State officials will offer two months of free health benefits to thousands of former welfare recipients who might have been inappropriately denied Medicaid when they stopped getting government checks.
Beginning next month, the Maryland Department of Health and Mental Hygiene will send medical assistance cards to 60,000 people whose Medicaid and welfare cases have been closed. The cards, good for November and December, will be accompanied by simplified forms aimed at getting low-income people to apply for Medicaid.
The state action came after lawyers for the Family Investment Program Legal Clinic in Baltimore, which offers free legal help to people weaning themselves from welfare, threatened litigation over denied benefits. The clinic made the complaints after 12 University of Maryland Law School students spent a semester interviewing former welfare clients -- and finding that many did not have health coverage.
"We have really tried to come up with a comprehensive approach to addressing this," said Debbie Chang, DHMH's deputy secretary for health care financing. "Our philosophy had been to keep these people on health care, and because of that we're taking an extra step."
In all, 61,000 households will get application forms to apply for Medicaid. Some -- but not all -- of those people will be eligible for the two-month benefit cards.
Before federal welfare legislation passed in 1996, welfare recipients automatically were considered eligible for Medicaid. That year, Congress separated the link, requiring caseworkers to examine whether people no longer getting cash assistance still were eligible for Medicaid.
The law also provided a year of transitional coverage to new jobholders, many of whom do not get health benefits from their employers.
But around the country, officials acknowledge that requirement has not always been followed, leading some people to lose their health benefits automatically. In May, the national advocacy group Families USA released a study estimating that in 1997, 675,000 people were left without health coverage as a direct result of the change in welfare rules -- 62 percent of them children.
Slipping through the cracks
Lynda G. Fox, secretary of Maryland's Department of Human Resources, said that while her department had a policy of preserving health benefits for people leaving welfare, some cases slipped through the cracks because of computer problems and human error.
That system has been fixed, she said. "We've done a lot of computer work that has significantly removed the opportunity for human error," she said.
J. Peter Sabonis, director of the Family Investment Program clinic, lauded the state's efforts yesterday, but said they did not go far enough.
For example, he said, the state should directly reimburse patients who paid for doctor visits and prescriptions on their own while off Medicaid. Instead, officials are planning to reimburse the providers, which in turn are supposed to pay back patients.
Other families who left welfare for work, who should have gotten an automatic year of transitional Medicaid regardless of what they were earning, now may not be eligible because they are making too much, Sabonis said.
The state "should be commended," he said. "But they didn't make restitution. When the dust settles, they really haven't completely righted the wrong."
How many people have wrongly lost benefits may never be known, state officials say.
Medicaid enrollment rose by about 20,000 people between January 1997 and January 1999, according to DHMH statistics. State officials say that leads them to believe that many people denied Medicaid have regained their coverage.
Some Maryland children who lost health benefits may have regained them through the Maryland Children's Health Program, which insures children in families with incomes up to double the poverty level.
To help determine where those families stand, the Department of Human Resources has hired the University of Baltimore to contact former welfare recipients to make sure they're receiving benefits to which they are entitled, Fox said. The state also has launched a hot line for families to request Medicaid application forms or report problems getting money back from health providers. The number is 1-800-332-6347.
Pub Date: 9/24/99