The biggest losers following the Utah Department of Health's recent $51 million budget cut are the poorest people in the state, whose access to health care has dwindled.
Most of that money was lopped off Medicaid as part of the state's cuts for fiscal year 2010, which began in July. As a condition of federal stimulus funds it received, the government insurance program was prohibited from changing its eligibility requirements.
So officials were forced concentrate in two areas: how much health care providers are paid and services considered optional by the federal government.
With a 25 percent roll-back in pay, Utah dentists took the hardest hit. Now 25 fewer dentists are seeing pregnant women and children, and more are threatening to close their doors to Medicaid clients if that lost pay isn't restored.
David Sundwall, the health department's executive director, told the Legislature's Executive Appropriations Committee Tuesday that the cuts may have been unfair. "(We are) holding the state more harmless than we are some of our (private providers)," he said.
Some 60,000 people on Medicaid also lost access to speech therapy, hearing aids, eyeglasses and chiropractic services.
Reductions in the department's Primary Care Grants Program, which supports doctors who see underserved patients in rural and urban areas, meant 3,000 uninsured people had access to 5,000 fewer primary care visits.
And the elimination of the Health Care Workforce Financial Assistance program -- which helps lure doctors to underserved areas by paying back their medical school loans -- meant 30 fewer doctors worked in areas where health care is sparse. That means 30,000 fewer Utahns are getting care.
With the state facing a steep revenue shortfall, the situation may be poised to get worse.
A one-time backfill of money -- allowed by the infusion of federal stimulus dollars -- prevented Medicaid providers' reimbursements from taking deeper cuts. If that money isn't restored again this year, dentists will take another 8 percent hit; inpatient hospitals, 17 percent; pharmacists, 3 percent and other providers, up to 2.5 percent.
Sen. Pat Jones, D-Salt Lake City, said when the economy rebounds, boosting provider reimbursements needs to take priority. "Otherwise," she said, "we're going to pay in the long run."
Children with Special Health Care Needs Clinics are facing a similar problem: a $1 million cut was backfilled, but the cut may go into effect in fiscal year 2011. If that happens, neonatal, neurology, and orthopedic clinics in Provo, Ogden, Logan, St. George and Salt Lake City will close, forcing some 1,000 children to seek care elsewhere.
Sundwall said most of these children are on Medicaid, however, and their families could travel to Salt Lake City for care at Primary Children's Medical Center.