Major rips found in social safety net 

Medicaid flaws

While many Americans believe that Medicaid, the federal program established in 1965 to provide health insurance to the poorest of the nation’s poor, serves as an effective social safety net, low-income advocates now say that some 13 million Americans are, in effect, working without a net.

A new report released by Montana People’s Action (MPA) in conjunction with Families USA, a national healthcare advocacy group, reveals that more than four out of five low-income, uninsured Americans remain ineligible for Medicaid or other public health coverage.

In Montana alone, the latest data reveals that an estimated 67 percent of all low-income parents—some 18,695 parents living below 200 percent of the federal poverty line— have incomes that the state considers “too high” to qualify for Medicaid coverage. The numbers among non-parents are even higher, with 47,432 Montanans who do not qualify for Medicaid assistance. The problem, say low-income advocates, is that under Medicaid’s broad federal guidelines, each state has the authority to set its own eligibility standards. As a result, Montana often denies Medicaid benefits to people based on the assets they own rather than on their annual income.

“People in Montana get dinged if they have a car or if they own a house, even though, realistically, those aren’t liquid assets,” says Melissa Case with MPA in Bozeman. “But the state has a lot of leeway in terms of both income eligibility and what kinds of eligibility tests they’re requiring people to meet.”

According to Case, one of the most surprising revelations to come from this study was the number of Montanans working one or even two fulltime jobs whose jobs do not provide health insurance, or who cannot afford to pay for health insurance themselves. Health plans, which for adults can run from $380 a month for a single person to more than $800 a month for a family, are essentially out of reach for virtually all low-income Montanans. That said, the problem isn’t confined just to low-wage workers.

“I’m blown away by the number of folks who are working at what I would consider to be relatively good jobs in Montana, jobs that are paying $9 to $15 an hour, where they still can’t afford health insurance,” says Case. “If it weren’t for CHIP—the Children’s Health Insurance Program—their kids wouldn’t be insured.”

MPA and Families USA are calling on Sen. Max Baucus (D-Mont.) as chairman of the Senate Finance Committee to address the problem in the Senate Finance Committee as its take up the various bipartisan proposals on their agenda in the coming weeks. According to MPA, a Congressional Budget Resolution has allocated $28 billion over the next three years to provide health care for the uninsured.

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