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Many More Sink into Gap Between Medicaid, Cobra

Thursday, June 18, 2009

Medicaid coverage, which insures three times more women than men, has risen by about two-thirds during the recession. But many jobless women don't qualify and are becoming uninsured. Second in a series on women's health care in the recession.

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Medicaid coverage, which insures three times more women than men, has risen by about two-thirds during the recession. But many jobless women don't qualify and are becoming uninsured. Second in a series on women's health care in the recession.
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Medicaid coverage, which insures three times more women than men, has risen by about two-thirds during the recession. But many jobless women don't qualify and are becoming uninsured. Second in a series on women's health care in the recession.

Rachel Klein of Families USA

(WOMENSENEWS)--Rosita Velez has fallen through the cracks.

Like many women who've lost their jobs in the recession, Velez, a widowed single mother from Bridgeport, Conn., has lost her insurance coverage. It disappeared last year along with her 10-year position at the local phone company.

Velez can't afford COBRA: continuation of her preexisting employer-sponsored coverage, which is federally supported yet would cost her $1,100 a month. Her unemployment insurance and death benefits from her late husband put her over the income threshold for Medicaid and state-sponsored insurance. So, like a growing number of women, Velez is going without coverage and has had none for the past nine months.

"My daughter qualifies for state health insurance, which is a blessing because she has a heart condition and epilepsy," says Velez. "But I have health issues, too: rheumatoid arthritis that causes pain and tingling in my hands because I can no longer afford the medication I need."

Nearly two-thirds of women aged 18 to 64 have employer-sponsored health insurance, while 16 percent have coverage through government programs such as Medicaid (which insures 10 percent of all United States women), reports the Washington-based National Women's Law Center.

More than 70 percent of Medicaid's adult beneficiaries are women. The program's total rolls include 30 million low-income children; 15 million of their parents; and 14 million people who have disabilities or are low-income seniors.

As the recession deepens, health advocates say those numbers are bound to shift, with fewer women receiving coverage through their jobs and more turning to the government for help--and not always getting that help when they apply for it.

Medicaid Rules Out Many

Many women don't qualify for Medicaid because they do not have dependent children.

Many, like Velez, have too much income to be eligible (though not necessarily enough money to afford private insurance coverage, which cost an average $4,704 a year for an individual and an average $12,680 for a family in 2008).

Even for women who do qualify, Medicaid may not come as quickly and readily as it did in the past, says Rachel Klein, deputy director of health policy for the Washington-based Families USA.

"Though formal studies on this have not been done yet, state government representatives say they've seen a two-thirds increase in the number of people applying for government-sponsored programs including Medicaid," says Klein. "And since the recession has forced states to lay off social workers, it is taking longer to process applications for these programs."

As the recession deepens, state and federal revenues are both declining, depleting Medicaid's two shared funding sources.

Federal Lawmakers Help

In February, federal legislators moved to address this concern by passing the American Recovery and Reinvestment Act of 2009. The law provides $87 billion for a temporary increase in the federal share of Medicaid costs.

Despite this help, Medicaid is still in trouble, reports the Kaiser Family Foundation, based in Menlo Park, Calif.

Kaiser studies indicate that 46 states are facing budget deficits that could total $350 billion from 2009 through 2011.

The foundation also projects that if unemployment--now 9.4 percent--rises to 10 percent, 13.2 million people will lose their employer-sponsored insurance, government-sponsored programs will enroll 5.4 million people and 5.8 million more will go without coverage.

Kaiser studies also show that for every 1 percent increase in the unemployment rate, 1 million more Americans will turn to Medicaid--and 1.1 more million will fall through the cracks and be left, like Rosita Velez, without any health insurance at all.

Unemployment has spiked 4.5 percent, up from 4.9 percent since the recession began in December 2007.

Discrepancies in eligibility requirements among the states also create unequal access for many women, says Cindy Pearson, executive director of the Washington-based National Women's Health Network. "In some states, you make too much money for Medicaid if you are at the poverty line. In other states, if a woman is pregnant, she can make two or three times the poverty limit and still get coverage."

Molly M. Ginty is a freelance writer based in New York City.

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