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Monday, May 17, 2004 - Page updated at 12:00 AM

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Guest columnist

Locke should delay increase in Medicaid premiums

Special to The Times

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We write in a relatively quiet — yet critical — moment when most of the people of the state of Washington are unaware of the dangerous gamble thousands of low-income families will be forced to make depending on a single decision in the next few days by Gov. Gary Locke.

Last session, the state Legislature decided to require some low-income families to pay monthly premiums for Medicaid. The result will mean more children will be removed from the Medicaid rolls.

In the past 16 months, over 45,000 eligible children in Washington state lost health-care coverage due to changes in the children's Medicaid program. Introducing new premiums at this time is a threat to a minimum of 4,000 more children and, though it's claimed the measure will save the state money, in reality it simply transfers the costs to all of us.

The Institute of Medicine, a private, nongovernmental organization associated with the National Academy of Sciences, reports that compared with the insured, the uninsured experience worse health and live shorter lives. Families suffer emotionally and financially when even a single member is uninsured. A 1999 national survey of families filing for bankruptcy showed that medical problems — illness or injury — were a major factor in almost half the filings that year. In 21 percent of those cases, no family members had health-care insurance.

When uninsured families face medical crises, crippling debt, bankruptcy and untreated illness follow. We know how easily this can happen; we see it in our ministries, if not in our own families. The facts would be appalling to us if we hadn't witnessed firsthand how a family's world can be shattered by a single health crisis.

Locke has at his fingertips the ability to delay implementation of Medicaid premiums for these children. As leaders among many of the state's faith communities, we wrote the governor a letter challenging him to stand with justice and human dignity on this matter. A decision to delay has still not come.

We now appeal to him publicly to delay the implementation of Medicaid premiums for children of low-income families for at least a year while it is determined whether charging some families premiums is a viable step toward guaranteeing health-care access for all.

We know that uninsured children are more likely than insured children to lack a usual source of health care, to go without needed care and to experience worse health outcomes. That means all of us will still be expected to pay for these children's health-care costs because the lack of preventive and timely care will ultimately mean they will need costly emergency room and hospital services where medical remedies are provided at a much higher price.

Dropping low-income families from the Medicaid rolls also begs the question: Won't requiring low-income families to pay premiums for Medicaid result in many simply choosing to take the risk of being uninsured? We fear it will. We know, as you do, that parents often need to spend their limited resources on necessary everyday expenses — such as putting food on the table.

Declines in Medicaid enrollment last year far surpassed estimates, and the result has been a solid financial gain for the state from children losing health insurance. We are troubled by this gain and believe that at least, these savings should be used to delay the implementation of charging Medicaid premiums to eligible families who are currently covered.

Our concerns come from our experiences in ministry, but we also believe there is a moral imperative to face this issue as a matter of justice. As leaders in our faith communities, we believe our society has an obligation to provide for the basic human needs of every person, and we will not be indifferent to that responsibility. We will do whatever is possible to assure that political choices do not reflect narrow interests but the principles of our commitment to justice. Health-care coverage for the most vulnerable among us — especially for our children — must be our high priority.

In this challenging moment, we ask the governor to use the power of his position wisely. Keep Medicaid coverage in place for these vulnerable children and their families until better alternatives are found.

The Rev. Tom Quigley is acting executive minister at the Washington Association of Churches. This guest commentary was co-signed by Bishop William Chris Boerger, Evangelical Lutheran Church in America; Bishop Elias Galvan, United Methodist Church; Rev. Randy Hyvonen, United Church of Christ; Rabbi James Mirel, Temple B'nai Torah, Bellevue; Sister Sharon Park, Washington State Catholic Conference; Rev. Dr. Jack Sullivan Jr., Christian Church (Disciples of Christ); and Bishop Vincent Warner, Episcopal Church in Western Washington.

Copyright © 2004 The Seattle Times Company

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