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U.S. Teen Birth Rate Drops Slightly

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Public Radio Programs A-Z | close Shots - Health NewsShots - NPR's Health Blog  < previous postnext post > U.S. Teen Birth Rate Drops -- Kinda 4:08

April 6, 2010

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By Brenda Wilson

After rising for two years, the U.S. teen birth rate has taken a slight drop. It's a welcome break in what many feared might be the beginning of a worrisome upswing in teen births.

There were fewer strollers on the road in 2008 than in 2007.

There were fewer strollers on the road in 2008 than in 2007. (iStockphoto.com)


There were fewer strollers on the road in 2008 than in 2007. (iStockphoto.com)



There were fewer strollers on the road in 2008 than in 2007.

There were fewer strollers on the road in 2008 than in 2007. (iStockphoto.com)

-->

Preliminary data from the National Center for Health Statistics show a 2 percent drop in teen births in 2008, and a similar decline for the general population birth rate. There were 4,251,095 people born in the United Sates in 2008, with more than 435,000 of them to teen moms.

The most dramatic change, according to Stephanie Ventura, chief of the reproductive statistics branch at the NCHS, was among Hispanics. The overall birth rate for that group declined for the first time in years, with births to Hispanic teens declining by 5 percent to hit a historic low.

Ventura doesn't want to speculate about the decline in Hispanic births, but for the overall population, she says it's the economy. "As early as 2007," she says, "some job sectors were declining."

A study from the Pew Research Center seconds that. Pew looked at 25 states to see if downturns in economic indicators such as income, housing prices and employment were followed by a decline in fertility. It noted that from 2003 to 2007, the date at which economists set the beginning of the current recession, the nation's birth rate grew. Early in 2008, births dipped and continued to decline

"There's been evidence since the Great Depression linking the economy to fertility, but until now, we didn't have a broader view," says Gretchen Livingston, a senior Pew researcher. "But these results are pretty compelling."

In a survey conducted by Pew in October 2009, 14 percent of 18- to 34-year-olds and 8 percent of those ages 35 to 44, say they postponed having a child because of the recession.

The National Center for Health Statistics did find an exception to the declining birth rate: Women over the age of 40 had a 4 percent increase in births. It was the highest birth rate for that age group since 1967, even though it's a small number of children being born.

As for the teen birth rate, Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy says, "We're not making progress."

She points out there was a 5 percent rise between 2005 and 2007. So this most recent 2 percent decline doesn't bring U.S. teen births back in line with the progress that had been made through the 1990s.

Brown says the dramatic decline has stalled. Births to teenagers have been hovering at around 41 out of 1,000 births since 2003. Teen births hit a record low of 40.5 out of a thousand in 2005 and started inching upwards again.

"If you look at those markers, they haven't gone up," says Brown. "There's an uptick and then a downtick, plateauing. This is not a trend. We're just bouncing around."

Still, teen births declined in all groups, except Native American Indians.

The sharpest drop -- 4 percent -- was among teenagers 18 to 19 years old.

categories: Children

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< previous postnext post > bloggerScott HensleyScott Hensley recent Entries Fruits and Veggies Prevent Cancer? Not So Much, It Turns Out U.S. Teen Birth Rate Drops -- Kinda More Medicaid Pay For Some Doctors, But Will It Last? Prescription Drug Overdoses Send More People To Hospitals Curing Childhood Cancer Carries A Price Later In Life Massachusetts Health Insurers Sue State In Bid To Raise Rates San Fran Pushes For Earlier HIV Treatment KFC Goes For The Gold With Its Fried Chicken Bread Francis Collins: DNA May Be A Doctor's Best Friend Flexible Spending Accounts Getting Slightly Less Flexible What is 'shots'?

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St. Vincent's Hospital Catholic last in NYC, to close

8: 58April 7, 2010.

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An injured firefighter is brought into the emergency room at St. Vincent's Hospital in Manhattan, Sept. 13, 2001.

