Asbury Park Press

Medicaid Recipients Win With Copays Dropped From Budget

Asbury Park Press — Thursday, June 21, 2007

BY THE REV. BRUCE H. DAVIDSON

New Jersey is a place where people can find outstanding health care and emergency treatment. However, many of the lowest-income people do not benefit from this resource. The cost and burden of medical care is a leading cause of homelessness in New Jersey, and many low-income people often forgo doctor visits and medications in order to meet the costs of food, utilities or child care.

A decision by the Corzine administration and leadership in the Legislature, however, affirms that the medical needs of the poor are being acknowledged and taken seriously.

In presenting the fiscal year 2007-08 budget, Gov. Corzine initially proposed that people who receive Medicaid benefits pay a copay for medications, outpatient use of hospital lab tests and medical day care services. This is not a new idea. It has been part of the proposed state budget for the last several years. Forty-five states already have adopted copays, but New Jersey's Legislature has rejected this idea every time it has been proposed.

Last week, the governor, Senate President Richard J. Codey, D-Essex, and Assembly Speaker Joseph J. Roberts Jr., D-Camden, have again decided the copay proposal should not be included in this year's budget. This is a wise and moral choice by leaders in government. It is also consistent with other significant anti-poverty efforts the governor has proposed.

And it is good news for people struggling with low wages and fixed incomes. The copays may seem insignificant to many people, and monthly "caps" seem to make them affordable for just about anyone. But, like any other copay, they can add up, especially if a person is a low-wage earner and needs several different services or medications.

To be eligible for Medicaid, a family of three would have an income of less than $23,080 a year. That's slightly less than $11.50 an hour for 40 hours a week. With average rents in the state running close to $1,200 a month for a two-bedroom apartment, it is fairly easy to see that these low-wage households are struggling just to put food on the table. Over the course of a year, copays could cost a family an additional $100 to $200. And $100 to $200 a year means a lot to these low-income households.

In the proposed fiscal year budget, the governor is calling for a raise in the eligibility level for the Earned Income Tax Credit. If this passes, that Medicaid-eligible family earning $23,080 a year could receive a benefit, interestingly enough, of just a bit more than $200 a year. Removing the copay provision means that low-income people will not lose the value of this benefit if they encounter a serious illness.

Many of us know firsthand that our access to quality care, medication and treatment is saving our lives. All of us need to think seriously about how much this is compromised for the lowest-income residents of this state. Copays have become an expected part of virtually every medical plan. For people fortunate enough to have resources of income and health insurance, copay costs are not likely to mean major deprivation.

At $23,000 a year, however, copays can be a deterrent, not just a costly inconvenience. People know that many serious illnesses can be managed or averted by regular use of a medication. But if your income is at a level that you need to rely on Medicaid, a copay may put you in the position of choosing between filling a prescription or applying that $10 to the rising cost of fuel oil.

Eliminating one barrier to health care for low-income people does not come close to fixing the problem of access. Public concern over the cost of medical insurance may finally push the federal government to consider some reasonable plan for universal coverage. This could take years to enact.

In the meantime, plans to expand access to health care in New Jersey are being developed by courageous leaders in state government, such as Sen. Joseph Vitale, D-Middlesex. People should begin to weigh in on this now. They can do so by visiting Vitale's Web page, where they can consider some options and express thoughts and opinions.

Leaders in state government were right to take Medicaid copays out of the state budget. One can hope they will not be included in future budgets. Medicaid copays basically impose a tax on people who are poor and have the bad fortune to get sick. New Jersey, the wealthiest state in the country, can find better and more just ways to balance its budget.

The Rev. Bruce H. Davidson is director of the Lutheran Office of Governmental Ministry in New Jersey.

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