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This edition focuses on an update on the state fiscal crisis
and its impact on Medicaid, and 2010 AAP Child Health Advocate Award
winner, Utah State Representative Tim Cosgrove.
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STATE BUDGETS AT MIDYEAR: IMPLICATIONS OF FMAP
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As we reach the middle of July, and with most states
having concluded their regular legislative business for the remaining
calendar year, it is evident that the fiscal crisis gripping state
capitals is far from over. While the broader economy is showing signs
of stabilization, the most recent economic downturn is continuing
to depress state revenues, and state level recovery is showing
only modest improvement. Compounding matters is the ongoing debate
in Washington, DC over the extension of $24.2 billion in Federal
Medical Assistance Percentage (FMAP) funding from last year's stimulus
legislation, now stalled in the US Senate, leaving states to wonder if
they will be left without the additional funding anticipated, and in
many cases, budgeted for in the coming fiscal year.
More than half of the states accounted for the extra funds
in their budget planning for fiscal 2011, and without the additional
FMAP funds to support state Medicaid programs, states will have to make
additional program cuts, raise taxes, or find other cost saving
measures to keep their budgets balanced. One of the prime targets for
these additional cuts is in physician Medicaid payment. Over the past
year, cuts have already been made in Kansas, Michigan,
Mississippi,
North
Carolina, Oklahoma,
Virginia,
and Texas,
and others may follow suit.
Due to maintenance
of effort requirements included in the recent federal health reform
legislation, states will be disqualified from receiving additional
matching federal Medicaid funds if they roll back enrollment or
eligibility. While these requirements ensure that states will not
shortchange their commitments to state Medicaid programs, they also
leave provider payment as one of the only viable remaining funding streams
from which states will be able to draw to sustain their programs.
Paradoxically, this will likely serve to discourage physician
participation in the program - at a time when there are not only
greater demands for its services, but as states prepare for its
expansion as part of health reform.
Additional resources:
• Recent
Dallas Morning News story illustrating how cuts are already
impacting provider participation in Medicaid.
• Wall
Street Journal article examining the implications to states if FMAP
funding is not released.
• A Kaiser
Family Foundation interview with Kansas Governor Mark Parkinson.
The Division of State Government Affairs will update AAP
chapters on these issues as more information becomes available. Please
contact the AAP Division of State Government Affairs at 800.433.9016,
ext 7799 or at stgov@aap.org with
any questions that you may have about state budget cuts or the current
status of state Medicaid programs.
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2010 AAP CHILD HEALTH ADVOCATE AWARD
UTAH STATE REPRESENTATIVE TIM COSGROVE
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The AAP Committee on State Government Affairs is pleased
to announce Utah State Representative Tim Cosgrove as the recipient
of the 2010 AAP Child Health Advocate Award. Representative Cosgrove
was nominated by the AAP Utah Chapter in recognition of his advocacy
work on behalf of children in Utah.
For the past 13 years, Representative Cosgrove has served as a child
advocacy specialist at Primary Children’s Medical Center. There, he
led the development of a grassroots advocacy group, The Child
Connection, which brings together physicians and citizen advocates
working in local communities to improve the health, safety, and
well-being of children.
In 2004, Mr Cosgrove was elected to serve the 44th District of the Utah
State House of Representatives. Representative Cosgrove was
instrumental in the enactment of child passenger safety legislation
and reinstatement of open enrollment for the Children’s Health
Insurance Program, and has been a champion for graduate medical
education and school nurse program funding, child abuse prevention,
and welfare reform.
The AAP thanks Representative Cosgrove for his career-long commitment
to child health and safety issues, and the Utah chapter for
submitting his nomination. If you have any questions about the AAP
Child Health Advocate Award, please contact Jeff Hudson in the AAP
Division of State Government Affairs at jhudson@aap.org or 800/433-9016,
ext 7799.
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The Division of State Government Affairs sends this update
to the Academy's Executive Committee, Board of Directors, District
Vice-Chairs, Chapter Presidents, Chapter Vice Presidents, Chapter
Legislative Contacts, Committee on State Government Affairs, Committee on
Federal Government Affairs, Chapter Executive Directors, and other
interested AAP members and staff.
For additional state legislative information, strategy suggestions,
in-depth resources on issues of pediatric interest, and past editions of
this update, log onto the AAP Member Center and see the State Government
Affairs area at http://www.aap.org/moc/stgovaffairs/.
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2010 State Primary
Elections
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GA: July 20
OK:
July 27
KS, MI,
MO:
August 3
TN:
August 5
CO,
CT,
MN:
August 10
WA,
WY:
August 17
AK,
AZ,
FL,
VT:
August 24
DE,
MD,
MA,
NH,
NY,
RI,
WI:
September 14
HI:
September 18
LA:
October 2
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