Injured firefighter moved to the emergency room in St. Vincent's Hospital in Manhattan, Sept. 13, 2001 (Stephen Czernin/AP)


Injured firefighter moved to the emergency room in St. Vincent's Hospital in Manhattan, Sept. 13, 2001 (Stephen Czernin/AP)



An injured firefighter is brought into the emergency room at St. Vincent's Hospital in Manhattan, Sept. 13, 2001.

Injured firefighter moved to the emergency room in St. Vincent's Hospital in Manhattan, Sept. 13, 2001 (Stephen Czernin/AP)

-->

Author: Scott Hensley

St. Vincent's Hospital in Manhattan, the last Catholic full-service hospital in New York, closes after years of financial losses and mounting debt.

KVH's Hospital voted Tuesday night on shutter St. Vincent which service, but will continue to offer outpatient care, including HIV/AIDS Center, while looking for a partner to maintain their startup reported WNYC. Mention surgeries stops on 14 April.

Hospital, anchorage in Greenwich Village, was founded by four nuns in 1849 in the treatment of cholera victims and provide charity care for the poor. Recently St. Vincent was in the front lines appeared AIDS and its Department of emergency medicine served as casualties from Sept. attack on the World Trade Center.

The hospital has amassed around 700 million USD in debt and defaulted on bankruptcy reorganization plan when it missed payments to the Trust Fund to cover the costs of medical Victoria, in accordance with WNYC.

"Eight separate budget cuts from New York State in the past two years and the worst recession in decades are linked to St. Vincent's with some serious financial challenges," said Henry j. Amoroso, CEO of St. Vincent 's, Crain's New York Business reported in February.

Beleaguered hospital to seek protection under Chapter 11 in 2005, emerging from bankruptcy two years later.

Financial strain and St. Vincent inability to find partner threatened to push the hospital to bankruptcy again. Money running and no solution in sight to the Board's Hospital decided to close the facility.

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FDA Looks high and low for consumer representatives

"," date ":" 20100407 "," pageTypeId ":" 1 "," orgId ":" 1 "," byline ":" NPR Science Desk "," aggIds ":" 103537970 "," commentCount ": 0}; npr.metrics.pageimpression ();} catch (e) {npr.messaging.exception (e, ' in metrics .js ', ' ready ' document.);}}); < previous="" postnext="" post=""> 11: 57April 7, 2010.

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Author: Joanne Silberner

Food and Drug Administration wants you ... Well, perhaps you.

Uncle Sam wants you.

FDA wants to serve on its Advisory Committee (Wikimedia Commons).



(Wikimedia Commons)




Uncle Sam wants you

(Wikimedia Commons)

-->

The Agency has issued a call for consumer representatives to serve on its advisory committees.Panels of experts help by Agency, figure out whether to approve drugs or devices or yank something off the market.

"You don't have to be a doctor, researcher or health care professional to serve as the representative of consumers," says FDA's Dornette spelling LeSane. But, she noted, you should have ties to the consumer or Community group.

You do not have the intention to get downloaded unless you understand some sophisticated scientific and statistical concepts and that you would be comfortable coming to conclusions about the risks and benefits associated with drugs and devices, you can see by the Agency.

The main task is to represent the voice of consumers in the deliberations of the Panel. in most cases even get vote. Of course committees only advice to the FDA, which usually but not always follows it.

What is life like for the Advisory Committee? depending on the Committee would meet once a year or several times, in one of several giant hotel windowless rooms FDA uses in and around Washington.

Usually you get great notebook or two previously prepared by FDA staffers and petitioning the FDA for approval.Then for a day or two, you can sit with 10 or 20 other members of the Committee and hear presentations from these FDA staffers and company officials and members of the public who either want to take up or use whatever it is it is viewed or been harmed by it.

FDA officials listen to Committee discuss issues, and sometimes asks the Committee to vote on specific questions.The term service is one of four years.You will get paid, although FDA is somewhat cagey about all you say, they will receive compensation for each day plus travel and meeting costs per diem.A is displayed for lunch free involved.

