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Cuts in Medicaid could sever lifeline for the poor, advocacy groups say

This article first appeared in the St. Louis Beacon, Oct. 13, 2011 - The American Diabetes Association and the American Lung Association have added their voices to groups concerned about the harm potential Medicaid cuts would have on chronically ill blacks and Latinos.

The two organizations joined a coalition of civil rights and health groups Thursday in issuing a state-by-state breakdown of the number of poor minorities whose health could worsen in the event Congress cuts Medicaid to reduce the federal deficit. While most Medicaid recipients are white, the study says a larger proportion of blacks and Latinos have low incomes and are twice as likely as whites to qualify for the program. It said one in four people in black and Latino communities rely on Medicaid, compared to one in eight whites. The study depicts low-income minorities as struggling with disproportionately higher rates of serious and chronic diseases, complications, poor health outcomes and lack of insurance.

"Medicaid has been the saving grace for these communities," the report says. "Cuts in Medicaid would yank this lifeline away from those who most need it."

The report includes the following findings:

  • Medicaid covers care for nearly 20 percent of the estimated 11,000 Missouri blacks with cancer. Ten percent of the estimated 1,000 Latino cancer victims in Missouri are covered by Medicaid.
  • Nearly 23 percent of the roughly 61,500 black Missourians with diabetes rely on Medicaid coverage. Nearly 12 percent of an estimated 7,600 Missouri Latinos who are diabetics rely on Medicaid.
  • More than 71,000 black Missourians suffer from chronic lung disease; 37 percent of them rely on Medicaid for care. 12,000 Latinos in Missouri also suffer from chronic lung disease, and that nearly 39 percent of them get care through Medicaid.
  • About 20 percent of the nearly 153,000 black Missourians with heart disease or stroke are on Medicaid. For the estimated 16,600 Latinos who have heart disease or stroke, nearly 11 percent are on Medicaid.

Along with the national diabetes and lung groups, the report's sponsors are Families USA, the Joint Center for Political and Economic Studies, the NAACP, the National Council of La Raza, the National Medical Association and the National Urban League.

Potential cuts would lead to more uncompensated care, which would translate into higher premiums for those with health insurance, according to the study. "Lost worker productivity, worse performance in schools for sick children, more medical debt would all be byproducts of cutting Medicaid," the report said.

Cuts in Medicaid are likely to be considered by the Joint Committee on Deficit Reduction, commonly known as the super committee, which is exploring ways to trim $1.5 trillion in federal spending over the next decade. Consisting of six Democrats and six Republicans from the House and Senate, the panel was set up as part of the deal in August to raise the nation's borrowing limit. If either the super committee or Congress fails to agree to a deficit reduction plan, the debt-ceiling deal calls for $1.2 trillion in automatic cuts, evenly divided between military and domestic spending, over the next decade.

Medicaid is a federal-state health insurance program for poor residents. Each state is required to cover services for poor children, pregnant women, parents with dependent children and seniors with disabilities. States also have the option of covering poor childless adults, but Missouri's program does not. The federal government adds a certain amount to each dollar that a state invests in Medicaid, with poorer states getting higher federal matches. On average, according to the report, the federal government contributes $1.60 for every dollar states put into their Medicaid programs. It is unlikely that financially stressed states would be able to offset any potential federal cuts in Medicaid.

One potential lifeline for the needy is the Affordable Care Act, the report says. Beginning in 2014, the health-reform law would extend care to most Americans unless the U.S. Supreme Court voids all or part of the law in response to legal challenges. The law is supposed to extend coverage to those with incomes below 133 percent of the poverty level -- roughly $30,000 for a family of four. In addition, tax credits would help provide care for Americans whose incomes are between 134 percent and 400 percent of poverty. This means a family of four earning between $30,000 and $90,000 a year would be eligible for the credits.

Although the study said health reform would benefit all Americans, it also said the law "could literally be lifesavers for millions of blacks and Latinos who are uninsured and who have serious health conditions."

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.