Hurley Robert, Katz Aaron, Felland Laurie
Issue Brief Cent Stud Health Syst Change. 2008 Jan(117):1-4.
The sensitivity of state budgets to economic cycles contributes to fluctuations in health coverage, eligibility, benefits and provider payment levels in public programs, as well as support for safety net hospitals and community health centers (CHCs). The aftershocks of the 2001 recession on state budgets were felt well into 2004. More recently, the economic recovery allowed many states to restore cuts and, in some cases, expand health services for low-income people, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Along with bolstering support of safety net providers and raising Medicaid payments for private physicians, some states advanced even more ambitious health reform proposals. Yet across communities, safety net systems face mounting challenges of caring for more uninsured patients, and these pressures will likely increase given the current economic downturn.
州预算对经济周期的敏感性导致了公共项目中医疗保险覆盖范围、资格、福利以及医疗服务提供者支付水平的波动，同时也影响了对安全网医院和社区健康中心（CHC）的支持。2001年经济衰退对州预算的影响一直持续到2004年。最近，经济复苏使许多州得以恢复削减的项目，在某些情况下，还为低收入人群扩大了医疗服务，这是根据医疗系统变革研究中心（HSC）2007年对12个具有全国代表性的大都市社区进行实地考察得出的结果。除了加强对安全网医疗服务提供者的支持以及提高对私人医生的医疗补助支付外，一些州还提出了更为雄心勃勃的医疗改革提案。然而在各个社区，安全网系统在照顾更多未参保患者方面面临着越来越大的挑战，鉴于当前的经济衰退，这些压力可能会进一步加大。