The Agency is holding a session A & Q on 30 April just outside the Washington for people interested in applying.You must register in advance to obtain and pay its own way but is nice time of year in domain controller, a user could eradicate intensive impact if things work out.

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View recent recommendations FirstMost all comments» FirstOldest < previous="" postnext="" post=""> Scott Hensley blogger Scott Hensley recent entries savings With Computerzing medical Records are hard to measure Excercise Trumps Gene In Teen obesity St. Vincent's last Catholic Hospital, in NYC, to close the fruits and Veggies Prevent cancer? Not so many turns it out US Teen Birth Rate Drops--Kinda Medicaid more payments for some Doctors, But Will It last? Prescription Drug Overdoses Send more People to hospitals curing Childhood Cancer carries A price later In Life Massachusetts Health insurers Sue State In quotes to lift the courses which is ' shots '?

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Savings From Computerizing Medical Records Are Hard To Measure

","date":"20100407","pageTypeId":"1","orgId":"1","byline":"NPR Science Desk","aggIds":"103537970","commentCount":0}; NPR.metrics.pageImpression(); } catch (e) { NPR.messaging.exception(e, ' in metrics.js ', 'document.ready'); }}); < previous postnext post > 3:15

April 7, 2010

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Computer and stethoscope with a USB plug.

Where's the socket for this thing? (iStockphoto.com)


Where's the socket for this thing? (iStockphoto.com)



Computer and stethoscope with a USB plug.

Where's the socket for this thing? (iStockphoto.com)

-->

By Christopher Weaver

When it comes to health policy, few ideas find as much bipartisan support as the notion that widespread adoption of health information technology could improve medical care and save Americans money. But, slapping a realistic number on those savings remains an elusive goal for health IT advocates.

A study published yesterday in Health Affairs takes another step towards putting a dollar-value on those savings. The Department of Veterans Affairs may have saved up to $3.1 billion between 1997 and 2007, the researchers report, but that finding is laden with caveats.

The report looked at the potential savings -- based on the real-world findings of other, narrower studies -- across the VA system. The possible dollar amount was based on things like faster access to records for staffers; reduced spending on radiological film; and the drug interactions prevented by electronic records and, therefore, the care not needed. But, in an interview, the researchers made clear that their finding shows only what is possible -- not what the VA actually saved.

"We are not certain to what extent they were realized," said Douglas Johnston, the executive director of the Center for Information Technology Leadership and one of the researchers. "We would like to have empirical studies. We know the VA is heading that way. It's our hope that this study would contribute to how to measure health IT value."

Johnston speculated that most institutions have only limited funds for self reflection. While the elusive dollar-value of health IT savings is a charged issue for e-health advocates, the hospital executives who control purse strings may be less interested. That's changing, Johnston said, in part because of federal stimulus funding that includes evaluation of a $30-billion-plus federal investment in health IT.

In the absence of an empirical savings estimate, President Barack Obama used a report from Johnston's center to quantify the savings from his then-planned e-health initiative on the 2008 campaign trail. The center anticipated that the entire health system could save $77.8 billion a year if e-health were ubiquitous.

That estimate was central to a critical Washington Post report exploring the tech-industry ties of the Center for IT Leadership's chairman, Blackford Middleton, who is also an author of the VA report. The Post implied that a potentially optimistic promise of savings encouraged the White House to back the e-health stimulus funding, which will benefit health providers, as well as software vendors who often have ties to researchers in the tiny health IT world. (Johnston said by e-mail that the Post's report was "off base," and that the researchers have "no financial stake or vested interest in any of the technologies we study.")

To be sure, squeezing value out of electronic medical records at all can be a challenge, and the VA's experience may not tell us much about what smaller hospitals and physician practices can expect. A separate article in the same issue of Health Affairs recounts a litany of e-health hiccups at a New Jersey primary care practice, including security glitches in e-prescribing and sluggish, user-unfriendly software.

