20032003 State Budget CrisisState Budget Crisis

Eli BriggsEli BriggsPolicy & State Affairs ManagerPolicy & State Affairs Manager

National Rural Health AssociationNational Rural Health Association

National Picture•31 states cut spending 14 states: across the board cuts 1.5 – 15%

•23 states reduced workforce

•13 states tapped rainy-day funds•17 states raised taxes more than 1%

Net tax increase $6.9 billion

National Picture

• 8 states used tobacco settlement

• Tobacco taxes: $642 million $3 billion in 2002

Medicaid

•37 states changed Rx policies

•9 states expanded or started medication assistance programs

•23 states reduced or eliminated optional benefits (dental, vision, chiropractic or mental health)

Medicaid• 38 states changed provider and

services reimbursement rates31 states reduced or froze rates

• $205 million tax increase on providers

• 23 states increased or established patient co-pays

State-by-StateOR: $1.1 billion tax increase, to be voted on Feb. ‘04

GA: Closing mental hospitals, Raised $180 million in cigarette taxes

UT: 600 state employee jobs cut

SCHIP cap, Medicaid benefits limited

PA: $4 billion shortfall

State-by-StateMN: Health care provider tax extended• Loan forgiveness for health profs

reduced• 2 rural hospital grant programs

combined and reduced• Funding for rural hospital capital

improvement program reduced• Collaborative NP program eliminated

State-by-StateCA: 5% Medicaid cut

Rural Health programs preserved

AL: $675 million shortfall, tax increase rejected by voters

NE: $750 million shortfall over 2 years5% tax increase, Cuts to Medicaid

KY: SCHIP and Transitional Medical Assistance to pay premiums

Advocacy Strategy

• Grassroots• Invite Policymakers to hear from you• Rural Caucus• Links to national resources

…. The mission of The National Rural Health Association is to improve the health and well being of rural Americans and their communities though advocacy, communications, education and research.

NRHANRHA

NRHA Government Affairs Office703-519-7910

Steve Wilhide, Executive DirectorAlan Morgan, Vice President of Gov’t

Affairs and PolicyEli Briggs, Policy and State Affairs

ManagerGreg Lynskey, Government Affairs

ManagerShelly TenNapel, Organizational

Development Manager