Pain of Colorado poor likely to be felt in classrooms

The ongoing recession and high unemployment is hurting Colorado families — 608,000 now qualify for Medicaid, the government’s health insurance for the poor — and the waves of pain again may extend into classrooms around the state.

Since Medicaid must be funded, as mandated by the federal government, state lawmakers are considering cutting school funding to cover the cost when they convene in Denver next month for the 2012 General Assembly. 

But it won’t be as easy as just reducing education funding because a judge recently ruled the state constitution requires lawmakers to spend more money on schools, as well. Some tough decisions await lawmakers.

At the heart of the problem is the growing number of Colorado poor: a $22,000 annual income for a family of four.

The state Department of Health Care Policy and Financing reports that the number of Coloradans who qualify for Medicaid grew by 216,000 since 2007. That translates into an extra $1.4 billion in costs to the state since the federal government only covers about half the cost of Medicaid.

Some advocates want to make sure lawmakers understand who benefits from Medicaid as they consider funding options.

Single people generally don’t qualify, unless they are developmentally disabled or are in other special circumstances, said Rachel Reiter of the policy and financing agency.

Generally, Colorado’s new poor are more likely to be people living in your midst, says Kraig Burleson, CEO of the Inner City Health Center in Denver.

“It’s not just the classic model of what you think of as poor,” Burleson said. “It’s your neighbors. It’s the recently unemployed. It’s just a different population than people think.”

Most people on Medicaid are kids, like the four children of Clara Harris of Aurora. Harris took them in as foster children covered by Medicaid, and then adopted them.

Harris, 55, also often babysits four of her grandchildren. Three of them are uninsured.

“His dad used to have insurance, but he can’t afford it anymore,” Harris said.

Last month, one of those uninsured children had to be rushed to the doctor with an asthma attack. The $70 bill for the doctor and prescription for 4-year-old Dante Jameson meant real sacrifice.

“We got together as a family and paid for it out of pocket,” Harris said.

Scraping up that money meant other things had to be cut.

“Seventy dollars means a lot to me,” Harris said. “I can take $70 and stretch it forever and make it work for my family. Food and everything else.”

On a recent day, all seven small faces crowded around Harris on the family couch, listening to her explain their tough circumstances in this economy.

“Just to feed them, to have a big Christmas dinner, it’s hard,” she said.

In February, Dante’s mom is having twins. She worked as an assistant manager at KFC, but lost the job and her insurance when she had to go on bed rest. She is applying for Medicaid, to get through her pregnancy, and likely beyond.

“My mom used to be in the hospital,” explained Dante. “Now’s she’s out. She had to get a needle in her arm. And she’s having two boys. And they’re twins, so when they get out they’re going to look the same!”

Of course, understand the problem doesn’t make the funding solution any easier.

Recently, Republicans proposed seeking federal permission to cut Colorado’s Medicaid budget. Gov. John Hickenlooper said no. The new federal health care law won’t allow states to restrict who qualifies, he said after a budget hearing.

“We can’t cut Medicaid. It’s against the law,” Hickenlooper told an Associated Press reporter.

Some Republican lawmakers believe some Americans think that government-funded health care is a “given.”

“It’s the entitlement mentality that we need to get past,” said state Sen. Kevin Lundberg, R-Berthoud. “We can’t provide all medical services for everyone at all times. When it comes to Medicaid, we need to find ways to keep the costs down, other than continually grow the pie.”

But Denver Democratic state Sen. Irene Aguilar, a physician, said: “We’ve cut all of the fat and are beginning to cut into the muscle” of the Medicaid program.

Aguilar says the people who rely on Medicaid are the ones who need it most: the disabled and the elderly.

“I hope as a country that we will continue to have a commitment to them and that . . . we’re not just going to let people die in the streets,” Aguilar said.

At the Inner City Health Center in Denver, 22 percent of the patients are on Medicaid and another 70 percent are uninsured. The phone rings constantly. New patients call to be seen for everything from diabetes to broken arms.

CEO Burleson is worried that more fortunate Americans are so overwhelmed with bad news about the recession that they are tuning out the problems of the poor and near-poor. He calls this a “sympathy gap.” He does not see any relief in sight for Colorado’s strained system of health care for the poor.

“I know there are some indicators – and I hope they’re true – that the economy may be improving,” he said. “But we don’t see that on the ground.  We don’t feel that within these walls.”

Gretchen Hammer, executive director of the Colorado Coalition for the Medically Underserved, warns that short-term cuts can hurt even more long-term.

“We’re 23rd in the nation for children who are overweight and obese,” she said. Failure to solve that will cause those children major health problems as they grow up. Ignoring the issue now, she says, will only cost a lot more down the road.