Indeed, the Congressional Budget Office has been more conservative in estimating the potential benefits. In a report last March, they estimated health IT spending under the stimulus could save the federal government around $13 billion over the next ten years, and may save the private sector some money as well.

Weaver is a reporter at Kaiser Health News, a nonprofit news service.

categories: Research

permalinkcommente-mail 3:15 - April 7, 2010

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Recent FirstOldest FirstMost Recommended View all comments »

< previous postnext post > bloggerScott HensleyScott Hensley recent Entries Massachusetts Insurance Dispute Goes To Court Ground Zero Workers Suffered Permanent Lung Damage FDA Warns: Fat-Dissolving Spa Claims Are Unfounded Exercise Trumps Gene In Teen Obesity FDA Looks High And Low For Consumer Reps St. Vincent's, Last Catholic Hospital in NYC, To Close Fruits and Veggies Prevent Cancer? Not So Much, It Turns Out U.S. Teen Birth Rate Drops -- Kinda More Medicaid Pay For Some Doctors, But Will It Last? What is 'shots'?

This blog covers news about health and medicine. It is written and reported by NPR's Science Desk.

For more about the blog, check out the Shots FAQ. And be sure to read our discussion rules before joining in on the conversation here.

ON HEALTH PODCAST

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You can drop the Shots team a note via our contact form.

Resources Centers for Disease Control: Swine Influenza World Health Organization: Swine Influenza NPR: Swine Flu - On The Edge Of A Pandemic search Shots - Health News Related News FeedsShots - Health News

More about News Feeds »

Shots - Health News archive April 2010 March 2010 February 2010 January 2010 December 2009 November 2009 October 2009 September 2009 August 2009 July 2009 June 2009 May 2009 April 2009   npr always on Newsletters Podcasts Mobile RSS Feeds Widgets API Radio news U.S. World Opinion Politics Business Technology Science Health Sports arts & life Books Movies Pop Culture Food Performing Arts Games & Humor music Concerts You Must Hear This Interviews & Profiles Music News Music BlogsRock/Pop/FolkJazz & BluesClassical Browse Artists A-Z All Songs ConsideredFrom The Top JazzSet Marian McPartland's Piano Jazz Mountain StageSong of the DayThe Thistle & Shamrock World Cafe World Of Opera programs a-z Morning Edition All Things Considered Fresh Air The Diane Rehm Show On The Media On Point Talk of the Nation Tell Me More Weekend Edition Saturday Weekend Edition Sunday Car Talk Wait Wait...Don't Tell Me! listen Hourly News NPR Program Stream Schedule Find Station Streams more Multimedia Columns Blogs Analysis Commentary NPR Ombudsman Topic Index Sponsor NPR NPR Shop About NPR Jobs & Training Press Releases Copyright NPR Terms of Use Privacy Policy Permissions Corrections Text-Only Site Help Contact Us Donate Our partner in public broadcasting pbs

FDA warns: Fat dissolving claims Spa are unfounded

"," date ":" 20100407 "," pageTypeId ":" 1 "," orgId ":" 1 "," byline ":" NPR Science Desk "," aggIds ":" 103537970 "," commentCount ": 0}; npr.metrics.pageimpression ();} catch (e) {npr.messaging.exception (e, ' in metrics .js ', ' ready ' document.);}}); < previous="" postnext="" post=""> 5: 25April 7, 2010.

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Author: Nadja Popovich

If it were heard come-that treatment spa may melt Your fat away, not buy it.

Food and Drug Administration said today has warned they were making six spas false and misleading claims about the procedure, often called lipodissolve.

But there may be, it further as lipozap, lipotherapy, Lipolysis mesotherapy or injection.

In no uncertain terms the FDA told their lips lipozap postal code and all other entities spa."They make it sound so good and so safe--where says, IT dissolves fat," "rozpływa IT out of the Office," "is no effect side," "EC previously done thousands of procedures," "FDA's Kathleen Anderson said in a conference call with Reporters. ' This really sells very well, and we're really, really interested.We have no good data, that is safe and effective. "This is what we want consumers to know."

