A group of low-income Utahns and a coalition of their advocates spent a good part of Thursday at the Capitol, holding a news conference, handing out letters urging health-care funding and reading the writing on the wall.
"We go through the same thing every year in one way or another," said Ricki Landers of West Valley about annual promises from legislators to expand or at least maintain low-income services. "And there's always some reason no matter if revenue is up or down they can't come through. So what I'm saying is we're sad but certainly not surprised. We make sure they get their pay increases and the best health-care coverage. Why can't they do this for us?"
Specifically, they don't want to lose vision and dental as covered services under Medicaid. The Legislature removed them as covered services five years ago, reinstated them a year ago and now appear to be on the verge of cutting them again in the wake of revenue figures that are sharply lower than projected.
The cuts haven't been made, but the group pointed out that doing so has become a habit when the Legislature is looking to save money. Vision and dental together would be about $2.8 million.
The health department has said it could make up some of the difference if administrators are permitted to shift budget items around, but they don't have that kind of money to transfer.
Darla Ball, who is covered by Medicaid insurance and hasn't been able to afford new glasses or see a dentist in five years, said she has no doubt that the first phase of a health-care system reform plan will no doubt get funded. Gov. Jon Huntsman Jr. has requested $30 million just to assess the scope of the problem. Even minor fixes done during the session now don't take affect for another year.
Finding a way to help people who haven't had glasses or had their teeth fixed should be part of that reform plan. And that could be done, easily and right now, Ball said.
"There is still a big surplus, just not as big as they were expecting," he said. "This is the most basic care you can have, and it can be the most expensive and most risky if you let your eyes or teeth go."
Landers said the only Medicaid dental work she's had done the past five years are extractions. She has had every tooth on the left side of her jaw removed, one on the right side is infected.
"And I just lost another one while I was eating mashed potatoes the other day," she said, noting that most lawmakers and most people don't know what it's like to try to make it as a disabled but independent person without basic health services. "I got infections going and I just got my 23rd antibiotic today."
Under current treatment arrangements, someone covered by Medicaid can have their teeth checked and have them extracted but fillings and other moderate dental services are not covered.
One of the top spending priorities by the joint Health and Human Services Appropriations Subcommittee was to raise the reimbursement rate to physicians who treat Medicaid patients. The state pays about 40 percent of what doctors are paid for by private insurance plans.
"That's just as important, maybe more important," Landers said. "Too many doctors are choosing to stop seeing Medicaid patients because they can't afford it. Having services covered won't mean much if we can't find the doctors who will take us."A letter from the group given to House and Senate leadership states that whatever reform initiatives are approved, "if basic healthcare services like Medicaid vision and dental are cut then this year's healthcare reform efforts will have been a failure."
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