Controlling state medical assistance costs

Washington taxpayers spend billions of dollars every year to provide medical assistance for needy individuals and families. But not all the recipients are truly needy or qualified for the assistance. Much of the money is going to illegal aliens and families and individuals who earn up to 250 percent of the federal poverty income level.

To ensure taxpayer dollars actually reach the folks who need them, lawmakers should consider the following recommendations.

1. Require documentation of income.
Before enrolling in a state-subsidized health care program, applicants should be required to verify their income level. Currently, the state does not require documentation of income eligibility for participants in maternity or children's programs. In addition, once a child is enrolled in a program, he or she can continue receiving assistance for twelve months regardless of changes in the family income. According to estimates by the Senate Ways and Means Committee, requiring proof of eligibility for these programs would save the state $35 million each budget cycle.

2. Reduce eligibility levels.
The State Children's Health Insurance Plan (SCHIP) currently provides health coverage to about 12,000 children (up to age 19) who live in households with income between 200 and 250 percent of the federal poverty level. At this level, a child in a family of three with a household income of $3,100 per month is eligible for the program.

Ten other states offer coverage to families earning more than twice the poverty level. Our neighbors do not. Oregon offers SCHIP and Medicaid coverage to families earning 170 percent of poverty. Idaho and Montana offer coverage at 150 percent of poverty. A plan being considered in the state senate this year would reduce Washington's eligible income level to 175 percent of the poverty level. Under these standards, a family of four could earn up to $32,000 a year and still receive assistance, and the state would save $95 million each budget cycle.

3. Stop providing prenatal coverage to illegal residents.
At a time when benefits are being reduced for legal Washington citizens the state should not be using taxpayer dollars to provide medical benefits to illegal residents.

Eleven states, including Washington, currently provide prenatal coverage to illegal aliens. Our neighbors—Oregon, Idaho and Montana—do not provide this coverage. Governor Locke's 2003-2005 proposed budget estimates that 6,800 pregnant women who are living in the state illegally and earning up to $2,300 a month will be eligible for prenatal benefits. This will cost taxpayers $47 million over two years.

Talk abounds of needing to cut medical assistance programs to make up for the state's budget shortfall. Lawmakers need to carefully review the state's medical assistance program to ensure efficient management of programs, verification of eligibility, and meaningful qualification standards so dollars and services reach state citizens who truly need them.

Prepared by Bob Williams, President and Senior Research Analyst (360) 956-3482

Evergreen Freedom Foundation P.O. Box 552, Olympia, WA 98507 Phone: (360) 956-3482, Fax: (360) 352-1874 Email: effwa@effwa.org