Procedure, touted as an alternative to Liposuction, involves a series of injection drugs expressed to dissolve fat.Medicines inside syringes differ from health resort of Spa, but usually include phosphatidylcholine and deoxycholate. so far, you can check out the description on the website of one of the companies that was warned here.

FDA says that no drugs, used in lipodissolve passed out in the Agency for this procedure."Is not approved by FDA injectable product which is phosphatidylcholine," Anderson noted. " That is to say, simply does not have. „

There are also Risks are understood.Pain at the injection site, knots under skin and permanent scarring reported no occurred but definitive studies on adverse reactions.

Outside spas six which have been issued warning letters FDA noted that in many other market procedures.

After returning to the 2006 American Society of aesthetic Plastic Surgery (ASAPS) said it was funding study lipodissolve. afternoon, Dr President-Elect ASAPS Felmont Eaves told Shots that results are expected to be presented in about two weeks at the next meeting of the national group.He confirmed, however, that the study was small and "in fact, there is no statistical right of reply to all questions you may have".

So far, Eaves simply said, is not evidence for lipodissolve."Is this mentality Wild West [with new procedures aesthetic] that go there and claim anything you want and patients are drawn," he said."So well is FDA is saying" no, you must have proof.„"

Eaves added, "you're in saying that the data is incomplete. We don't know if it works, and if it is safe or not until we have more data."

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View recent recommendations FirstMost all comments» FirstOldest < previous="" postnext="" post=""> blogger Scott Hensley Scott Hensley recent entries Massachusetts insurance disputes Goes to Court Clinton workers suffered permanent Lung damage economies of Computerizing medical Records are hard to measure Excercise Trumps Gene In Teen obesity FDA Looks high and low for consumer representatives of St. Vincent's last Catholic Hospital, in NYC, to close the fruits and Veggies Prevent cancer? Not so many turns it out US Teen Birth Rate Drops--Kinda Medicaid more payments for some Doctors, But Will It last? what is ' shots '?

This blog covers news about health and medicine; it is written and submitted by NPR's Science Desk.

For more information about blog check out Shots FAQ and be sure to read our rules before joining the discussion on the conversation here.

Health PODCAST

NPR health podcast.Detailed reports on medicine, staying healthy and the major issues surrounding health care.

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The new law Health extends High-Risk Coverage

Author: Sarah VarneyApril 8, 2010.

Audio for this story from Morning Edition is not available.

Transcript text sizeAAAApril 8, 2010 from KQED

When Miles Owyang was born six weeks premature, the doctors determined that he had a heart ailment. it was nothing serious, just something to monitor.

Miles is currently, radiation 9 years and acute tennis player and lacrosse sickness for it has never been a problem until his parents, both engineers electrical Silicon Valley, the loss of their jobs and their employer-based insurance and had to look for individual family policy.

No insurer would accept Miles.

His mom, Tara Anderson, applied to join California's high-risk pool. "They told us it will probably be about three months before it is accepted, "says.

High-risk Pools in most countries are largely seen as an error. They were originally intended as the insurers ultimately for those closed with private health insurance market, but according to the National Association of high-risk programs, basins cover only about 200 000 Americans.

California plan is limited to 7,100 members and often has a waiting list.Premiums and deductibles are wildly expensive and policy are spending caps, which often are exceeded.

New federal law healthcare reserved 5 billion USD in order to finance new high-risk programs that are more affordable and open to more people.

Deborah Chollet, health insurance expert on company nonpartisan research Mathematica, says people who apply to new programmes will pay the standard rate or rate they pay for the policy, if they have a condition that it excluded from the scope.

That's huge benefits, "says.Medical fees for people in high-risk pool you can drop as third party, and they will not be nominal annual or lifetime finish, adds Chollet. Family would pay no more than 11,900 dollars annually.Individuals pay under 6,000 dollars annually.

