Katrina's Effect on Medicaid Hurricane Katrina left many survivors in urgent need of medical care and without money to pay for it. Many of the hundreds of thousands of evacuees in other states will likely qualify for Medicaid, but unless Congress acts, those host states will be expected to pick up part of the bill.

Katrina's Effect on Medicaid

Katrina's Effect on Medicaid

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Hurricane Katrina left many survivors in urgent need of medical care and without money to pay for it. Many of the hundreds of thousands of evacuees in other states will likely qualify for Medicaid, but unless Congress acts, those host states will be expected to pick up part of the bill.

RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. I'm Renee Montagne.

SUSAN STAMBERG, host:

And Susan Stamberg. Now that most immediate medical needs of Katrina victims have been met, attention is turning towards more long-term health needs. The president and Democrats and Republicans in Congress agree that some expansion of federal funding for Medicaid will be necessary, but they don't yet agree on how or how much. NPR's Julie Rovner reports.

JULIE ROVNER reporting:

Before the storm, nearly a million of Louisiana's four and a half million residents got their health care through Medicaid, and since the hurricane, residents who need health care are turning to Medicaid in increasing numbers, says Ruth Kennedy, the state's deputy Medicaid director.

Ms. RUTH KENNEDY (Deputy Medicaid Director, Louisiana): We are taking, literally--this is not an exaggeration to say we're taking thousands of applications at the shelter and our hot-lines, our telephone lines where we're trying to process address changes.

ROVNER: All this with a work force down by a third because those staffers were themselves displaced by Hurricane Katrina. And not every story has a happy ending. One patient in New Orleans Charity Hospital was waiting for brain surgery when the facility was evacuated, Kennedy says.

Ms. KENNEDY: He was in a safety net hospital here in Baton Rouge. They do not do this type of surgery. The only hospital that does this type of surgery, his status as uninsured is an issue.

ROVNER: Which is a polite way of saying the hospital wouldn't take him because he couldn't pay. Kennedy says her staff is being forced to turn away many storm victims applying for Medicaid because they don't fit into one of the program's categories, such as being a child or having a permanent disability.

Ms. KENNEDY: They maybe were hurt during or after the storm. They have no income and their disability does not meet the criteria that is going to last 12 months, but they need help. And at this point, we're not able to certify for Medicaid because there's not an existing category.

ROVNER: Ironically, things are slightly better for evacuees who've gone to other states. Normally you have to prove you're a resident of the state where you're applying in order to get Medicaid. But the federal government last week moved to make it easier for evacuees across the country to get Medicaid in their temporary home states if they're otherwise eligible. Mark McClellan is administrator of the Centers for Medicare and Medicaid Services.

Mr. MARK McCLELLAN (Administrator, Centers for Medicare and Medicaid Services): We're waiving the usual residency requirements. We're waiving a lot of the normal documentation requirements because many of these people don't have the information verifying their household income or their employment. We are using a simplified application, one that is feasible for states to adopt in cases where they're helping a lot of evacuees on the ground quickly.

ROVNER: President Bush and McClellan have already promised states taking in evacuees that the federal government will foot the bill for what would normally be that state's share of Medicaid costs. But that change can only be made by Congress. House and Senate Democrats last week unveiled a bill that would go well beyond what the administration has in mind. For example, it would also extend eligibility temporarily to any resident of the storm-stuck states who's lost his or her job. Cindy Mann, a federal Medicaid official in the Clinton administration, says unless that happens, a 55-year-old grandmother from Louisiana now living in the Astrodome in Texas, for example, still wouldn't qualify for coverage.

Ms. CINDY MANN (Federal Medicaid Official): She may need insulin and heart medication. But as a childless individual who's maybe not to the point of fully disabled, there's no category for her and yet she is, obviously, without any means of support or ability to pay for her health-care coverage.

ROVNER: But while current Medicaid head Mark McClellan wouldn't rule that out, he said there are other ways to pay for needed health care, including through the Department of Homeland Security.

Mr. McCLELLAN: They have a national disaster medical system, payment system, which is helping with hospital costs, prescription drug costs, other costs for people in shelters right now. We are working to provide new ways of paying for uncompensated care for people who don't have coverage.

ROVNER: The Democrats' legislation would also have the federal government pay the full states' share of Medicaid for that states most directly affected by Katrina for a year while they get their economies back up and running. No price tag has been attached to the measure and neither the Bush administration nor Republicans on Capitol Hill have yet proposed anything specific. Julie Rovner, NPR News, Washington.

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