Good decision for New Jersey’s poor

Good decision for New Jersey’s poor
Home News Tribune Online 06/20/07

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

In presenting a budget for the state of New Jersey for fiscal year 2007-08, Gov. Jon S. 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 and has in fact been part of the proposed state budget for the last several years. Forty-five states in this country already have adopted copays, but the New Jersey Legislature has rejected this idea every time it has been proposed.

Corzine, Senate President Richard J. Codey and Assembly Speaker Joseph J. Roberts Jr. have again decided that the copay proposal should not be included in the budget. This is a wise and moral choice by leaders in government. It is also clearly 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.

Indeed, in the proposed budget for fiscal year 2007-08, the governor is calling for a raise in the eligibility level for the state’s 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.

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. But for those earning $23,000 a year, 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.

Of course 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, of course, 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, like Sen. Joseph Vitale, D-Middlesex. People should begin to weigh in on this now and can, in fact, 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 that they will not be included in future budgets.

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