Countries cut the payments of medical care providers long before Trump’s strikes

Every day for nearly 18 years, Alessandra Fabrilo was a medical care provider for her son, in addition to being his mother.

“It is almost impossible to explain what is necessary to keep a child alive,” said Vabrilo, whose son suffered, said, “It is almost impossible to explain what is necessary to keep a child alive,” said Vabrilo, whose son suffered, said: “

Through the Medicaid program in North Carolina, Maklakoff qualifies for a large list of medical care at the family home in Chapel Hill. Fabrelo said she works with employment agencies to arrange services. I also learned to give the care of a doctor, a skilled nurse, or the therapist who is highly trained because she could not often get help.

Now, the extensive discounts to North Carolina MEDICAIID will make the finding and payment for care more difficult.

Throughout the country, the states are scrambling to close the budget deficiency and look to Medicaid, one of the largest costs 1 trillion dollars During the next decade.

North Carolina and Idahu have already announced plans to reduce medical care payments for health care providers, including hospitals, doctors and care providers.

In Michigan and Pennsylvania – the lawmakers have not yet passed the budgets this year – the spending on Medicaid is part of these discussions. in Washington State“The legislators agreed to the program on the program that will not affect who is qualified.”

Medicaid is government health insurance for low -income persons or disabilities and paying both federal dollars and the federal dollar of the program.

MEDICAID Agency in North Carolina announced that it will be called on October 1 a Minimum 3 % reduction In payment for all service providers who treat Medicaid patients. Primary care doctors face 8 % of specialized doctors, a 10 % decrease in payments, according to the Ministry of Health and Humanitarian Services in North Carolina.

Fabrilo said that her son’s dentist has already contacted that the office would not accept medical aid patients in November. Fabrello is afraid that the work of the teeth will become another qualifying service for her son, but it cannot be obtained because there is not enough service providers who accept Medicaid coverage.

She said that vocational therapy, speech, nursing care, and rest sponsorship are all difficult or impossible. In a good week, her son will get 50 hours of skilled nursing care for the 112 hours to qualify.

“When you say,” we are just cutting the prices of service providers, you are actually cutting it to all his needs. “

Shannon Dowler, the former chief medical official in North Carolina, said that the low payments for dentists and other service providers will reduce the number of service providers in the state’s Medicaid network and lead to “an immediate loss to reach care, worse results, and cause higher costs of the estuary.”

Dowler said the imminent cuts in North Carolina “do not have anything” with the new federal law that reduces the financing of medical aid.

“This looks like onions layers,” she said. “We harm ourselves in North Carolina before the game, before we need to do so.” North Carolina is expected to be alone He lost about 23 billion dollars In the Federal Medical dollar over the next decade.

More than 3 million North Caroline were registered in Medicid. The legislators in the state, who were laid off, agreed to the mini budget in July to continue financing the state programs that granted the Medicaid agency $ 319 million less than it requested. Dowler said that legislators could choose Medicaid re -financing this fiscal year.

“We all hope to change,” Deller said, adding that if it does not happen, you will see the practices of Medicaid’s coverage. “

Every year, at least 2019, MEDICAID Agency in North Carolina has requested more money than it received from the state legislature. A variety of federal resources, including funds provided to the states during the Covid-19, helped bridge the gap.

But this money has been given this year, leaving the agency with an option: canceling some of the optional parts of the program or forcing every provider that accepts the general insurance to take a wage reduction. The state mostly chose for the latter.

“It is a difficult moment for Nortaq Carolina,” said Jay Ludulam, Deputy Minister of North Carolina Midikid. The budget reduction is “the opposite direction at all for the place we want to really go, and we need to go, has been directed as a country.”

For Anita Case, which leads a small group of health clinics in North Carolina, the cuts make it difficult to care for the “most vulnerable in our society”.

Three clinics in the western Carolina state in Carolina, North Carolina, serve about 15,000 patients in and around Atulla, including many non -English -speaking tourism workers. The case said that she would consider employment, services and contracts to find places to trim them.

Idaho has about 350,000 people registered in Medicaid. This month, the state leaders there responded to the lack of a state budget of $ 80 million by reducing Medicaid salaries 4 % in all fields.

The extensive cuts sparked a violent reaction from the nursing house operators and the defense groups for patients. The leaders of Dar Nursing Company wrote in a The last opening In the Idahu state newspaper, 75 % to 100 % of financing in its facilities comes from Medicaid and will be forced by discounts to “reduce employees or accept a fewer population.”

The Ministry of Health and Social Welfare in the state of Idaho AJ Mcwhorter said the state had faced difficult options. I expected 19 % growth In the MEDICAID District this year.

Tony Lawson of the Idahu Hospital Association said that the financial pressure will be greater in about twenty small hospitals – those of 25 beds or less – and the state. Lawson, the chief of the organization’s call, said that one of the hospital leader reported that they had less than two days at hand to make salaries. Others said that they had been reported for 30 days or less.

“We hope that none of them will be closed,” Lawson said, adding that she expects the units of work, delivery and behavioral behavior, which often losing money, is the first to go because of this last discount in the country in payments. She said that many hospitals in rural areas mostly of the state closed work and delivery units last year.

Brian Sigitz, Director of State Financial Studies at the National Society for Government Budget Employees, said that Medicaid constitutes an average of 19 % of the state’s general spending, and the second is only on the kindergarten stage until 12 years.

The states generally had a strong growth in revenue in 2021 and 2022 due to economic growth, which included federal aid to stimulate the economy. The growth of revenue has slowed since then, and some states have lower income and property taxes.

Meanwhile, spending on medical aid, housing, education and disaster response has increased.

In North Carolina, Vabrilo was unable to work outside the care of her son. Fabrilo said her savings had almost exhausted, and she was on the brink of financial ruin until North Carolina began allowing parents to compensate for the duties of sponsorship. She received this income for a year. Without it, she was concerned about losing her home.

Now, if the state discounts persist, it faces a salary reduction.

Fabrilo said: “As fathers, we are indispensable to our children, and we are struggling to struggle to survive us over it.”