Clip files / Local news from the states

This column features selected short items about state health care policy.

RIte Care rolls drop, losing poorest

PROVIDENCE, RI—Enrollment in the Rhode Island's RIte Care program has shrunk by nearly 6,000 in the past year, and advocates say they are concerned that a change in federal policy is causing the poorest of the poor to lose their state-subsidized health coverage.

Among families earning less than the federal poverty level — $17,170 a year for a family of three — enrollment dropped by more than 4,000 people, according to Rhode Island Kids Count, which gets regular updates on enrollment figures from the state Department of Human Services. "That's the core population that RIte Care is intended to reach," says Jill Beckwith, a policy analyst with Kids Count.

The bulk of the enrollment drop also came in the last six months. Since January, the program has seen a net loss of 4,852 members, said Lisa Franchetti, a membership analyst with Neighborhood Health Plan of Rhode Island, whose plans cover about 60% of RIte Care subscribers. Since January 2005, RIte Care enrollment has fallen from 119,000 to 111,000, but the drop in the last six months is "unprecedented," says Neighborhood Health Plan spokesman Tom Boucher.

Mr. Boucher, Ms. Franchetti, and Ms. Beckwith say the federal Deficit Reduction Act is responsible. The bill, passed by Congress last year, contained a variety of measures, including stricter requirements for documentation and proof of identity for people receiving government-subsidized health insurance. The stricter standards have applied to all new enrollments since January. People now need an official copy of their birth certificate, which costs $20 in Rhode Island and can cost substantially more if ordered by mail from another state. Beckwith noted that she paid $75 to the State of New York for a copy of her own birth certificate before a recent trip to Mexico. For a family of three making $17,000 a year or less, that's a significant burden, she said.

New enrollees also need four pay stubs to substantiate the income level they are claiming. Each of the requirements is "another piece of paper that has to be in someone's file before eligibility can be determined, and another reason for denying them if they fail to get that piece of paper in there," says Linda Katz, policy director for the Poverty Institute at Rhode Island College.

— Providence Journal, 9/4/07