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2003-12-19 -- States Cut Health Spending on the Poor

States Cut Health Spending on the Poor
Changing the Channel, Poverty in the US.


Associated Press, Fri Dec 19

States Cut Health Spending on the Poor

By MARK SHERMAN, Associated Press Writer

WASHINGTON - More than 1.2 million low-income Americans, including
500,000 children, have lost health coverage as a result of state
cutbacks in programs for the poor, according to a new study by a
liberal Washington think tank.

Thirty-four states have cut health insurance programs for the poor and
children because of deep budget deficits over the past two years, the
Center on Budget and Policy Priorities said.

Further cuts are likely next year, when a temporary federal government
increase in its share of Medicaid expires, the group said. Medicaid is
the joint federal-state health insurance program for the poor.

"Cuts of this magnitude in health coverage for low-income families are
unprecedented," said Leighton Ku, a senior fellow at the think tank.

The report is being released Monday with a state-by-state survey of
cuts and restrictions in coverage. The center provided a copy to The
Associated Press.

The federal Centers for Medicare and Medicaid has no data that
suggests so many people are losing benefits, a spokesman said.

The cuts have come primarily in Medicaid and the State Children's
Health Insurance Programs, or SCHIP, created in 1997 to cover those in
poor families who earn too much to qualify for Medicaid. Government
and private studies have found that SCHIP helped reduce the percentage
of American children without health insurance.

But now, states are restricting eligibility for Medicaid and SCHIP.
For example, Missouri tightened the Medicaid eligibility limit from
100 percent of the federal poverty level to 77 percent, the report
found.

Six states, Alabama, Colorado, Florida, Maryland, Montana and Utah,
have stopped enrolling children in their SCHIP programs, the report
said.

One of those children is Zion Brown, 3, of Orlando, who has been on a
waiting list to enter Florida's Medi-Kids program for four months,
said his mother, Jeanane Frank.

Frank said she signed her son up for the program after getting a
letter from state officials saying he was eligible. Then she received
another saying he was on a waiting list.

In the meantime, Frank said she can't afford a doctor's visit for
Brown and so can't get him his immunizations.

"If he can't get his shots, he can't go to daycare and I'm afraid
that's going to put me out of a job," she said. Frank lost her
eligibility for Medicaid when she took a full-time job at a resort,
she said.

Other states required participants to reapply for their health
benefits more frequently - every 6 months instead of annually - the
report said. Such changes are considered barriers to enrollment that
inevitably result in people losing their coverage.


On the Net:

Center on Budget and Policy Priorities: http://www.cbpp.org

State Children's Health Insurance Program: http://cms.hhs.gov/schip/

Medicaid: http://cms.hhs.gov/medicaid/


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New York Times, Friday, December 19, 2003


Change the Channel

By BOB HERBERT

Saddam is now a staple of the Leno and Letterman shows.

And Paris Hilton outgunned President Bush in a prime-time shootout
between Fox and ABC.

And we're already choosing up sides on Kobe's and Jacko's guilt or
innocence.

We really are amusing ourselves to death, as Neil Postman pointed out
a couple of decades ago. He might as well have been speaking into the
void. It's only gotten worse.

Americans are the best-informed people in the history of the world.
But we are experts at distancing ourselves from any real
unpleasantness. Most of us behave as though we bear no personal
responsibility for the deep human suffering all around us, and no
obligation to try and alleviate it.

Paris, Jacko, Saddam. The world is like one big media show, a
made-for-TV spectacular. We can change the channel if things get too
ugly. Or just turn the television off. Genuine social consciousness is
for squares.

Example: The nation's at war. Is there any reason to share in the
sacrifices wars usually require? Nah. The grunts can do the fighting
and the dying. And we can put the costs on a credit card. Future
generations will pay for it.

And here at home? The headlines tell us things are pretty good. The
economy's turned around and the president's poll numbers are up. Let's
head for the mall.

The problem is, if you peel away the headlines and look more closely
at reality, you'll see some things that aren't so amusing. In New York
City, which is just now emerging from the recession, there are more
homeless people than at any time since accurate records started being
kept in the late 1970's.

Each night more than 39,000 people - nearly 17,000 of them children -
seek refuge in the city's shelters. "It's the greatest number of
homeless since the Great Depression," said Patrick Markee, a policy
analyst with the Coalition for the Homeless.

The faces of the destitute are changing as more and more families with
children - in New York and across the nation - find themselves without
the money necessary for food or shelter.

The U.S. Conference of Mayors released a report yesterday showing that
over the past year hunger and homelessness continued to rise in major
American cities. A survey of 25 cities showed an increase of 17
percent in requests for emergency food assistance and an increase of
13 percent in requests for emergency shelter.

A surge in the Dow is big news. Surges in hunger and homelessness are
not.

A broader look at the levels of serious distress being faced by
increasing numbers of Americans comes from the latest Index of Social
Health, which is published annually by the Institute for Innovation in
Social Policy at the Fordham University Graduate Center in Tarrytown,
N.Y.

The institute analyzes government statistics in a wide variety of
areas, including infant mortality, children in poverty, teenage
suicide, health insurance coverage and homicide rates, as a way of
monitoring the "social well-being of the nation."

The latest index, which covered the year 2001 (the latest year for
which complete statistics were available), showed the social health of
the nation taking a steep dive. It was the biggest decline in the
index in two decades. And preliminary data for the years since 2001
show the decline continuing, according to Dr. Marc Miringoff, the
institute's director.

The categories that worsened in the latest index were children in
poverty, child abuse, average weekly earnings, affordable housing,
health insurance coverage, food stamp coverage, the gap between rich
and poor, and out-of-pocket health costs for those over 65.

Two indicators reached their worst levels on record, food stamp
coverage (which correlates with increases in hunger) and income
inequality.

"These numbers are usually invisible to us," said Dr. Miringoff. "They
tell us an untold story, not just about the poor but the working poor
and the middle class as well. It's shocking to see such a sharp
decline in just one year. It tells us that something's going on with
the basic fabric of our society."

We might actually pay attention to problems like hunger, homelessness,
housing and health costs, if only we could find a way to make them
amusing.