IF YOU'VE NEVER had to choose between heating and eating - paying for fuel vs. paying for food - you're in a fortunate group. This year, you're also in a much smaller group. That's because the federal dollars for low- income home energy assistance funds (LIHEAP) have been sharply reduced - to less than half of last year's allocation, forcing more families to make the choice.

Last year, 547,000 Pennsylvania households got help paying for heating, in cash grants from $300-$1,000, or crisis grants of up to $400. Those amounts have now been reduced to $100-$300, and $300 for crisis grants. Eligibility for the program has also been limited; now, a family of four qualifies with an income of under $33,000. The state relies solely on the federal funds for this program, and unlike many other cold-weather states, makes no contribution of its own to the program.

Winter will always bring misery to some; a downturned economy has simply widened the misery net. Yet, this year seems particularly harsh, especially because many are now facing an even harder choice between heating and eating: It's the choice between being able to take a sick child to the doctor . . . and not being able to because of lost Medicaid coverage. In addition to administering the cuts in LIHEAP, the state is making major cuts to the Medicaid program. According to a report in the Inquirer, the state has cut 150,000 from the Medicaid rolls since August, including 43,000 children - 11,000 of those Philadelphia children. The Department of Public Welfare says it is just purging people who shouldn't be in the program to decrease fraud and abuse, but the steep cuts suggest a wider purging, helped along by cuts to the department's staffing that delay the application process.

Pennsylvania is not acting alone; since Medicaid is a big part of many state budgets, states around the country are cutting, but few are cutting at the rate of the commonwealth.

The budget constraints are real; on the other hand, these short-term cuts lead to much larger expenses down the road, as people without health coverage flood emergency rooms. There has to be better thinking about a middle ground.

Meanwhile, if you live in Pennsylvania, don't be poor. If you are, you're too distracted being hungry and cold to notice the irony of what the state Legislature neglected to do this session: establish an extraction fee for gas drillers, which would have meant millions in revenue coming into the state. That failure could make you sick, if only you could afford to be.