Policy logging will also Pull. some States current applicants must demonstrate that private insurers discard it.Under the new law of each of the existing condition, who have no coverage may join the program. the Federal Government will determine what are the conditions, but they are likely to be the same long list used by insurers, including cancer, diabetes, heart disease and even pregnant.

My feeling is they intend to allow people in circumstances justified ... If someone has made every effort to maintain, they may be entitled to this, it added Chollet says that 1 to 2 million people can gain coverage under federally funded program.

Probably goes some of the allocation of Federal 5 billions of dollars directly to countries to expand their pools. However, some 15 countries don't have high-risk pools, and others would have to amend their legislation in order to qualify for funding.The Federal Government will likely also offer national pool.

Still Lesley Cummings, Director of the California primary risk medical insurance program, its high-risk pool, says has considerably more questions than answers about the new programme."We still don't know the details of how work and enthusiasm of our federal colleagues," Cummings says.

The Federal Government has started reaching countries to assess their interest in starting or expanding coverage for medically uninsurable.States have until the end of this month to submit an application.

The law says, these new high-risk pools must be implemented by mid June. you'll be phasing in 2014 when private insurance companies will be forced to sell policies to "medically uninsurable."

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Tennessee Removes 100,000 From Medicaid Rolls

by Anita Wadhwani

text sizeAAAApril 8, 2010

After losing the use of her arms and legs in a car accident five years ago, Jessica Pipkin received around-the-clock nursing care through Tennessee's Medicaid program. Pipkin, 28, said the care — which cost an average of $37 an hour — allowed her to live at home here with her husband and two children.

In September, however, Pipkin lost her benefits as part of a state reassessment of many of the program's enrollees. Officials concluded that she and her husband make too much money to qualify for TennCare, the state's Medicaid program.

Pipkin is not alone. About 100,000 people — mostly elderly or disabled residents — have been dropped since January 2009, including approximately 37,000 who had relied on the state program for all their health care needs. Coverage for 8,000 children was also reassessed, but a TennCare spokeswoman said the number of children ultimately cut from the program could not be verified.

The state's actions follow the resolution of a long-running court case involving people who receive Supplemental Security Income (SSI), a federal assistance program for low-income residents who are aged, blind or disabled and some infants hospitalized for long periods with major medical problems. SSI recipients are automatically eligible for TennCare, but the state had sought to discontinue coverage for those who lost the SSI benefits.

Some enrollees sued, arguing that the state was not taking into consideration whether they qualified on their own for TennCare. In 1987, they got a federal court injunction that prohibited the state from denying benefits to anyone who had ever qualified for SSI. As the case languished for two decades, the number of people affected grew to more than 150,000, about 13 percent of all TennCare enrollees. The group became known as the "Daniels class," named for Cluster Daniels — one of the original participants in the lawsuit — who has since died.

In January 2009, a federal district court rescinded the injunction after the state argued that its new process for determining Medicaid eligibility had been approved by federal officials. The court action cleared the way for an evaluation of the Daniels class of recipients.

"It is important to note that this is not a 'disenrollment' process," said TennCare spokeswoman Kelly Gunderson. "It's a re-verification process. ... It's really an issue of fairness. All our enrollees go through an annual reevaluation process. It's only fair that this group of people does the same thing to make sure they actually qualify for benefits."

State officials said the process is necessary to remove people from the program who have moved out of state, are no longer disabled or whose incomes exceed the limits. Under state guidelines, recipients cannot earn more than 74 percent of the federal poverty level, or $16,500 for a family of four.

So far, the state has found that 55,000 beneficiaries can continue to receive TennCare benefits. However, reducing 100,000 people is expected to cut the program's costs $170 million annually, just over 2 percent of its $7 billion annual budget. These reductions are an anomaly this year; Medicaid programs have been barred by the federal government from making even small eligibility changes as a condition of receiving extra funding from the stimulus package.

