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Christie eyes curb on Medicaid rolls

Gov. Christie plans to seek approval for a proposal that would deny Medicaid coverage to adults in a family of four with an annual household income of little more than $6,000, down from the current $30,000.

Gov. Christie plans to seek approval for a proposal that would deny Medicaid coverage to adults in a family of four with an annual household income of little more than $6,000, down from the current $30,000.

A single mother raising three children who earned as little as $118 a week would not qualify for the government-funded medical coverage.

The eligibility-requirement change, which must be cleared by the Obama administration and would apply only to new adult Medicaid applicants, would follow Christie's eliminating - for the second year - a long-standing line item that would provide nearly $7.5 million in funding to family-planning clinics.

A 26-13 vote to restore the aid was passed in the state Senate on Monday, but was one vote short of a veto-proof majority.

The measure, which received some GOP support, also would require the state to expand Medicaid coverage for family planning and women's health care for the poor. It would be eligible for $9 in federal money for every $1 invested by the state. Christie has vetoed similar proposals in the past.

On Monday, Democrats linked Christie's opposition to funding the family-planning clinics - which provide a range of health-care services - and his attempt to all but freeze future Medicaid enrollments, which experts say would disproportionately affect poor mothers, as part of a larger "war against women" by the Republican governor.

"Who's going to raise the children if the family, the mothers and the fathers, can't have health care?" Sen. Shirley Turner (D., Mercer) asked at Monday's Senate hearing.

Christie has said his cut to family-planning clinics is a fiscal issue unrelated to his personal antiabortion beliefs. The funding sought by legislators could not be used for abortions.

The clinics are a source for Pap smears, breast-cancer screening, and STD treatment, according women's health advocates. Since the first cut last year, six of the state's 58 family-planning centers have closed.

In joining Democrats to reinstate the funds - which advocates said could come from a windfall in tax collections the state treasurer revealed last week - Republican Sen. Diane Allen (R., Burlington) cited two clinics that have closed in her county, and warned that eliminating access to cancer screenings "may cost women their lives." Dawn Addiego (R., Burlington) was the only female senator to vote against the bill.

The state has a redundancy in services, according to Christie, whose proposed budget would increase funds for family health services - including prenatal care - $32 million over what it was during the Corzine administration.

Women also can seek care at federally qualified health centers, the governor has said. But while the budget would slightly increase funding to the centers for care of the uninsured, the administration proposes to cut providers' patient reimbursement rate by 10 percent.

And, say Democrats, health centers also are so overwhelmed that they often can't see expectant mothers until their second trimesters.

"How dare my colleagues tell me that I or my daughter or any woman in New Jersey should be relegated to sitting in an emergency room to get prenatal care, or any kind of care?" asked Senate Majority Leader Barbara Buono (D., Middlesex).

"No one, in this state, is denied medical care," including the poor, Sen. Joseph Pennachio (R., Morris) said during debate on Monday.

New Jersey contributed $4.6 billion to the $10.7 billion Medicaid program in the state in 2010. But an estimated 23,000 people will be rejected if the federal government approves the state's proposal to freeze Medicaid enrollment for certain adults next year, according to Department of Human Services spokeswoman Nicole Brossoie.

The current program provides benefits to adult parents making up to 133 percent of the federal poverty level, or about $29,727 for a family of four. The state seeks to impose an income limit of $4,428 for a family of two, $5,316 for a family of three, and $6,084 for a family of four.

No one currently enrolled would lose benefits, and children still would be accepted, according to the state.

Brossoie said the state is proud that it accepts children in families with incomes of up to 350 percent of the federal poverty level.

"When you look at the program and the priorities in the program, a policy decision was made that it's important to insure children to keep them healthy," Brossoie said. Because state finances dictated the need for "cost containment," she said, "we had to look at the expansion categories for adults."

The Assembly will hold a hearing on the Medicaid plan Tuesday.

In an interview Monday, Assembly Speaker Sheila Oliver (D., Essex) called it the "craziest proposal."

"To think that low-income women who aren't insured have other places to go is just not true," she said.

The proposed measure is drastic and will prevent people working full-time minimum-wage jobs from receiving health care, said Ray Castro, a senior policy analyst at New Jersey Policy Perspective, a liberal-leaning think tank.

Though the federal health-care overhaul law will expand Medicaid starting in 2014, "things are going are going to get a lot worse before they get better," Castro predicted.

Dr. Jeffrey Brenner, who founded the Camden Coalition of Healthcare Providers to more efficiently provide care to the poor, said the Christie proposal was "rationing care."

"It's a quick and shortsighted solution" to the state's budget woes, he said, citing his group's success at reducing Medicaid costs. "Our challenge going forward is to figure out how to provide better care at less cost."

The state last week submitted a concept paper to the federal government outlining its proposals, and will submit a formal application for a so-called "global Medicaid waiver" next month. New Jersey is counting on receiving approval by Oct. 1.

All 120 seats in the Democratic-controlled Legislature are up for election this year, and focusing on Christie's "war" against women can help Democrats raise funds, according to pollster Patrick Murray, a political science professor at Monmouth University. Though polls show Christie has a far lower approval rating among women, Christie also can get political mileage out of the funding challenges, he said.

The cuts burnish Christie's profile among Republicans around the country - and not just among social conservatives who have opposed funding to Planned Parenthood. The governor has criticized President Obama and congressional Republicans for not curtailing entitlement programs such as Social Security. By taking on Medicaid, regardless of whether his proposal is accepted by the federal government, Christie puts action behind his talk.

At the same time, it doesn't hurt Christie in his bid for reelection in 2013 either, Murray said. That race hinges on whether he can reduce spending enough to lower property taxes, not on whether he takes care of the poor: Voters who would like more public assistance for the impoverished aren't voting for Christie regardless, Murray said.