To: xcr600 who wrote (12603 ) 6/26/2003 12:04:56 PM From: Bucky Katt Read Replies (1) | Respond to of 48461 Facing a Crunch, States Drop Thousands Off Medicaid Rolls 'Optionals' Who Didn't Meet Strict Guidelines Received Health-Care Coverage Nevertheless By SARAH LUECK Staff Reporter of THE WALL STREET JOURNAL SCRIBNER, Neb. -- As he usually does before his twice-a-month visits to the Scribner Pharmacy, Bob Hudson sat down at his home computer recently to check his bank account. The balance was $38.95. "It's enough," he said. Mr. Hudson, 33 years old, drove to an ATM machine and withdrew two five-dollar bills to cover the $2 Medicaid co-payments on his medications for diabetes and asthma. But the unemployed welder soon is likely to be dropped by Medicaid, after which he'll face a $900 monthly tab for prescription medicines. "If I lose Medicaid and can't get my medication, there will be a coffin, and I'll be laying in it," he says. Mr. Hudson is a Medicaid "optional," one of an estimated 15 million low-income people who for years have been permitted to participate in the joint federal and state health-care program for the poor even when they didn't meet the most stringent federal eligibility requirements. For a Nebraska family of six, that would be an annual household income below $10,500. Now, as cash-strapped states struggle to balance budgets, many are eliminating Medicaid coverage for optionals. Medicaid consumes on average 15% of state budgets, and in the last two years, at least a dozen states passed legislation or received federal permission to disqualify hundreds of thousands of people hovering at the margins of poverty. Last year, Michigan cut about 38,000 Medicaid recipients. In Colorado, lawmakers voted in February to cut 3,500 legal immigrants, one-fourth of them children. In April, 36,000 childless adults in Massachusetts were cut. Tennessee last year pared 200,000 people from its expanded program for uninsured people. In some cases, those changes have taken full effect; others have been delayed by lawsuits or political wrangling. During the next year, about one million optionals will lose Medicaid coverage if all of the cuts take effect, according to an analysis in March by the Center on Budget and Policy Priorities, a Washington think tank that focuses on low-income people. Many will join the 41 million people in the U.S. who already have no health insurance.online.wsj.com