Medicaid changes would bump some out of health care

Measure would save state about $2 million a year, reduce care for pregnant women and children

Posted: Tuesday, April 08, 2003

A Senate committee Monday proposed saving about $2 million next year by providing health care to fewer pregnant women and children.

The Health Education and Social Services Committee did so by amending a bill to put tighter limits on how much money a family can make and still qualify for Denali KidCare.

That program provides health care to children and pregnant women in families that make too much money to receive traditional welfare, but don't have health insurance through their jobs.

The committee's proposal would reduce the income level to qualify for Denali KidCare from 200 percent of the federal poverty level to 175 percent of the current level.

That would mean children in a family of four making more than $40,260 a year would no longer qualify. Under current guidelines, a family of four can make up to $45,996 a year.

Sen. Gary Wilken, a Fairbanks Rebublican, said the current guidelines seem excessive, particularly since Alaska Permanent Fund dividends aren't counted in deciding eligibility.

"This is very much a judgment call," he said, in offering the proposed numbers adopted by the committee. "It's subjective, but I think it's a place to start our discussion."

The changes were made to a bill introduced by Republican Gov. Frank Murkowski. Murkowski had proposed freezing the income guidelines that determine eligibility for Denali KidCare, as well as the income guidelines for receiving Medicaid-paid nursing home care. That would allow fewer people to qualify for the programs over time.

Murkowski did not propose actual cuts in the income guidelines.

"They are high standards," Health and Social Services Commissioner Joel Gilbertson acknowledged. "The governor does support those high standards, however."

Gilbertson estimated the committee's change would save $2 million. He did not know how many people would lose coverage.

Marie Lavigne of the Alaska Public Health Association urged the committee not to change the current program.

"From a public health perspective, any short-term savings does not compare to the greater long-term costs to the health of pregnant women and children," Lavigne said.

Uninsured children are four times more likely to go without medical care than insured children with the same needs, she said. And when they do get care, they are sicker and more likely to wind up in the emergency room, Lavigne said.

Wilken's amendment and the bill passed on a 3-2 vote. Republican Sens. Lyda Green of Wasilla, Fred Dyson of Eagle River and Wilken voted "yes," while Anchorage Democrats Gretchen Guess and Bettye Davis voted "no."

The committee made no changes in the section of the bill dealing with eligibility for nursing home care. The measure freezes the top income level at which Alaskans can qualify for nursing home care or similar home-based services at $19,872 a year.

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