Struggling States Cut Healthcare for Poor Before Obama Can Bolster
Coverage
http://www.truthout.org/011409HA
The unprecedented reductions come as millions are losing their jobs
and insurance. They are so steep that the federal rescue package may
not be able to revive them.
Washington - Even as President-elect Barack Obama plans an
ambitious push to expand health coverage nationwide, states are
slashing health services to their poorest residents amid the economic
downturn.
The unprecedented cuts in public assistance come as millions of
Americans are losing their jobs and health insurance.
In many cases, the cuts are so deep that even the massive federal
rescue package being assembled on Capitol Hill may not be enough to
restore services being eliminated in the burgeoning crisis, health
officials warn.
And the faltering economy has all but killed trailblazing state
campaigns to expand coverage for the working poor - once seen as
hopeful signs for national health care reform.
Illinois' senior citizens are facing the traumatic prospect of
being moved from nursing homes teetering on the edge of bankruptcy as
the homes wait for months to be paid by the floundering state
government.
South Carolina has cut treatment for low-income women under 40
with breast or cervical cancer and stopped providing nutritional
supplements for people with kidney failure.
In southern Nevada, cancer patients without health coverage no
longer have a place to get chemotherapy after the state's largest
public hospital stopped providing outpatient oncology services.
"This is exactly the time when we should be beefing up services,"
said Anthony Wright, executive director of Health Access California,
a
leading consumer advocacy group. "Instead, we are unraveling the
safety net to the point where it may not be possible to stitch it
back
together again."
Congressional Democrats hope to begin offering some help today,
as
the House takes up legislation to expand the popular State Children's
Health Insurance Program, a top priority of the incoming
administration.
The expansion, which could extend coverage to an additional 4
million low-income children, was vetoed twice by President Bush in
2007, but is expected to easily win approval now.
Lawmakers on Capitol Hill are also at work on a stimulus package
that could include as much as $100 billion to bail out Medicaid, the
primary federally funded health program for the poor administered by
the states.
That aid package is expected to require states to maintain some
of
the medical services currently on the chopping block, though it may
come too late to reverse many cuts already made.
Lawmakers plan additional assistance to help Americans keep their
health insurance if they lose their jobs.
But even some congressional leaders concede the help will be
insufficient. "Let's be honest," said Sen. Richard J. Durbin (D-
Ill.),
a close Obama ally. "We won't be able to save every soul here."
At least 44 states are facing budget shortfalls over the next two
years totaling more than $350 billion, according to a recent survey
by
the Center for Budget and Policy Priorities, a liberal Washington-
based think tank.
Unable to run deficits like the federal government, states have
been scrambling for months to cut aid to schools, universities and,
increasingly, residents who rely on the state for medical care.
Nationwide, roughly 60 million low-income people -- half of them
children -- use the Medicaid program to get some form of healthcare,
including basic physician services, prescription drugs, X-rays,
dental
care and even hospice care.
Some of those services are now in jeopardy.
Florida is poised to cut its home services for poor senior
citizens, such as bathing and meal preparation, as nearly 19,000
seniors in the state are on a waiting list to get the care rather
than
be sent to nursing homes.
Utah lawmakers are looking at cutting public health programs and
eliminating coverage for about 20,000 low-income people who rely on
the state-funded Utah Primary Care Network.
"The scale of this is unprecedented," said AARP Vice President
Elaine Ryan, who has spent nearly three decades working on health
policy at the state and federal level. "I really have never seen
anything like this."
Some states have tried to avoid cuts in services by delaying or
reducing payments to doctors and other medical providers who treat
low-
income patients.
This is taking a toll, however, as a growing number of providers
stop treating those with state-funded insurance.
Nevada's largest county closed its outpatient oncology clinic
last
year, citing decreases in Medicaid funding for treating low-income
cancer patients.
Now, advocates in Las Vegas are having to counsel patients to
look
at getting care by moving to other states where they have relatives.
"We're essentially creating medical refugees," said Stacey Gross,
community programs manager at Susan G. Komen for the Cure of Southern
Nevada.
Melvin Siegel, who operates five nursing homes serving some 400
seniors around Springfield, Ill., said he is close to closing because
of slow payments from the state.
Nursing homes, which rely heavily on Medicaid, often don't have
the option of rejecting patients on public assistance.
"There is no place to go," said Siegel, 79, who said he has
borrowed against his home, life insurance and retirement savings to
keep in business. "If this falls apart, I'll be penniless. . . . It's
never been this bad."
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