STATEMENT OF SUSAN FRIETSCHE
STAFF ATTORNEY
WOMEN’S LAW PROJECT
Western Pennsylvania Office

 June 21, 2005

The Women’s Law Project is a non-profit women’s legal advocacy organization with offices in Pittsburgh and Philadelphia . Our services are free, and we often assist women who depend on the Medicaid program for their health care.

The proposed state Medicaid cuts would have a devastating impact on our clients. For women with serious or multiple health problems, the limits on inpatient hospitalizations, physician’s visits, and covered prescriptions could amount to a death sentence. A woman with cancer whose course of chemotherapy or radiation therapy requires nearly twice as many visits as the proposed limits allow will have to stop her cancer treatment halfway through. Women with diabetes and hypertension and mental health problems will have to choose which prescriptions to do without, or will have to take only half of their pills to try to stretch them further.

As harsh as these cuts are, the cuts would be even more severe for women whose eligibility for Medicaid flows from General Assistance. These GA-category women, who get General Assistance because they are receiving services for domestic violence, are temporarily disabled, or are in treatment for addiction, would have even stricter limitations on their health care—half the number of covered prescriptions, half the inpatient hospitalizations.

It has been suggested that the proposed Medicaid cuts will not actually be as vicious in practice as they appear on paper, because people with a true health crisis could resort to an exceptions process, where the limits on service could be waived by the Welfare Department on a case-by-case basis. The problem, however, is that this “survival of the fittest” approach to health care leaves little hope for the most fragile patients, who would be unable to fight their way through the appeals process.

To qualify for an exception, a patient would have to show three things:

• that she has a “serious chronic systemic illness or other serious health condition” AND
• that the limit on medical care would jeopardize her life or result in the rapid, serious deterioration of her health, AND
• that it would be efficient and economical for the Medicaid program to let her have the needed health care.

What about women whose condition, like multiple sclerosis, will likely deteriorate slowly, not rapidly? What about women who need additional health care to stay out of a nursing home? What if a Medicaid administrator does not consider a critical prescription to be “economical” for the Medicaid program? What about doctors who simply cannot or will not complete the additional paperwork necessary to document the need for an exception and advocate for their patient through the exception process? Under such a system, how many doctors will willingly accept Medicaid patients for treatment?

It’s encouraging that Governor Rendell has recently indicated that his priority now is to restore some Medicaid services to affected individuals. However, many women who rely on Medicaid cannot afford to lose any of the services it currently provides. Plainly, there are other ways to save money than by cutting needed health care to low-income cancer victims, domestic violence survivors, working mothers, women with disabilities, women in drug treatment, and elderly women. These women have suffered enough. Surely, every possible alternative should be examined and exhausted before we turn to these women to balance the budget for us.

On behalf of these women, we call on the Governor and General Assembly not to make any cuts in Medicaid services to individuals.

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