Monday, September 30, 2002
By Alonzo Weston
St. Joseph News-Press
Lesleigh Haight lost her independence to multiple sclerosis. The illness forced her to move in with a friend earlier this year.
Now she’s afraid she will lose her dignity, too, come Tuesday. That’s the day changes in the Medicaid “spend-down” program are supposed to take place across the state.
“I’ll have to beg to be able to do things,” Ms. Haight said. “Makes you feel like a worm.”
Ms. Haight is one of more than 25,000 low-income and disabled people in Missouri who rely on Medicaid health-care coverage. Like many of them, she is concerned about the coming changes in Medicaid coverage that she doesn’t fully understand.
Ms. Haight has no trouble comprehending the part where it will cost her more money. She also understands the changes might cause many others to lose their independence.
“I think it will force people to go into nursing homes whether they want to or not,” she said. “I think it’s baloney. I don’t know why it’s happening.”
The Medicaid spend-down revision is happening because Missouri Gov. Bob Holden believes he can trim $16 million from the state budget.
The way the program works now, the state government pays Medicaid patients for the drugs they purchase.
Medicaid spend-down works by allowing a person to qualify for Medicaid assistance by “spending down” to an eligible amount. The person can use prescription costs to reach that amount. Once that amount is met, the person is eligible for Medicaid for three months.
On Tuesday, spend-down will become the responsibility of the Medicaid recipient. He or she will have to pay out of pocket for medicine to meet the eligibility requirements.
Medicaid eligibility also will be conducted on a monthly basis, meaning a person will have to qualify for coverage from month to month instead of every three months.
In Ms. Haight’s case, that just means she’ll have less money for the little things, said her friend and caretaker Iva Artherholt.
“She ain’t going to have money for nothing. Ain’t going to have money to get Taco Bell,” Mrs. Artherholt said.
Ms. Haight was diagnosed with multiple sclerosis in 1984. She had been able to live on her own with help from her mother and Ms. Artherholt until this spring. Complications from the disease and an infection forced her to have an operation that left her bedridden and needing 24-hour assistance.
Mrs. Artherholt became her hired caretaker through the Midland Empire Resources for Independent Living — MERIL — program.
The 44-year-old St. Joseph woman moved in with Mrs. Artherholt, Mrs. Artherholt’s husband, John, 8-year-old son, Nick, and mother-in-law, Amy Troxell.
“It was either go in a rest home or pay for more help,” Mrs. Artherholt said. “With spend-down the way it’s going, it was going to be hard. She would have been forced to go into a rest home.”
Ms. Haight is able to meet her $450 spend-down now with the cost of the 12 pills she has to take daily. She has enough left of her $1,011 monthly Social Security check to pay Mrs. Artherholt $500 for room, care and board. She has plenty left over for clothing, toiletries, other needs and occasional wants. After Tuesday, Ms. Haight will have to pay the $450 spend-down every month from out of her own pocket. That will leave her with nothing but a pittance each month to spend on other needs and wants.
“My pocket is not that deep,” she said. “I’m not going to have anything.”
At least Mrs. Artherholt said Ms. Haight will still have a friend.
“Most people won’t have that luxury, she said. “I’ll still buy her favorite food and stuff, but that’s me. Everybody ain’t me.”
Debra Merritt, executive director for MERIL, said most people won’t be that fortunate, either. She also said she believes the spend-down change will eventually cost the state more money.
“In the long run it will increase spending for the state,” she said. “More people will end up in the hospital and in the nursing homes. I don’t think they looked at the long-term expense to the state.”
“My biggest concern is that individuals with disabilities will suffer,” Ms. Merritt added. “Most are going to have to choose to do without something.”
Karan Miller is preparing to do without everything but her home and her two best friends after Tuesday. Those are sacrifices the disabled North Side woman said she refuses to make.
“I don’t want to give that up (my house),” she said. “I got a dog and a cat, and I’ll be damned if I kill one of them. They mean the world to me.”
Ms. Miller also is not in the best health. The 58-year-old woman takes 15 different daily medications to cover her many ailments.
“I have diabetes, osteo-arthritis, gouty arthritis, asthma, blood problems …,” she said. “I’m either to the point where I can bleed to death, have a heart attack or a stroke or a blood clot. I’m not sure if I don’t have one in my leg right now.”
The spend-down amount she will have to pay from her monthly $557 Social Security check is only $11. But that’s an $11 that is often hard to come by, she said.
“When I get my check, then whatever’s left I go buy my paper supplies and cleaning products,” she said. “I know $11 don’t seem like much, but if I don’t have $11 in by the first of the month, I don’t get my medicine.”
InterServ enables Ms. Miller to be able to live own her own. She relies on many of the services the agency offers to keep her independence.
“She receives help from our in-home services department. She also receives services from our counseling department … and food from our food pantry, meals and clothing,” said Laura Elder, InterServ resource development director. “It takes every penny of her check to live on.”
Dave Howery, InterServ’s executive director, said he expects many more people will face hardships after Tuesday. He said the local community will be called on to support those people who will be affected by the changes. That means the cry for help could end up on the doorsteps of the churches, social service organizations and the public. But not many will ask for help, Mr. Howery said.
“There will be so many who will suffer in silence,” he said. “People
should have access to health care. It’s our basic legal right.”
Content ©2002, The News-Press