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Report shows Medicaid cuts most affect women

November 30, 2005
By: Leslie Yingling
State Capital Bureau

JEFFERSON CITY - Recent cuts and eligibility reductions to Missouri Medicaid have the hardest effect on women, according to a report released yesterday by the National Women's Law Center.

The nonprofit organization, which advocates for women's legal rights, called on the state's Medicaid Reform Commission to examine how the state health care program affects low-income women and their families. The commission is charged with crafting a program that will replace Medicaid in 2008.

"Medicaid is a critical lifeline for many women and their children," said Judy Waxman, vice president for health of the National Women's Law Center. Because women work in lower-paying jobs than men, often without employee insurance, "women often have no choice but to turn to Medicaid for medical coverage for themselves and their families," she said. Women are most affected by eligibility reductions because the majority of parents eligible for Medicaid are mothers, Waxman said.

In Missouri, women comprise 79 percent of Medicaid recipients who are not elderly or disabled, Waxman said. Two-thirds of mothers on Missouri Medicaid are single mothers, and the program pays for 43 percent of births in the state, according to the report.

Single mothers were a "significant population taken off the Medicaid rolls," said Medicaid reform Commission chairman Sen. Charlie Shields, R-St. Joseph.

"There are alot of single mothers living in poverty that were eligible before and now are not, so we are looking at them in our goal to help all Missourians have some kind of health coverage," he said.

Reductions in income levels required for Medicaid eligibility are causing Missouri women to lose coverage, Waxman said. The eligibility level for parents was reduced to the mandatory 22 percent of the federal poverty level, "the most drastic cut in the entire country," she said. Under the new guideline, a family of three can earn $292 per month or less to qualify for Medicaid, she said, while before the change, the same family's monthly income could reach $980.

Stephanie Harris of Cape Girardeau, a 27 year-old single mother of a five year-old son, said that because of the lower eligibility standards she will lose her Medicaid coverage at the end of the month.

Harris is a social work student at Southeast Missouri State University, where she works part-time as a switchboard operator. She says she will go on to pursue a master's degree.

"Eventually I'm not going to need this program," she said. "At this point I really do."

As a family of two, Harris said that to keep Medicaid she could earn no more than $234 each month.

"That's ridiculous," she said. "There's got to be a better way to have done this."

The elimination of the women's comprehensive health care program from Medicaid reduced thousands of women's abilities to get preventive health care, said Kerri McBee, executive director of the Alliance for the Status of Missouri Women.

Amy Blouin, executive director of Missouri Budget Project, a welfare advocacy organization, said the program gave 30,000 women access to preventive health care services including pelvic exams, breast exams, and cancer screeenings.

"The program was very affordable for the state," she said.

Much of the Medicaid Reform Commission's work sessions have emphasized preventive care. "We don't want people to have to get ill before we pay for medical expenses," Shields said.

"If we are serious about preventive care, we need to institute basic women's health and family planning coverage, and expand the eligibility for all women to what it is for pregnant women, which is 180 percent of poverty," said commission member Rep. Margaret Donnelly, D-St. Louis.

"The National Women's Law Center report shows that these cuts don't make much economic sense," she said.

The commission is examining ways to save money without imposing too-stringent eligibility requirements, Shields said.

"We believe there are many ways to save money as you look forward, not only with eligibility," he said. "It may be possible to expand eligibility."

The commission's recommendations are due to Gov. Matt Blunt on Jan. 1.