hile headlines continue to tell us how great the
economy is doing, states across the U.S. are pulling the plug on
desperately needed health coverage for low-income Americans, including
about a half-million children.
Even as the Bush administration continues its bizarre quest for
ever more tax cuts, the states, which by law have to balance their
budgets, are cutting vital social programs so deeply that tragic
consequences are inevitable.
The cruel reality is that Americans at the top are thriving at the
expense of the well-being of those at the bottom and, increasingly, in
the middle.
A new report by the Center on Budget and Policy Priorities shows
that 34 states have made potentially devastating cuts over the past
two years in public health insurance programs, including Medicaid and
the very successful children's health insurance programs known as
CHIPS. More cuts are expected this year.
"Almost half of those losing health coverage (490,000 to 650,000
people) are children," the report said. "Substantial numbers of
low-income parents, seniors, people with disabilities, childless
adults and immigrants are also losing coverage. Cutbacks of this depth
in health insurance coverage for low-income families and individuals
are unprecedented."
The worst of the cuts are in Texas. "The Lone Star State has
adopted deep cutbacks in its State Children's Health Insurance Program
that will cause about 160,000 children — one-third of its SCHIP
caseload — to lose coverage," the report said.
Texas is also making Medicaid available to fewer pregnant women, a
dangerous move that increases the number of women without coverage for
prenatal care and the actual deliveries. "All told," the report said,
"Texas is eliminating coverage for between 344,000 and 494,000
children and adults. Census data showed that, even before these
changes, the percentage of people who were uninsured was higher in
Texas than in any other state."
A loss of health coverage frequently leads to a reluctance to seek
needed care. "In poor or low-income families, where there is not a lot
of disposable income, people will avoid going to the doctor or getting
a prescription," said Leighton Ku, one of the authors of the report.
"Certain diseases can then become much more severe. With children,
it's likely that they won't get treatment for ear infections, asthma,
diabetes — conditions that can ultimately lead to
hospitalization."
When treatment can no longer be avoided, the financial consequences
can be ruinous. Medical expenses are one of the leading causes of
bankruptcy in the U.S.
Officials at the center noted the case of a woman in St. Louis who
works but whose annual income is below the poverty line. Under
eligibility rules in effect until 18 months ago, she would have
qualified for Medicaid. Under the new rules, she does not.
The woman became ill and was told upon her release from the
hospital to seek follow-up care. But without any health insurance, her
medical bills have been overwhelming. According to the center, "[The
woman] has occasional abdominal pain but is not getting any treatment.
She intends to declare bankruptcy because she cannot pay the $47,000
she owes in medical bills, but so far has been unable to save the
funds needed to pay for a bankruptcy filing."
People caught in this kind of squeeze often find themselves
"sicker, much poorer, or both," said Robert Greenstein, the center's
director.
It seems extremely strange that in the United States of America,
the richest, most powerful nation in the history of the world, we are
going backward in the 21st century in our ability to provide the most
fundamental kinds of health care to ordinary people, including
children.
The health insurance cutbacks would have been even worse if not for
the $20 billion in emergency state aid that was reluctantly approved
by the Bush administration and the Republican-led Congress last year.
Despite the economic upturn, states are still struggling. They face a
collective budget deficit of $40 billion to $50 billion for the coming
fiscal year, and there is little sentiment among Republican leaders in
Washington for another round of fiscal relief.
Maybe the nation itself needs a doctor. Shoving low-income people,
including children, off the health care rolls at a time when the
economy is allegedly booming is a sure sign of some kind of sickness
in the society.
