Tuesday, August 30, 2005

Case-in-point: Medicaid Cuts Force People to Quit Jobs

Another example of Republicans 'helping the economy.'

XIN LI, COLUMBIA MISSOURIAN - Alice and Jeff Vandyke have faced their share of hardships during their 19 years of marriage. Jeff has a developmental disability that’s left him with limited mobility from his neck down; Alice suffers from a back injury... The Vandykes are among 18,000 Missourians with disabilities, including 488 in Boone County, who will be affected by elimination of medical assistance for workers with disabilities.

The program, which the Vandykes have been enrolled in for four years, has served as a major incentive for people with disabilities. It has let them hold down a job by providing Medicaid coverage and allowing a monthly income of up to 250 percent of the federal poverty level, or $1,994.

That’s about to change.

More than half of Missourians with disabilities who were enrolled in the medical assistance program, amounting to 9,529, will lose their Medicaid coverage altogether. Another 4,700 people with disabilities in the program, including the Vandykes, are being forced to choose between losing their Medicaid coverage or enrolling in a program known as “spend-down,” the main Medicaid program for people with disabilities who are not employed.

But enrolling in spend-down comes with a price of its own: many people with disabilities who have part-time jobs would lose their incentive to keep working...

“They are doing their best with their jobs. They try to be productive. They feel good about themselves and put something back to the system,” Hendren said. “But now all that will be gone.”

Under spend-down, individuals must pay their own medical expenses until their income drops to 85 percent of the federal poverty level, or $678 a month. At that point, the state will pick up the tab. The more someone earns, the more medical expenses they would need to shoulder. That leaves the Vandykes in what they see as a no-win situation.

Moving to spend-down would allow them to keep their Medicaid benefits. But no matter how much they earn, $1,300 a month is the most income they could keep. After paying for rent and utilities, the couple would only have about $54 a month for food.

At mid-week, the Vandykes were leaning toward enrolling in spend-down. Otherwise, they will both lose their entire Medicaid coverage and have no way to afford their medical bills...

Benefit specialists and Medicaid case workers offered the couple some solutions, but the Vandykes consider some of them unacceptable. One suggestion, getting a divorce and living in separate residences, would allow Jeff, who has the highest medical expenses, to continue his Medicaid coverage and would allow Alice to return to work.

(Guess that's the Republicans way of promoting the 'sanctity of marriage' nowadays....)

“We just live day by day,” Alice Vandyke said. “The legislators and governor have no idea the effects they will have on people. Maybe they don’t know the impact, or they just don’t care.”

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