The Commonspace > March 2003

Over the summer, my employer, Crown Optical, noticed a sharp drop in the number of people coming into our stores to purchase eyeglasses. It was easy for us to see that it was primarily the three stores that provide the majority of their services to Medicaid patients. It turned out that only about half of the adults who were due for exams and to purchase new eyeglasses were coming in — a noticeable difference in the traffic in our typically busy stores.

Marijean Jaggers The reason? The State of Missouri, in all of its infinite wisdom, eliminated the coverage for eyeglasses for adult Medicaid patients in July of 2002. The budget cut was an attempt to reduce the billion dollar budget shortfall. Eyeglasses for the poor are worth a paltry $600,000 in savings when eliminated, a mere drop in the bucket in comparison with the goal. For the Medicaid patient, a single pair of glasses can cost $100 or more out-of-pocket; at any price, glasses are too expensive for a person who must choose between clear vision and food or utilities.

Last month, the state was forced to focus on this error and fix it, as St. Louis Circuit Judge Steve Ohmer ruled on Feb. 19th that the state must immediately restore eyeglass benefits, which are mandated by law, to the Missouri Medicaid adult population. The unfortunate detail is that it took legal action against the state to bring about this ruling. Saint Louis University Law Clinic's John Ammann and Alton, Illinois, attorney Tom Kennedy filed the suit at the urging and with the support of Crown Optical, the area's largest eye care provider. The optical practice was the sole provider in support of this case. The legal team had won a similar suit regarding dental benefits for Medicaid patients in August of 2002.

While immediate relief for Medicaid folks has been gained, the next challenge is to avoid legislators' temptation to change the law, thereby permanently reducing the budget, but leaving the state's poor at risk for dental health and eye health problems — a poor substitute to gain a quick fix for the budget.

These health benefits are crucial to maintain the quality of life for these patients. In the case of the eyeglass benefit, during the time of the budget cut (July 1, 2002 through February 24, 2003), most eye doctors reported that only about half of the Medicaid patients who were due for an exam and a new pair of glasses made or kept appointments for their eye care. As recent history has taught us, these patients, without the incentive of a new pair of glasses, will not obtain an eye health exam. Eye exams, beyond a means to providing an eyeglass prescription, provide insight and diagnosis for eye diseases such as glaucoma and macular degeneration and for such general systemic disorders as diabetes and hypertension. If the law is changed, the results could be devastating to the overall eye health of the indigent population of Missouri. It is not at all a stretch to imagine a future in that environment where an elevated number of Missourians would suffer from vision loss and even blindness due to diabetic retinopathy or untreated vision conditions like macular degeneration and glaucoma.

The permanent loss of vision is too big a sacrifice for anyone to make as a contribution to the state's financial hardship.

Contact your state legislators and let them know that you believe the poor should be allowed the opportunity to see clearly...and remind them that it is certainly easier to get out and vote when voters can see to do so.

Marijean Jaggers is the Public Relations and Marketing Coordinator for Crown Optical, a freelance writer and the mother of two children.