Social services chief: Fees could push NJ poor to skip care

from Newsday

By TOM HESTER Jr.

The state human services commissioner Monday said it was a "valid concern" poor people would avoid medical care if Gov. Jon S. Corzine's proposal to charge them new fees for prescription drugs and some hospital visits is approved.

Gov. Jon S. Corzine proposed co-payments for Medicaid recipients to raise $7.55 million for the cash-strapped state budget.

Legislators fear the payments could prompt poor people to forego health care, especially senior citizens, the disabled and mentally ill.

"I do think it's a valid concern," Jennifer Velez, the state human services chief, told senators during a Monday hearing. "I couldn't tell you that it's not."

New Jersey is among eight states that don't charge Medicaid co-payments for prescription drugs.

Corzine proposes a $6 co-payment on emergency room visits that aren't a true emergency to raise $550,000, and a $2 co-payment on prescription drugs to raise $7 million. The prescription drug co-payment would be capped at $10 per month per person.

Corzine proposes spending $33 billion next fiscal year, but legislators and advocates for the poor fear the co-payments, even if small, could be too painful for people with little margin for extra expenses but serious medical problems.

"They obviously will make a choice, whether it's food, clothing or shelter, as opposed to pursuing their meds," said Sen. Dana Redd, D-Camden.

Velez said the state has little choice. Corzine has proposed $2.7 billion in cuts amid chronic budget woes.

"There are very few, if any, really good options," Velez said. "This is not a particularly good option, but the reason why it's in the budget this year is the dire situation."

Mary Lynne Reynolds, executive director of The Mental Health Association in Southwestern New Jersey, said 5,000 New Jerseyans with mental illnesses live in boarding homes.

She said most of those people receive Medicaid and Social Security insurance that pays for room and board and a $50 per month personal allowance to buy personal effects and amenities such as snacks and newspapers.

"Boarding home residents barely get by now," she said. "Forcing them to pay up to $10 a month will make their lives more difficult, and many will have to chose between medications and other important basics."

Legislators and Corzine must adopt a budget plan by July 1.

This is the third time the Democratic Corzine has proposed Medicaid co-payments since becoming governor in 2006. His fellow Democrats who control the Legislature rejected them the first two times.

New Jersey spends 11 percent of its $33 billion budget on Medicaid, which is jointly funded by the state and federal government and pays for health care for the poor, elderly, disabled and low-income families with children. It serves more than 1 million people.

Recent state audits found wasteful spending in the program, including allowing people earning as much as $295,000 per year to join, and equipment purchasing problems.

Velez told senators the department is fixing the problems and reported six people who may have committed fraud to the state Attorney General's office. However, senators remained skeptical that enough steps are being taken.