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Medicaid Strained By Rising Need

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The Associated Press

The Tampa Tribune

Published: December 22, 2008

WASHINGTON - That day in July was one that Tammy Morse won't soon forget.

Five months earlier, her husband had lost his job as a recruiter for the financial services industry. Now it was the summer and the family savings were gone. She saw no way to get health insurance coverage for her family other than to apply for Medicaid.

That was why she made the drive from her Stratford, Conn., home to the nearest office of the state's Department of Social Services.

"It was humbling," said the mother of two. "It's funny how your attitude changes, because honestly, I was probably a little judgmental previously. ... For lack of a better way to put it, that was for other people. It wasn't for me."

Across the country, similar stories are playing out for thousands of families.

Since the recession began a year ago, many states have seen increases in the Medicaid rolls just as tax revenue is falling below projections. Governors have lobbied President-elect Barack Obama and Congress to help them weather the downturn by increasing the federal government's share of Medicaid spending for at least two years.

The governors said the extra $40 billion would ease the service cuts or tax increases that legislatures would need to enact to balance state budgets.

In Connecticut, a state faring better than many, enrollment in the Medicaid program, Healthcare for Uninsured Kids and Youth, has climbed from about 312,000 last December to about 329,500 in November - a 6 percent increase.

Cassandra Edmonds, a single parent who joined HUSKY in October, is a newcomer to the program, like Morse. Her job as a parent-activities coordinator with the Bridgeport, Conn., school district was eliminated to save money. She has found a job selling life insurance, but her earnings are low enough that she is eligible for HUSKY coverage.

The insurance is particularly important for her 4-year-old son, who has glaucoma and tubes in his ears to prevent repeated infections. He has to check in with a specialist about every three months for each condition. Edmonds said she never imagined she would be relying on government safety nets to make that happen.

"I never really thought I would be without a job," Edmonds said. "I have an MBA."

Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank, sympathizes with families relying for the first time on Medicaid. Still, he disagrees that the federal government should reward states that did not plan adequately for the bad times.

The bill will fall to future generations, he said.

"And who better to push those costs onto than to people who can't even vote yet?" Cannon said.

STATES CUT VISION CARE, DRUG REFILLS

Nineteen states have enacted or proposed cuts in their Medicaid or State Children's Health Insurance Program budgets for the current budget year or for 2010, according to Families USA, which conducted a state-by-state survey:

•Arizona requires adults to reapply for Medicaid every six months rather than annually, which is expected to reduce the rolls by 4,500.

•California does the same for children, and Republican Gov. Arnold Schwarzenegger proposed reducing eligibility limits for parents from 100 percent of the poverty level to 72 percent. The state also is considering putting new applicants for children's insurance on a waiting list.

•Nevada eliminated vision care for adults and limited coverage for personal-care services that reimburse providers for helping people meet basic needs such as feeding and bathing.

•South Carolina enacted a limit on prescriptions and refills to a maximum 31-day supply.

•The most common Medicaid cut that states made was to lower payments to doctors and other providers; some 14 states have done so this year.

Source: The Associated Press

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