MEDICAID: WELFARE REFORM PUSHING CHILDREN OUT OF PROGRAM
"When Congress voted last year to overhaul the nation's muchThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
maligned welfare system, it explicitly sought to prevent poor
children from losing" Medicaid Benefits. However, the Los
Angeles Times reports, "thousands of children have fallen out of
the Medicaid program, even though they are still eligible."
Estimates of the decline in the number of children enrolled in
Medicaid vary from 200,000 to one million of the 16.5 million
children eligible for benefits.
MISCOMMUNICATION
Child health advocates attribute the drop to a variety of
problems, from "mistakes by the nation's sprawling welfare
bureaucracy to fear on the part of immigrants in California and
elsewhere that continued reliance on government benefits ... will
hurt their chances to become citizens." However, there is
concern among policy experts that the problem is only going to
get worse because "the welfare changes are just beginning to go
into effect in most states." Under the welfare reform law,
Congress "decreed that children should remain eligible for
Medicaid if their parents would have qualified for AFDC under the
old law." However, both government officials and Medicaid
beneficiaries seem confused by the new law. Diane Rowland,
director of the Kaiser Foundation on the Future of Medicaid,
said, "We've got ... fear, confusion and people being told they
are not eligible for benefits that they are eligible for, and
people who are misinformed when they come in here to apply for
benefits." The Los Angeles Times reports that women leaving
welfare for jobs "may not realize that, because they are still
poor, their children are still eligible for Medicaid." Pat
Redmond, health director of Philadelphia Citizens for Children
and Youth, said, "Many women believe erroneously that there are
work requirements or time limits attached to Medicaid, and some
seem not to be applying."
UNKNOWN CAUSES
Although federal health officials acknowledge that fewer
children are enrolled in Medicaid, they say they have not
"analyzed the cause." Sally Richardson, director of the center
for Medicaid and State Operations at the Department of Health and
Human Services, said, "There may be some fallout from welfare
reform, and we will step in and try to correct that whenever we
see it happening." Officials say other factors could be causing
the drop. One such cause is the "booming economy." However, the
Los Angeles Times reports that "census data show that the poor
are no better off than they were a year ago." And, as the cut-
off age for Medicaid eligibility is increased to 19, more
children should be enrolling in the program, not fewer.
IMMIGRANT CONCERNS
In California, a problem frequently cited is fear among
immigrants that reliance on benefits could jeopardize their
citizenship applications. Ken August, a spokesperson for the
California Department of Health Services, said that his
department is seeking out immigrants "who are not receiving the
medical benefits to which they are entitled." He said, "There's
clearly some confusion out there. ... Some people who may qualify
may not be taking advantage of the program."
WISCONSIN'S EXPERIENCE
Wisconsin, one of the first states to implement a
comprehensive welfare reform plan, could show what is in store
for the rest of the country. Although caseworkers are "strictly
prohibited from automatically dropping former welfare recipients
from the program," there are 43,000 fewer children on Medicaid
rolls in the state than there were three years ago. Analysts say
that this 40% to 50% drop in Medicaid enrollment in Wisconsin and
"two other states with similar programs" may be due to
"aggressive implementation of welfare reform." Peggy Barbels,
director of the Wisconsin Bureau of Health Care Financing, said,
"For three generations of families, they all got welfare, food
stamps and Medicaid rolled into one. Now the programs are
separate. Medicaid does not automatically come to you. We're
trying to reach out to those families. Believe me, we're trying"
(Rubin, 11/18).