Budget Cuts Hit Programs for the Poorest

As Congress wrapped up its work last week, most of the headlines were about renewing the Patriot Act and drilling for oil in the arctic. Gaining less notice were several bills that would dramatically cut programs aimed at low-income Americans.

One was the annual spending for the departments of Labor, Health and Human Services, and Education.

Its final passage went almost unnoticed Wednesday night, because the Senate declined to take a roll call on a measure that reduces funding for popular social programs by more than $1 billion.

Lawmakers then passed a second spending bill that lops another 1 percent from the same programs.

According to Bob Greenstein, executive director of the Center on Budget and Policy Priorities, the cuts include a $350 million reduction in child and family services programs, including Head Start, a cut of 4 percent, he says. That means there will be 25,000 fewer Head Start slots for low-income children.

A separate budget bill approved by the Senate Wednesday got somewhat more attention, after Vice President Dick Cheney cast a tie-breaking vote.

That measure would reduce spending for Medicaid, Medicare and other major health and welfare programs.

"Today what we voted on means that we're going to cut entitlement spending, slow that growth by $40 billion," said Senate Majority Leader Bill Frist (R-TN). "It demonstrates fiscal responsibility. It shows that we're going to eliminate wasteful Washington spending."

Sen. Rick Santorum (R-PA) said that Democrats were overreaching when they claimed the cuts would hurt poor people.

"What we've done here today is we've made some changes to those programs that make those programs better, more efficient and more targeted to the people in need," Santorum said. "That is not cutting benefits to those who are entitled to entitlements; it is making those programs work better and in the context of more fiscal responsibility."

But Greenstein of the Center on Budget and Policy Priorities disagreed.

"Rhetoric saying things like 'Oh, this just slows the rate of growth' makes it sound like low-income families are getting expanded benefits and the benefit will simply expand a little less. That is flatly not true," Greenstein said.

"No knowledgeable person who follows the low-income programs would accept the view that there's no pain to needy and vulnerable people in this bill," he added.

According to the Congressional Budget Office, the bill would, among other things, cut funding for enforcement of child support, resulting in children losing some $8 billion. Also, poor families would pay more for their health care. And seniors would have a harder time qualifying for nursing home care.

Greenstein says one of the most potentially damaging provisions would require those applying for Medicaid to present proof of citizenship — either a birth certificate or passport.

Many low-income Americans don't have access to their birth certificates — or don't have one at all.

For example, African Americans born in the south in the 1930s and '40s — as many as 20 percent, according to one study — don't have birth certificates because hospitals wouldn't accept black women in labor.

As a result, Greenstein says, "We're facing the prospect of significant numbers of elderly black Americans being thrown off of Medicaid because they can't provide a birth certificate — because they weren't born in a hospital due to discrimination."

The budget bill that passed the Senate by one vote, however, is not yet on its way to President Bush. Senate Democrats forced a small change that requires the House to vote again. So there could be further revisions.

That prospect has given groups that oppose the measure another month to try to reverse the handful of votes that would change the outcome.

The seniors group AARP is leading the opposition.

"We're gonna give it our best shot," said AARP's David Certner, "to really educate people what is in this bill, why the choices that were made in this bill were so bad, why it was such a problem to go after poor people on Medicaid and deny people long-term care, and yet give a pass to the pharmaceutical industry and the managed care industry."

Certner was referring to the fact that negotiators for the House and Senate dropped provisions that would have cut spending at the expense of drug and managed-care companies.

For example, one jettisoned provision would have required drugmakers to offer deeper discounts on drugs sold to Medicaid. Instead, most of the reductions in federal outlays rely on boosting the amount that low-income Americans must pay for prescription drugs.

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