Five years of high unemployment have driven another 216,000 Coloradans into such dire straits that they qualify for Medicaid, the government health insurance program for the poor.
That jump – to a total of 608,000 people in major financial trouble – has cost Colorado’s budget an extra $1.4 billion since 2007. The continuing rise in the cost of Medicaid is the main reason the governor proposed cutting school funding again this year.
Something has to go.
State officials blame the recession for pushing so many people into the very low level of income required to qualify for Medicaid– such as $22,000 or less for a family of four. A single person doesn’t qualify, except in special circumstances, like if they are developmentally disabled, said Rachel Reiter of the state Department of Health Care Policy and Financing.
The recession has changed the type of people who need help with health care, says Kraig Burleson, CEO of the Inner City Health Center in Denver.
“It’s not just the classic model of what you think of as poor. It’s your neighbors. It’s the recently unemployed. It’s just a different population than people think,” Burleson said.
Most people on Medicaid are kids, like the four children of Clara Harris of Aurora. Harris took them in as foster children covered by Medicaid, and then adopted them.
Harris, 55, also often babysits four of her grandchildren. Three of them are uninsured. “His dad used to have insurance, but he can’t afford it anymore,”Harris said.
Last month, one of those uninsured children had to be rushed to the doctor with an asthma attack. The $70 bill for the doctor and prescription for 4-year-old Dante Jameson meant real sacrifice.
“We got together as a family and paid for it out of pocket,” Harris said.
Scraping up that money meant other things had to be cut. “Seventy dollars means a lot to me,” Harris said. “I can take $70 and stretch it forever and make it work for my family. Food and everything else.”
On a recent day, all seven small faces crowded around Harris on the family couch, listening to her explain their tough circumstances in this economy.“Just to feed them, to have a big Christmas dinner, it’s hard,” she said.
In February, Dante’s mom is having twins. She worked as an assistant manager at KFC, but lost the job and her insurance when she had to go on bed rest. She is applying for Medicaid, to get through her pregnancy, and likely beyond.
“My mom used to be in the hospital,” explained Dante. “Now’s she’s out. She had to get a needle in her arm. And she’s having two boys. And they’re twins, so when they get out they’re going to look the same!”
The soaring number of people on Medicaid is the main reason that state lawmakers are once again contemplating cutting funding for education. Medicaid is mandated by the federal government, which pays only half the cost. The state must cover the rest.
Recently, Republicans proposed seeking federal permission to cut Colorado’s Medicaid budget. Gov. John Hickenlooper said no. The new federal health care law won’t allow states to restrict who qualifies, he said after a budget hearing. “We can’t cut Medicaid. It’s against the law,” he told an Associated Press reporter.
Some Republican lawmakers believe some Americans think that government-funded health care is a “given.”
“It’s the entitlement mentality that we need to get past,” said state Sen. Kevin Lundberg, R-Berthoud. “We can’t provide all medical services for everyone at all times. When it comes to Medicaid, we need to find ways to keep the costs down, other than continually grow the pie.”
But DenverDemocratic state Sen. Irene Aguilar, a physician, said, “We’ve cut all of the fat and are beginning to cut into the muscle” of the Medicaid program.
Aguilar says the people who rely on Medicaid are the ones who need it most: the disabled and the elderly. “I hope as a country that we will continue to have a commitment to them and that...we’re not just going to let people die in the streets.”
Complicating the legislators’ decision is a recent court ruling that the state constitution requires them to spend more money on schools.
At the Inner City Health Center in Denver, 22 percent of the patients are on Medicaid and another 70 percent are uninsured, mostly because they can’t afford it and they are not poor enough for Medicaid. The phone rings constantly. New patients call to be seen for everything from diabetes to broken arms.
CEO Burleson is worried that more fortunate Americans are so overwhelmed with bad news about the recession that they are tuning out the problems of the poor and near-poor. He calls this a “sympathy gap.” He does not see any relief in sight for Colorado’s strained system of health care for the poor.
“I know there are some indicators – and I hope they’re true – that the economy may be improving,” he said. “But we don’t see that on the ground. We don’t feel that within these walls.”
Gretchen Hammer, executive director of the Colorado Coalition for the Medically Underserved, warns that short-term cuts can hurt even more long-term.
“We’re 23rd in the nation for children who are overweight and obese,” she said. Failure to solve that will cause those children major health problems as they grow up. Ignoring the issue now, she says, will only cost a lot more down the road.
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