Children on Medicaid get reprieve

OLYMPIA – Gov. Gary Locke on Tuesday granted a reprieve to the parents of 74,000 children who rely on Medicaid for their kids’ health care by delaying a plan to make them pay monthly premiums for each child.

Health-care advocates estimate that nearly 9,000 of those kids are from Spokane County.

Under a controversial new state budget rule, the state planned to make those parents pitch in $10 to $15 per child per month for health care, starting in July. If they didn’t pay, the kids would be booted off Medicaid.

Locke, who had initially supported the plan, said Tuesday he’ll delay requiring the payments until July 2005.

“Even these seemingly small premiums may be detrimental to low-income families,” he said.

That’s for sure, said Jennifer Hansen, a 32-year-old mother of two in Spokane. She has no health insurance, but her 8-year-old daughter and 13-year-old son are covered by Medicaid.

“People that have a lot more money say, ‘What’s $15?’ ” Hansen said. “But $15 to someone that has only $300 – and has to support three people with rent and food and everything – $15 might as well be a million.”

The new rule would have applied to parents earning 150 percent to 200 percent of the federal poverty level, or $23,500 to $31,300 for a family of three. State lawmakers, particularly in the Republican-controlled Senate, argued last winter that people should be required to pay at least something for health care.

“Everybody ought to have a stake in their own health care, whether it’s a couple dollars or a couple hundred dollars. In this case, it would be a couple dollars,” said Sen. Joe Zarelli, R-Vancouver. “I don’t think it’s an issue of money. It’s an issue of responsibility.”

Hospitals, doctors and advocates for the poor, however, pleaded with lawmakers and the governor. Even a small payment, they argued, would sometimes be too much for families struggling to pay the rent and put food on the table.

The payments, advocates predicted, would cost 4,000 children their Medicaid eligibility. Among those: an estimated 327 in Spokane County. And when they got really sick or injured, critics pointed out, the children would still likely turn up at clinics and hospitals, without any coverage at all.

“Uninsured children don’t just disappear,” said Paola Maranan, executive director of The Children’s Alliance, an advocacy group.

Locke, in an interview, said he still supports the idea of having people pay something.

“I very much believe in a very modest cost-sharing as part of family personal responsibility,” he said.

But he said the state can afford to phase it in more slowly than planned. Here’s why: Two years ago, Washington tightened the rules for Medicaid recipients. Instead of taking people’s word for how much they earned (and checking up with random audits), the state now requires people on Medicaid to show how much money they earn. And eligibility is now reviewed every six months, instead of every year.

As a result, Washington’s Medicaid rolls have shrunk by more than 20,000 people. That saves taxpayers about $12 million in the two-year budget cycle ending next June. The new payments would have raised about $4 million a year.

“It’s easily offset by the savings,” said Jon Gould, deputy director of The Children’s Alliance, an advocacy group.

Still, some lawmakers apparently felt like they’d been bypassed by Locke.

“We negotiated a budget in good faith. He (Locke) was a participant in that,” said Zarelli. “Now he just wants to do what he wants to do. . . . We’re not in the Kingdom of Locke.”

Locke said that the payments weren’t spelled out in the budget; they were simply among the assumed savings.

“This was one of those assumptions,” Locke said. “If we’re able to reach the same level of savings, why not do it?”