Don’t Change Poverty Level Adjustment, TMA Tells Feds
By David Doolittle


Possible changes to how the federal government determines the national poverty level could negatively affect the well-being and health care options for large portions of the population, a coalition of 10 state medical associations told the nation’s chief statistician this week. 

Writing to Nancy Potok of the federal Office of Management and Budget (OMB), the Coalition of State Medical Societies urged OMB to research the effects of changing how the Census Bureau’s Official Poverty Measure (OPM) is determined before deciding whether and how to change it. 

The OMB in May announced it would seek comment on using an alternative index of inflation, such as the Chained Consumer Price Index (C-CPI) or Personal Consumption Expenditures Price Index (PCEPI), to adjust the OPM each year. The indices tend to lower estimates of inflation by as much as 0.25 percentage points compared with the traditional index, which already “does not adequately reflect the needs of low-income populations,” the letter states. 

However, OMB said it would not seek comments on how the change might affect programs that rely on the poverty level to establish eligibility, including Medicaid and the Children’s Health Insurance Program (CHIP), the letter said. 

“As physicians, we are not experts on the various inflation indices, but we do know what is good for our patients,” the letter says. “We strenuously urge OMB to suspend further discussion of adopting a new index until the agency researches and seeks input on the wider, long-term implications such a change would have on communities across the United States.” 

In addition to Medicaid and CHIP, other programs that could be affected include:

  • National Breast and Cervical Cancer Early Detection Program;
  • Maternal and Child Services Health Block Grant;
  • Medicare Part D prescription drug subsidy for low-income seniors;
  • Supplemental Nutrition Assistance Program; and
  • School meals. 

Adopting the new indices could cause hundreds of thousands of children, seniors, and people with disabilities to lose health care coverage, which would also negatively affect employers – particularly smaller businesses, the coalition said. 

Declining coverage rates will also increase physicians’ uncompensated care costs, a financial strain for all practices, especially those in rural and underserved areas, medicine’s letter warned. 

“When underserved communities cannot recruit physicians, that in turn jeopardizes the viability of their local hospitals, typically one of the largest local employers,” the societies wrote. 

The letter acknowledges that the poverty index is outdated and the guidelines “do not adequately reflect the needs of many individuals and families in our communities who earn too much to qualify for the many poverty-related programs yet who earn too little obtain services on their own. 

“At the same time, OMB’s decision to reject comments on the direct and indirect impact of a new inflation index puts the cart before the horse,” the letter says. “Undoubtedly such a change will have far-reaching consequences that require further analysis and discussion.” 

Along with Texas Medical Association, the Coalition of State Medical Societies includes the state medical associations in Arizona, California, Florida, Louisiana, New Jersey, New York, North Carolina, Oklahoma, and South Carolina.

Last Updated On

June 27, 2019

Originally Published On

June 26, 2019

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David Doolittle


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Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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