Maryland mishandle welfare reform

Thousands may have lost Medicaid because of bureaucratic snag

May 21, 1999|By Kate Shatzkin | Kate Shatzkin,SUN STAFF

Thousands of Marylanders may have left the welfare rolls over the last two years only to have their health insurance improperly cut off due to a bureaucratic snags, according to advocates and state officials who are trying to correct the problem.

Other families that have tried unsuccessfully to join the welfare rolls also may have been wrongly denied Medicaid.

"I'm excited to be working, and in another sense I'm depressed," said Darlene Curry, a Northeast Baltimore woman with diabetes and asthma who has struggled to regain medical assistance since leaving welfare in 1997 for a job as a school custodian. Her bills for insulin, syringes and asthma pumps can total $200 a month -- a third of her take-home pay, she said.

Lawyers for former welfare clients and state officials are trying to find out how many families have been affected -- and how many are still without benefits. State officials say they need to review the cases of more than 70,000 people -- two-thirds of them children -- who may be eligible for Medicaid but are not receiving it.

The problem is not unique to Maryland.

When federal welfare reform legislation passed in 1996, welfare recipients automatically were considered eligible for Medicaid. But in order to aid the transition for people leaving the welfare rolls under the reform, Congress severed the linkage, requiring that caseworkers do an independent evaluation of whether people leaving welfare were still eligible for medical assistance. For new jobholders, such as Curry -- employed but without health insurance -- the reform legislation provided for a year of transitional coverage.

But in a study released this month, a national advocacy group reported that many states appear to have been ignoring those requirements. The study, by the health policy group Families USA, estimated that in 1997, 675,000 people across the country were left without health coverage as a direct result of welfare reform. Children made up 62 percent of those left without benefits, the group said.

Georges C. Benjamin, secretary of the Maryland Department of Health and Mental Hygiene, said he is confident that many of those who had lost Medicaid improperly either have subsequently been returned to the medical-assistance rolls or are no longer eligible.

In fact, Medicaid enrollment in Maryland rose by about 20,000 people between January 1997 and January 1999, state figures show, suggesting to Benjamin that some families have been able to regain medical assistance shortly after losing it. Some children may have been identified through the year-old Maryland Children's Health Program, which insures children in families with incomes up to twice the poverty level.

Officials with the health department and the state Department of Human Resources have issued new procedures for caseworkers to prevent them from cutting off medical assistance without a separate evaluation, and are adjusting the state's welfare computer system.

Officials are trying to track down people who may be eligible for help, using University of Baltimore researchers, letters, calls and possibly radio ads to find them.

"We probably have the most comprehensive plan of any state in the nation to begin working on this problem," Benjamin said. "A year from now, we think we will have made tremendous strides."

Some of those strides came after 12 students at the University of Maryland Law School spent a semester interviewing former welfare clients -- and, along with lawyers for the Family Investment Program Legal Clinic in Baltimore, recently threatened the state with litigation if the practices weren't changed.

"The default positions on the computer have been set, until very recently, to turn people down," said Karen Czapanskiy, a professor at the law school who supervised the students. "We are really glad that it is now something they are taking energy to work on."

Princess Norwood of West Baltimore lost medical coverage when she was cut from the welfare rolls in January. She had missed too many days of a job-training program, she said, because she needed to care for her 3-year-old son, who has severe asthma. But advocates say that because she had no income, she should have remained eligible for medical assistance.

Norwood waited two months before she could return to both the welfare and Medicaid rolls -- a period during which she treated her own asthma with medication already on hand for her son.

"While I didn't have medical assistance there wasn't really any use going to the clinic," Norwood said. "I figured that I wasn't going to get what I needed to get."

Families with questions about health insurance eligibility for children should call 800-456-8900.

Pub Date: 5/21/99

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