Katrina and Bush: Two Nightmares Without End

Here:

Two months after vicious winds and surging waters crushed communities on the Gulf Coast, the health institutions impacted by the storm are at the center of a different calamity, fraught with waiting lists, empty prescription bottles and unpaid medical bills.

The Bush administration’s plan for addressing the health needs of hurricane survivors is to adjust the Medicaid system, the federal healthcare program for the poor. But healthcare advocacy groups say such stopgap measures fail to remedy the short-term crisis or the longstanding problems amplified by the plight of Katrina’s poorest victims.

Through a special waiver program, the Department of Health and Human Services has authorized states to provide Medicaid to Katrina survivors, based on existing eligibility guidelines that cover families, the elderly and the disabled. But these provisions leave out many poor adults, including those who have lost jobs and employer-sponsored healthcare plans due to the hurricane.

Medicaid enrollment patterns in Louisiana’s hurricane-shelter population indicate that even in their native state, a large portion of people seeking assistance will be shut out of the system. A state-led outreach effort in shelters, which ended last month, found that nearly one in every five survivors who requested Medicaid was rejected during initial eligibility screenings because they did not fit Medicaid requirements.

Tara Lachney, a spokesperson for the Louisiana Department of Health and Hospitals, reported that of about 6,900 remaining households that progressed to the application process, nearly 60 percent were denied coverage, or had their applications shelved "in hopes that we would be able to cover them under a future program."

Those hopes are riding on legislation to expand Medicaid in Katrina’s wake. A bill introduced by Senators Charles Grassley (R-Iowa) and Max Baucus (D-Montana) would essentially grant full coverage to all affected individuals who met basic income requirements and would waive state matching fund rules, thus committing the federal government to absorbing the full cost.
But conservative lawmakers have stalled the proposal, instead pushing through a narrower plan that would relieve impacted states of matching payments but would not broaden eligibility categories.