The controversy is the latest episode in the evolution of TennCare, which was once considered a blueprint for helping the uninsured. Even as the Clinton administration's plan for national health reform fizzled in the mid-1990s, Tennessee staged the single largest expansion of a Medicaid program in the country, enrolling half a million new beneficiaries. Those heady days are gone. Facing serious fiscal problems, the state during the past five years has pared Medicaid by 200,000 people before beginning the cuts of the Daniels class.

Advocates for Daniels-class recipients who have lost their coverage said they are struggling to get health care and some cannot continue regimens such as chemotherapy, transplant care or expensive medications. "There are no services in the community to replace their care," said Dan Ramey, a social worker with the Tennessee Health Care Campaign, a nonprofit consumer health advocacy organization. "TennCare was the safety net."

State officials said that the savings from the Daniels cuts averted even larger planned cuts to the program this year as the state faces a $400 million budget gap that Tennessee Gov. Phil Bredesen, a Democrat, proposes to close with $200 million in TennCare cuts.

"If you're a state like Tennessee that has significant numbers of people in your Medicaid program who are not mandated to be there, you're going to be looking closely at them to balance your budget, even if they are in these horrible situations," said Todd Eberly, assistant professor of political science and coordinator of public policy studies at St. Mary's College of Maryland and a former Medicaid consultant. "Unfortunately, most of Medicaid is not designed for people in medical need."

Pipkin said she can't afford to pay for 24-hour care on her own; her husband earns $19,000 a year as a Direct TV technician and she receives $14,400 in Social Security disability payments, a program that is separate from SSI. She is relying on friends and family members to help her with physical therapy, catheter care and many of her medical needs. She said the loss of TennCare benefits is a serious blow. "I've given up being able to put my arms around my children, go to college, help other people," she said. "I feel like I've given up enough."

She has recently qualified for another program that provides daytime home assistance, but the aide cannot give her medicine, monitor her blood pressure or change her catheter.

Thomas Moore, 64, of Woodbury, Tenn., who is facing serious health issues following treatment for cancer, also lost his TennCare coverage and is now uninsured. He began receiving SSI in May 2008 following a hip fracture, but under federal guidelines, he was required to move to the Social Security program when he qualified at the age of 62. Those monthly benefits put him above the state limit for Medicaid. He is unable to qualify for Medicare health benefits until he reaches the age of 65.

His recent treatment for colon cancer and lymphoma at a hospital in Nashville was covered under his TennCare benefits, but now he cannot afford the surgery he was planning in late August—just weeks after he was cut from TennCare on Aug. 4—to reverse his colostomy.

"I was just flabbergasted," said Moore. "Here I am three-quarters of the way through getting well after two types of cancer and needing surgery and colon tests and CAT scans to see if the lymphoma's come back and here they cut me off. There's nothing I can do until I turn 65 now, except wait and hope I don't get sicker."

Hospital and doctors have also complained about the cuts, saying they are being forced to absorb expenses for the former TennCare patients. They note that many of those patients receive specialized, high-cost care for acute medical conditions.

Vanderbilt University Medical Center in Nashville, which treats more TennCare patients than any other hospital in the state, estimates that 1,600 patients who use its facilities or doctors are among those who have been cut from TennCare rolls. Vanderbilt says its uncompensated care has grown from $108 million in 2005 to about $276 in 2009.

Warren Beck, associate vice chancellor for health affairs and senior vice president of finance at Vanderbilt's medical center, said, "We know patients that have been on SSI are not going to be very healthy. My gut feeling is that we can expect to take on a heck of a lot more patients and responsibility for a heck of lot less money."

This story was produced through collaboration between NPR and Kaiser Health News (KHN), an editorially independent program of the Henry J. Kaiser Family Foundation, a nonpartisan health-care policy research organization. The Kaiser Family Foundation is not affiliated with Kaiser Permanente.

Related NPR StoriesMedicare Spending On Hospitals Gets Web Treatment April 8, 2010New Health Law Expands High-Risk Coverage April 8, 2010How The Health Bill Could Affect You March 22, 2010 

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