko suffers many medical disorders, including asthma and osteoarthritis. She is unemployed. At 56, she is too young for Medicare, but too sick to find affordable insurance on its own.
"The worst case scenario is that something catastrophic happens to me, that I could lose everything," she said. "A Bill large hospital, or a large medical or surgical bill, I could be out in the street.". I could be homeless. »
"Costs of ' Out Of Control"
Shupenko is one of some 1 400 New Jersey residents who lose their coverage financed by the State of this year. And Governor Christie, a rising star in the Republican party, said New Jersey has no choice but to make even deeper cuts in health spending.
"The growth of the Medicaid is out of control", he said in February, his speech on the budget. "We manage better." Medicaid spending will grow by nearly one billion dollars last year. This is the definition of a control program off. »
A few weeks ago the Christie administration released more details on how he intends to manage health expenditures. The part the most controversial of the New Jersey plan would block access to Medicaid for approximately 23 000 people - the next year and he could do so primarily by the exclusion of any adult who made more than 6 000 $ a year.
Democrats - including State Senator Joe Vitale - are promising to fight against the cuts.
"We have seen a backyard of stable March over the past two years," said Vitale. "Huge jumps by considerably reducing access to affordable health care for hundreds of thousands of New Jersey." It is wrong. »
A modest proposal?
The Federal Government is expected to go look for the tab for a major expansion of Medicaid, but not until 2014. In the meantime, States have to apply for a special Washington waiver if they want to make major changes to Medicaid eligibility. Compared to other States - including Arizona - changes in New Jersey is to research are modest, says Jeffrey Brenner, Director of the Camden Coalition on health care providers.
"To the credit of Governor Christie, he chose to innovate and to try to Medicaid to provide better care at lower cost," said Brenner. "If we are to put in perspective."
Even with the proposed reductions, Brenner, said program Medicaid in New Jersey would always enter approximately one million people. But it is little comfort to Crystal Snedden with New Jersey citizen Action. It calls into question the Christie administration proposed Medicaid cuts will really be saving as much money as announced.
"On paper, according to their budget, it will look as they have saved money, but we all know that in the long term, this will we cost more money in charity care and more money in a sicker population," she said.
New Jersey exemption application is not formally due until the end of the month, but opponents are already urging the administration Obama to dismiss key parts.
Health carecloseMorning Edition-Earlier this year, a Florida judge struck down large parts of the right to health of President Obama.
The share of compensation of States consumes 22% of the budget of the average state.
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