A push by Congress to rein in a runaway federal budget deficit by trimming spending for social programs could end up poking sizeable holes in New York's safety net for the poor.

A $50 billion budget-cutting bill approved by the House last week would squeeze thousands of the state's 4 million Medicaid recipients, reduce child support collections and trim the growth in spending for other anti-poverty programs over the next five years, say advocates for the poor.

In an effort to soften the blow, New York Republicans persuaded House GOP leaders to drop a proposal to increase Medicaid co-payments from $3 to $5 for the poorest beneficiaries. But the bill still would allow states to impose substantially higher fees on other low-income Medicaid beneficiaries and scale back Medicaid services.

That worries Maxine Green-Bolden, who lives at the White Plains YWCA. Out of work after suffering a reoccurrence of cancer last February, Bolden, 52, enrolled in Medicaid after she could no longer afford her apartment and private health care insurance.


With a $1,200 monthly Social Security check as her only income, she is worried what might happen if states gain more authority to reform Medicaid.

"The cuts could really affect me because I'm on chemotherapy and I've been in the hospital five times this year," she said.

Beverly Corbin, a 53-year-old single mother from Brooklyn, fears she'll have to pay more for medication for her 4-year-old daughter, Kwanzaa. "She is asthmatic and I'm on disability and Medicare, so keeping her together is very difficult," said Corbin, who was among dozens of low-income women chanting "Don't shred the safety net" during a demonstration at the Capitol last week.

Although the bill mostly pares back the growth in spending for federal anti-poverty programs, the cuts could be troublesome in expensive housing markets such as Westchester County, where low-income people already struggle to pay rent.

"Everybody here is rent-burdened," said Dennis Hanratty, executive director of the Mount Vernon United Tenants, which runs a homelessness prevention program in Westchester County. "People spend 50 percent, 60 percent and 70 percent of their income for rent. The slightest thing that happens in their lives, they are damned."

New York's custodial parents could lose an estimated $482 million in child support collections over the next five years because of the bill's $303 million cut in federal matching payments to the state for enforcement. And of the 70,000 legal immigrants projected to lose food stamps by 2008, about 13,500 currently live in New York, says the Center on Budget and Policy Priorities, a liberal think tank.

Not a done deal

The budget cuts are far from a done deal. A Senate deficit reduction bill trims only $35 billion from future federal spending and doesn't call for higher Medicaid fees or cuts in food stamps and child support enforcement. With very little overlap between the House and Senate bills, negotiators will have a difficult time reconciling the differences.
The House's budget-cutting bill passed 217-215, reflecting sharp divisions between Republican conservatives who sought even deeper budget cuts and moderates who won 11th-hour concessions to soften the cuts. The moderates also secured help for two other New York priorities: increases in a program that helps the poor pay their heating bills and support to renew a federal subsidy program for dairy farmers.

Conservatives argued the bill is only a modest step toward bringing down escalating costs of entitlement programs and reducing the federal deficit.

"The safety net is not shrinking," said Brian Riedl, senior budget analyst at the Heritage Foundation, a conservative think tank. "Overall, the federal government is spending one-sixth of the federal budget on anti-poverty programs this year, which is the highest proportion of federal spending ever spent on anti-poverty. Reducing the growth rate from 39 percent to 38 percent is not too much to ask."

Others warned that rising Medicaid costs will bankrupt states in 20 years if the program is not reformed. Under the House bill, federal Medicaid spending would still increase by 7 percent a year for the next several years.

Rep. Sue Kelly, R-Katonah, a GOP moderate who voted for the bill after spending cuts were modified, said the Medicaid reforms were written essentially the way Republican and Democratic governors requested as steps to eliminate waste, fraud and abuse.

But Democrats, advocates for the poor and even some New York Republicans say the budget cuts nevertheless could still hurt a significant number of needy people. Republican Rep. John Sweeney of Clifton Park voted against the bill because he said cuts would reduce access to health care in his Hudson Valley district. Rural hospitals, which are already struggling to survive, could take a big hit from the proposed Medicaid cuts.

"It's not a small trim to the tens of thousands of people who are going to lose services," said Richard Kirsch, executive director of Citizen Action of New York, a consumer group. "These are real cuts to real people."