WASHINGTON -- Nearly a million low-income parents have lost their Medicaid coverage and probably are uninsured as a consequence of welfare overhaul, says a new study by an advocacy group that lobbies for universal health coverage.
Families USA examined Medicaid figures in 15 states with most of the uninsured low-income population and found that 945,880 adults with children had been dropped from the program from 1996 to 1999, a decline of 27 percent. More than 2.5 million were enrolled in Medicaid in the 15 states at the end of last year.
The study, released Monday, blamed the problem on states, saying they mismanaged the implementation of the 1996 welfare reform law and improperly kicked people off of Medicaid once they left welfare, created barriers for people to sign up and set income eligibility requirements way too low.
In Louisiana, for example, a family of three earning more than $3,168 a year would be ineligible for Medicaid, the study estimated.
''The basic thrust of welfare is to move people to jobs, but unfortunately when they do so they are considered to have too much income for Medicaid,'' said Ron Pollack, executive director of Families USA. ''So the reward of moving off welfare is getting no health insurance.''
Pollack and other advocates for the poor complain that state and federal officials have been too quick to declare welfare overhaul a success because so many people have dropped off the rolls. They say that doesn't take into account side effects like losing health benefits, which can destabilize families.
States have recognized the problem and are taking steps to fix it, said William Waldman, executive director of the American Public Human Services Association, whose members include state welfare agencies. Many states focused first on dealing with uninsured low-income children and now are shifting attention to uninsured adults, he said.
''It remains an issue that needs to be addressed,'' Waldman said. ''I think you'll see some very significant developments in the states.''
New York and Ohio are expanding Medicaid eligibility and other states are reinstating people who were wrongly cut off. The government recently ordered all states to find people improperly dropped from Medicaid and sign them back up.
Families USA did not check whether those dropped from Medicaid had other insurance. But Pollack said studies have shown that many low-income workers and people leaving welfare have jobs that don't offer health insurance and those they are offered insurance usually can't afford the premiums.
The group looked only at parents with family Medicaid coverage. The 15 states in the study are those with the largest number of uninsured poor people and represent 70 percent of all low-income uninsured Americans.
Texas, which has one of the highest rates of uninsured people, had the biggest percentage drop in Medicaid enrollees. Some 106,000 people lost Medicaid during the 4-year period, a 46 percent decline, the study found.
State officials said several programs had been put in place to get families signed up or provide transitional benefits to people whose incomes exceed the cutoff.
''We try to outreach to families that may be still eligible for Medicaid,'' said Charles Stuart, spokesman for Texas' health and human services department. ''We know there are people who have gone off (welfare) and lost Medicaid.''
In January, the state sent notices to more than 275,000 Texas families that left welfare since 1996 informing them they may still be eligible for Medicaid. Medicaid status is now automatically reviewed when someone leaves welfare and transitional Medicaid benefits are available to those with ''earnings issues,'' Stuart said.
In his Republican presidential campaign, Texas Gov. George W. Bush has proposed giving $2,000 tax credits to help poor people purchase health insurance. His Democratic rival, Vice President Al Gore, wants to raise income limits on a federal health program for poor children and let their parents into the program. President Clinton has a similar proposal.
Medicaid cost an estimated $181 billion last year, with the federal government picking up $103 billion and the states the rest.
Brainerd Dispatch ©2013. All Rights Reserved.