24 Mar Thousands Face Delays in Government Health CareMarch 24, 2010
By: John HannaSource: Business Week
The sour economy has pushed a growing nu mber of families into government health programs but in cash-strapped states like Kansas, thousands face delays in actually getting the coverage.
Kansas has a backlog of nearly 25,000 applications for Medicaid and the Children’s Health Insurance Program, and about 17,000 of those are more than 30 days old, up from only 10,000 about a month ago. State officials blame such delays on multiple rounds of budget cuts for the agency that administers the programs.
Clinics providing services to poor and working-class families say some of them have been waiting several months to have their state coverage confirmed. Clinic workers and health care advocates worry that many are delaying medical care or racking up large bills without knowing whether they’ll be paid.
Angela Perry, an unemployed nurse in Wichita, has been waiting for three months to find out whether she and her husband, also unemployed, will be covered by Medicaid. He has heart problems but can’t get tests he needs, and their prescriptions run $300 a month. Her 10-year-old son has skipped daily medications for his anger problem.
"If I have to go to the emergency room, I have to pretty much be on my deathbed," Perry said.
For families like the Perrys, the recession has a cruel twist. Just as they are most in need of state help, it has become less accessible. The sweeping federal health care legislation that President Barack Obama signed Tuesday increases who can receive Medicaid, but Kansas struggles to handle its current load.
And it’s not the only place where applicants for medical coverage face delays. The Kaiser Commission on Medicaid and the Uninsured recently reported that Medicaid enrollment in the U.S. grew by 3.3 million — or 7.5 percent — fro m June 2008 to June 2009 while most states had significant budget problems.
"At the same time, states are cutting back on their administrative resources," said Robin Rudowitz, the commission’s associate director. "It is a likely situation that they’re going to face some additional backlog."
Besides the backlogs, budget problems are affecting Medicaid and other social service programs in other ways. Wisconsin put 29,000 childless adults on a waiting list because it couldn’t afford coverage for them. Arizona legislators have granted the governor the power to kick 310,000 people off Medicaid by changing eligibility requirements.
And in November, Kansas Gov. Mark Parkinson ordered a 10 percent cut in reimbursement rates to health care providers serving Medicaid participants.
It’s not clear exactly how Obama’s health care overhaul would affect those numbers over time, but his plan eventually will extend coverage to 32 million uninsured Americans.
Nevertheless, the current backlog in processing Medicaid applications is frustrating.
"These kinds of things punch a big hole in the safety net," said Krista Postai, executive director of the Community Health Center of Southeast Kansas, in Pittsburg. "Every day, it’s a struggle to get people what they need."
Desiree Barnett, a Wichita resident who lost her job at a call center last summer, came to the nonprofit Medical Service Bureau for help after her 1-year-old son developed a sinus infection. The bureau provides prescriptions for poor families or connects them with company discounts.
But Barnett has collected several t housand dollars in hospital bills because she’s taken her 3-year-old to the emergency room several times for serious asthma attacks. She couldn’t enroll him in a Head Start program this winter because she couldn’t get him the required physical.
"I don’t have the money, and I don’t have a medical card," she said.
Medicaid covers poor families and adults, while CHIP is for children with parents who work but can’t obtain or afford health insurance. As of January, about 314,000 Kansas residents a month were receiving state medical coverage; that’s 5 percent higher than it was for fiscal year 2009, which ended last June.
In Kansas, Parkinson and legislators cut funds for the Kansas Health Policy Authority by more than 20 percent. The authority runs Medicaid and CHIP, and its budget-reduction measures included staff cuts.
"The resources just aren’t there to handle the volume of applications that we receive," said Andy Allison, the authority’s executive director.
Allison said he worries about the state’s ability in the near future to keep meeting the federal government’s 45-day guideline for processing applications. But others, like Postai, question whether Kansas is in compliance now.
"I’m hearing that it’s not unusual for people to be waiting 60 days or longer," said Dave Sanford, executive director of Wichita’s GraceMed clinic.
Meanwhile Perry, the unemployed nurse, has watched her son’s grades slide when he wasn’t on his medications because he had trouble controlling his temper and concentrating at school.
She also took him to the emergency room in December in January, for strep throat and stitches in his foot. She’s waiting for the bills to arrive and expects them to be "hefty."