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NewsFebruary 20, 2005

Dan Pennington of Cape Girardeau sees nothing good in his near future. The only possible outcomes -- financial ruin or his own death. "In six months what's going to happen is I'll have a heart attack, make it to the hospital in time and declare bankruptcy or I'll have a heart attack and not make it to the hospital in time," Pennington says...

Matt Sanders ~ Southeast Missourian

Dan Pennington of Cape Girardeau sees nothing good in his near future. The only possible outcomes -- financial ruin or his own death.

"In six months what's going to happen is I'll have a heart attack, make it to the hospital in time and declare bankruptcy or I'll have a heart attack and not make it to the hospital in time," Pennington says.

The 51-year-old man with two children in high school has led a successful career in management at car dealerships, but he is one of 459,000 Missourians who could be affected if Missouri Gov. Matt Blunt's proposal to cut Medicaid benefits goes through as planned.

The governor's office says Medicaid cuts are a necessary sacrifice to carry through Blunt's plan to make government more efficient, increase funding for education and balance the budget without raising taxes.

"The budget is broken and needs new direction, and it needs to live within its means," said Terri Durdaller, a spokeswoman for Blunt. "So we have to control spending by the state government, and this includes social welfare spending."

Medicaid is a huge drain on the budget, taking up 30.7 percent of the state's total expenditures in fiscal year 2004, which is higher than every state except Tennessee.

Other states have shown it can be done, Durdaller said, and if a budget has to be made without tax increases and with increased spending on education, controls have to be implemented elsewhere.

To make up for lost health-care benefits, the governor wants to create jobs that come with good pay and benefits to let those who need benefits get them through private sources.

With heart disease, diabetes and an amputated leg that keeps him from being on his feet for more than just a couple of hours each day, Pennington is at risk of losing benefits from a program that he says allows him to survive.

"I led a very intense schedule," Pennington says. "I tried to stay in the industry, and that affected my health even worse, so I was forced to go on Social Security disability."

The Medical Assistance for Workers with Disabilities program, one of the programs to be eliminated by Blunt's proposal, has provided Pennington affordable medical coverage and pays most of his prescription costs. Medicines cost him $129 a month.

If MAWD is eliminated, Pennington said, his health-care costs would rise to $594 a month, which is far more than he can afford on his $2,000 monthly disability payments. His wife has a part-time job, bringing home only about $90 each month.

"With what disability pays you, there's just absolutely no way that this is affordable," Pennington says. "So it's really a nonprogram. Without that program there, no health coverage would be available for me, nobody would touch me."

If he loses his Medicaid coverage, he would have to pay about $400 per month for his medications, he said.

Care concerns

Medical-care providers understand the need to fix the state's budget problems, but many are concerned of the possible outcome.

"I think that there will be a number of patients, especially adult patients, that will lose their benefits," says Vicki Smith, chief executive officer at Cross Trails Medical Center, which has offices in Cape Girardeau, Marble Hill, Mo., and Advance, Mo.

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She estimates that about 30 percent of the facility's patients receive Medicaid benefits. Cross Trails gets a higher rate of return from the claims than private practices because it's a federally funded facility and part of its mission is to provide care for those on Medicaid and Medicare.

Smith is especially concerned about adult dental care, one of the benefits that would be eliminated under Blunt's proposal.

"A high percentage of our adult patients in dental have Medicaid," Smith says. "Dental care is not a cosmetic thing, and it's not all about a toothache. Unhealthy gums can lead to heart disease and other contributing illness."

John McMullin, owner of John's Pharmacy, deals with a lot of Medicaid claims every day. He said the system can be a cumbersome bureaucracy, plagued by regulations that change constantly as the government tries to save money.

"What they pay for this week, they may not cover two weeks from now," McMullin says. "They're trying to limit their exposure on what they're paying. We understand what they're trying to do, but it's difficult to know what they'll cover from one week to the next and even more difficult, if you have to talk to them, to get through to a real person."

He says he understands both sides of the argument.

"They want to provide medication to the clients that need it, but at the same time as a taxpayer you realize they're trying to be prudent in what they pay for it. If you were given the task of spending the state's money judiciously you would, wouldn't you, because it's actually your money."

A vote for Blunt

Pennington voted for Blunt in November, and the governor's platform was clear -- saving government money and not raising taxes. But from his perspective as someone who could be in serious jeopardy when the next budget passes, Pennington thinks money could be saved in other ways.

Fred Moreno, a 67-year-old who lives alone in Cape Girardeau, provides an example of the hardships Pennington might face if the proposed cuts go through. Moreno is also an amputee and a diabetic who takes medication to control his blood pressure.

When he had his right leg amputated last May due to diabetes, he was able to get medical coverage through Medicaid and Medicare. About a month ago, he got a job at the local American Red Cross working 24 hours a week at $6 an hour. That cost him his Medicaid coverage and put a huge burden on his finances.

"If you're not working, they'll help," he says, "but if you get any kind of little job, they'll just terminate you because you get over the limit."

Now Moreno pays $432 every month for the medication he needs. One of his prescriptions, Plavix, costs $156 a month.

He has to get by on only $667 a month from Social Security and the $144 a week before taxes he makes from working. He doesn't have enough to pay his bills.

"You go from J.C. Penney to Goodwill," Moreno says. "No vacation, no eating out as much, just little things."

Another medical problem like the one he experienced last May would be catastrophic, he says. "I would just have to quit taking my medicine and just die. But I'm a survivor -- I do whatever I have to."

msanders@semissourian.com

335-6611, extension 182

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