My Best Writing by Michael Belanger: Medicaid Cuts Create Problems for SSI Users in Michigan (Pictures and Video Located at Bottom)

Cuts in vision, dental and hearing care in Medicaid have created concern for the disabled in Michigan who live on Supplemental Security Income.

There are currently about 1.7 million users in the Medicaid program. The program provides medical care for individuals who are considered in poverty. A person on SSI is only allowed to have $2,000 in his or her bank account. July 2009, Gov. Jennifer Granholm signed executive order 22 which cut vision, dental and hearing care for anyone who is 21 and older on Medicaid. The changes have had an impact on the disabled who make $674 a month on SSI and are no longer insured by their parents for whatever reason.

The new cuts can be a detriment to those struggling with both disability and added financial burdens of new health issues under these headings: Vision care deals with eye exams, glasses and contacts which are no longer covered in Medicaid. Eye exams can tell an eye doctor if the patient has a serious eye condition or if one could develop in the future. One Michigan resident is learning to live without vision care.

Michael Blizman, 37, a resident of Dearborn Heights was diagnosed with a degenerative eye disease called keratoconus. He was diagnosed two years ago with the problem.

The eye problem is a progressive thinning of the cornea, which will eventually stick out of the eye. The disease causes blindness in the eye.

Blizman was born with cerebral palsy and uses a wheelchair for mobility purposes.

“When you grow up having to use a wheelchair -- and I think this is especially true when you have cerebral palsy, given that each case is different -- you become grateful for the things that you are able to do: having the ability to write, hearing and seeing,” he said. “But now, I'm facing the probability that I will not be able to see. So what's going to happen to me? How am I going to get around by myself if I cannot see? I'm going to lose even more of my independence, and I'm scared not knowing what's going to happen.”

Blizman is not alone, and routine eye exams are the first line of defense in determining a number of issues. Issues such as cataracts and glaucoma are easily unnoticed and can only be detected by an eye exam, according to Optometrist Neil Deledda.

“If people are not allowed to have routine eye exams, there’s going to be a lot of underserved people going around with these diseases going undiagnosed and that can result in irreparable vision loss,” Deledda said.

For all the changes in vision care, dental care has also undergone some changes. Routine exams, cleanings, fillings, dentures and all other non-emergency procedures are no longer covered.

Ashley Carson, 27, is one of the people hurting from the cuts in Medicaid. Carson, who has a form of muscular dystrophy, is unable to afford the procedures for a cavity and the pulling of a wisdom tooth. Carson is currently unable to work and only makes $674 a month on SSI – out of which she must pay rent and other expenses.

“For two cleanings, I've paid with cash close to $600, and I’m still under going treatment for a deep cavity which will need a root canal or to be pulled,” Carson said. “The oral surgeon is looking at my wisdom teeth because I have some swelling on the upper left gum line which the dentist thinks is due to the way the tooth has angled in.”

Dental professionals are as concerned as patients about the cuts in oral care from Medicaid.

“It is very upsetting that many people are unable to access health care because of a lack of insurance and the high cost of dental care,” Dental Hygienist Marion Sanford said. “People are walking around with dental issues that can cause life threatening problems.”

The routine exam could catch periodontal disease and oral cancer. Periodontal diseases are infections of the gums and bone that surround and support the teeth, according to the Centers for Disease Control and Prevention. It is called gingivitis in the first stages of the disease. Periodontitis is the last stages of the disease. The gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out, according to Sanford. Periodontal disease is mostly seen in adults.

But most adults do not realize the other possible health associated with periodontal disease. It can cause a heart attack when particles enter the blood stream. The disease can also hurt an unborn baby, even causing a premature birth, Sanford said.

Also, yearly dental exams can recognize the early stages oral cancer. People diagnosed with oral cancer have a 52 percent mortality rate, according to the Centers for Disease Control and Prevention. The Oral Cancer Foundation Web site indicates there are 35, 000 new cases of the cancer each year in the U.S.

Hearing aids are also no longer covered in the Medicaid program for any Michigan resident who is 21 and older. Hearing issues are present at birth or are caused by ear infections, according to Patricia Woods, a Miracle Ear Hearing Consultant. Woods said the cost of hearing aids range in price from $1,500 to $3,000.

The Department of Community Health accounts for 28.4 percent of Michigan’s total appropriations in 2009-2010. The cuts were made because of the state’s economic situation, according to State Senator Raymond E. Basham. Michigan’s unemployment rate is about 10 percent, meaning that the state is not generating enough tax revenue to cover the costs of government funded programs. Michigan’s deficit for the 2008-2009 fiscal year was $1.7 billion.

“I opposed these cuts and would have supported additional revenue through taxes in order to maintain these critical Medicaid programs,” Basham said. “Unfortunately my Republican Senate colleagues supported an all cuts budget to resolve Michigan's deficit that resulted in the loss of these Medicaid programs. Michigan will be faced with another deficit this year.”

The cuts the governor signed in July brings awareness to the benefits of disabled adults in higher education and in the workforce. Only 22 percent of the disabled are in the workforce as March 2010, according to the U.S. Department of Labor. Under the SSI requirements, the disabled adult is only allowed to make $65 while working. Some income from is excluded if used for certain things such as a wheelchair. The SSI recipient is responsible for paying rent if he or she is living somewhere for free. If the adult lives with his or her parents, the adult is supposed to pay $140 a month in rent. The recipient also has to pay for other things such as a cell phone bill, cable bill and medical bills.

Because an SSI check is worth $674, the answer to get the disabled off of Medicaid is higher education and work assistance programs. An individual with bachelor’s degree has a medium salary of $41,000 for 2006, according to the National Center for Education Statistics- Fast Facts. There are many ways to get the disabled in higher education and in the workforce of Michigan.

1. The Federal Pell Grant provides people who make less than $30,000 a year free tuition. The $ 674 check qualifies the individual for the full amount of the grant, which was $5,350 for the 2009-2010 school year. The amount changes based on a student’s part-time, full-time status, age and living situation. A parent’s income has an impact on the amount of the grant awarded to the student if he or she is 25 years old or younger.

2. Michigan Rehabilitation Services helps individuals with physical and mental disabilities find jobs or to get help with educational expenses. The requirements for an individual to receive services are a physical or mental disability that creates a work-related barrier, benefit from some type of vocational training and have the desire to work. A plan is created for the user by a counselor to achieve the best possible job opportunities.

Companies are also reaching out to help people in economic struggles. Sears Optical works with One Sight to provide free eye exams and glasses to people who cannot afford vision care. Each vision center does this throughout the country. In terms of dental care, most dentists do not offer special payment plans for people who have no dental insurance. Dental schools are one of the few options that people have to get dental work done at reduced fees. As of writing this article, no hearing aid payment plans were readily available.

Tooth Problems- Oral Cancer and Periodontal Disease