One of the most riveting videos on YouTube today is Ms. Hutchinson’s Testimony.
Fair warning: don’t expect to be entertained. This isn’t a video about a celebrity’s funniest moment or a scandalous story about a famous boss misbehaving or one aimed at the Mr. Fixits of the world.
Although it could be.
Ms. Hutchinson’s Testimony is about real-life; one few of us want to acknowledge and even fewer want to experience. Real-life heaped with tragedies and problems stemming from a core issue that has life or death consequences. An issue that needs to be fixed.
The Federal Poverty line is used to determine eligibility for every type of federal, state and local public assistance program, from food stamps to housing assistance to Medicaid; programs meant to aid the poor.
In Texas, that line determines whether a woman will live or die from breast cancer.
The so-called “poverty line” was determined in the mid-1960s, by calculating the amount of money it costs to buy a basic basket of food and then multiplying that amount by three. Each year, the line is updated to account for inflation. In the 1960s, food consisted of one-third of a family’s income; today, food is about one-seventh of the family’s income as the costs of housing, healthcare and childcare have all risen disproportionately.
The current poverty line is $12,880 for a single person and $26,200 for a family of four. If a person lives in a household whose income is less than that amount, he or she is considered poor. If the household’s income is that amount or more (even by one dollar), he or she is “not poor.”
Calculating the poverty line does not consider other living costs besides food, and the federal poverty line is the same whether a person lives in New York City or in Channelview.
The established poverty level is then compared to the total household income. Every member of the family’s income is counted, from the principal wage earner to the teenager working part-time at the local hamburger shop. It also includes every type of income, including wages, child support, unemployment, and even any support from outside the household. Far be it for a family down on their luck to have a generous relative willing to pay their rent for a couple of months. That generosity will count against them.
At The Rose, we know first-hand the tragic impact of these calculations.
Every year, we serve roughly 7,000 uninsured women. Every year we diagnose 170 to 200 uninsured, low-income women.
We use the income criteria at or below 200% of the federal poverty line to align with the State’s financial requirement. That’s a bit better than the 100% poverty level, but not by much. In dollars and cents it means, if she’s single, her income can be $25,760 and for a family of four it increases to $53,000.
I could not count the number of times we have seen women, whose income barely crossed the line, be denied acceptance into the Medicaid Breast and Cervical Cancer Services (MBBCS) program. That is the State’s only program that provides treatment for breast cancer to uninsured, low-income women. Even as little as $100 a year made her ineligible. The State uses gross pay, we use net, to determine eligibility.
$100 a year, $8.33 a month will cost her life.
Much like the examples Ms. Hutchinson shared, we’ve seen women take drastic measures to qualify for the MBCCS program. Some have quit their minimum wage job and been forced to live off the goodness of other people. Others have divorced their husbands after decades of marriage; a dangerous step considering the loss of any legal protection of marriage. For some women, it meant the end of a marriage and going through treatment totally alone.
They must be able to show reported income for 40 quarters or ten years to qualify. Heaven forbid if they have been a stay-at-home mom and never worked, or only worked some years. Sure, if they are married, they can borrow from their husband’s income…if he allows it…some won’t. Many have had to sell what little assets they have; owning two cars is a no-no when it comes to Medicaid.
Many have moved to a new county, leaving homes they have lived in for years, to qualify for public health, when Medicaid doesn’t approve them.
They do these things because their option is facing breast cancer without treatment.
We agree with Ms. Hutchinson. A solution could be found and it would have to start with changing the way we determine poverty levels and that starts with the baseline amount.
Using three baskets of food, even with today’s prices, just won’t cut it.
*Amy J. Hutchinson testified in April 2020 before the House Committee on Oversight and Reform, which was called to examine the negative effects on children as a result of the (then) administration’s proposed regulations to reduce the poverty guidelines.
*The MBCCS program has saved the lives of thousands of uninsured, low-income women since it was enacted in 2007 in Texas, but there will always be those who fall through the cracks.