Kimy McGuy is among a large, select, group of Rhode Islanders for whom next month's election is very personal.

Her life -- her financial life -- is so delicately balanced that the secretarial worker ends every month with just $50 dollars to spare. With just one flick of the pen next year, Democratic Governor Myrth York or Republican Governor Don Carcieri could upset this balance by cutting the state's childcare subsidy.

That program allows McGuy, 29, to send her six-year-old daughter to all-day kindergarten in North Providence, paying $25 a week instead of $110. Should Carcieri or York decide to raise the co-pays that McGuy and others pay, McGuy and many others would immediately be in the red.

But McGuy and other parents will go into the voting booth Nov. 5 blind.

Because the candidates -- while sympathetic to an array of state-financed social programs -- have not said outright whether they will support or cut them.

Carcieri, in an interview with the Phoenix, sounded kindly and knowledgeable about Rhode Island's approach to childcare, health insurance and welfare reform. But he says he needs to carefully go through all state programs to see if the money is having the desired effects.

York is more elusive. During the three weeks in which this article was being prepared, the Democrat and her staff refused to sit for an interview, even when the Phoenix made the request personally before a recent debate. York says her campaign was too hectic in the closing weeks to spare the time.

Position papers on her campaign Web site generally do not address many of the programs, and while York has a long record of supporting liberal causes, she apparently makes no pledge to fund them.

This is a change from the current governor, Lincoln Almond. While sharply criticized by anti-poverty advocates, particularly on housing, Almond for the past eight years has expanded, then protected, what he called the "core" programs affecting the poor: the Family Independence Program (welfare reform), RIte Care (medical insurance), and childcare.

But Almond also leaves his successor with a wrenching budget deficit of at least $200 million, at a time when crumbling bridges, rising education costs, the needs of economic development -- including scheduled tax cuts to attract business -- and a host of other programs vital to the state need more money.

Social programs make an inviting target.

The state spends more on "human services" than any other category in its $5.2 billion budget -- 40 percent. Childcare is an example. It costs $70 million a year, with 80 percent paid by state taxpayers. The architects of the state's progressive approach to welfare reform believe that without affordable childcare, mothers could not realistically move into the workforce, since most entry-level jobs are low-paying.

So, in addition to promoting job-training and education, allowing welfare recipients to stay on the program longer, and subsidizing the wages of low income workers, the state made a bold -- and expensive -- commitment to childcare.

A dedicated budget-cutter could trim millions by raising co-pays, or excluding some families, even without killing the childcare program. Asked about this, Carcieri says, "It is hard to make these judgments as you sit from the outside, looking in. You really need to sit with the people that are running these programs, and sit with their personnel, which I intend to do."

But even small changes would hurt people like McGuy and the thousands of other Rhode Islanders who are in the same fix with other programs.

One out of 10 residents -- 121,800 parents and children -- receives RIte Care; 43,300 are on the Family Independence Program; 12,400 children get daycare.

What follows is an attempt to compare what is known about the candidates' thinking -- in Carcieri's own words -- and from York's campaign documents and other sources.

Family Independence Program (FIP)
* Cost: $82.9 million for welfare families. The state pays $13.3 million, or 16 percent.
* Change: A reduction of five percent, or $5 million, from the previous year as the number of welfare recipients dropped.
* Number of participants: 43,250 children and parents, compared to 51,489 when reform began in 1997.

FIP is Rhode Island's answer to the welfare "reform" begun during Democratic President Bill Clinton's administration The national goal is to end welfare as a lifetime guarantee, instead giving families up to five years to get a job.

Rhode Island took what supporters describe as an enlightened -- but economically hardheaded -- approach.

Not only does the Rhode Island program allow recipients to remain on welfare longer than some states, it subsidizes wages of low-income workers, provides child support, allows for education and skills training, and provides RIte Care to help get people permanently into the workforce.

Supporters say the program, while slower, is working. States with sharper reductions are seeing growing welfare caseloads during the economic downturn; the numbers in Rhode Island continue to drop.

"I think the program overall has done well," says Carcieri. "It's gotten people off, and apparently kept them off." But he notes that neighboring Massachusetts and Connecticut have had sharper declines. Even though their numbers are now increasing, he wonders if they are still ahead of Rhode Island in overall, net caseload reductions.

"Whether we've gotten enough people into the workforce," Carcieri says, "whether we could have gotten more into the workforce had we pushed more aggressively, I don't know. That needs to be looked at."

Because York declined to be interviewed, despite repeated requests for comment, her position can't be stated with certainty.

When she was in the General Assembly from 1991 to 1993, York had a record of supporting progressive programs. But her campaign documents seem silent about FIP.

RIteCare
* Cost: $269.3 million, of which 55 percent, or $139.6 million, comes from the federal government, through the state-federal Medicaid program.
* Change: Costs went up 5 percent, or $11.9 million, this past year, by more than 60 percent in the past four years.
* Number of participants: 121,843 now, compared to about 70,000 in 1996.

RIte Care has become one of Rhode Island's most liked and praised programs, because it's provided comprehensive health care to thousands of families. It's one reason why Rhode Island has one of the nation's best records for health coverage. But as one of the fastest-growing programs, it is a tempting subject for anyone serious about cutting spending.

This past year, the Democratic-controlled General Assembly and the out-going Republican governor Almond took a major step at curbing some RIte Care costs by ordering RIte Care recipients with higher incomes to pay small premiums every month. The premiums are between $43 and $58 a month for three-member families that earn between $22,530 and $37,550. About 700 families have left the program, meaning that some of their 1046 children don't have health-care.

Jane A. Hayward, director of the Department of Human Services, says the state has taken in about $2 million in premium payments, and that at least some families who dropped out have access to other insurance. But anti-poverty advocate say some children now have no coverage.

RIte Care cuts can boomerang.

By giving people access to medical care, the state prevents illnesses before they become expensive to treat. Further, state cuts trigger bigger losses of federal funds. For every $1 cut in RIte Care funds, the state saves only the 45 cents in state funds, and loses 55 cents from the federal government. Ocean State Action, an advocacy group, estimates that hospitals have "saved" $23 to $36-million in free care costs because of RIte Care.

In documents on her Web site, and in comments at a public forum, York says she was an original co-sponsor of RIte Care program when a state senator. She proposes to open RIte Care to small businesses, which would shoulder those premiums. She also would allow unemployed persons to buy RIte Care for 18 months.

Carcieri says, "It's a great program, that's getting all these kids covered, and it's getting them plugged into primary care networks." Noting that RIte Care has pushed Rhode Island into the honored position of having one of the country's best health insurance records, he said the program brings in millions of federal dollars.

But Carcieri is troubled that there seems to be no clear answer about whether such a costly program -- funded by taxpayers who already pay their own medical insurance -- actually has helped hospitals reduced their free-care costs.

"The tougher issue to get at here is the argument with RIte Care that, by insuring the children . . . with the Medicaid funds, we are actually reducing health-care costs," he says.

Childcare
* Cost: $70.6 million, of which, 80 percent, or $56.2 million, is paid by the state.
* Increase: $3.5 million, or seven percent, in state funds this year.
* Number of participants (children): 12,388

An entitlement for childcare is one of the keystones of Rhode Island's progressive approach to welfare reform. Anti-poverty advocates say that not only does the entitlement to child care services help families leave welfare, it also helps low income workers from having to turn to welfare.

The benefit is based on income: a family of four, earning nearly $40,000, is entitled to a subsidy. Parents, depending on income, pay from nothing to $48 a week. What makes the program enticing to budget-cutters is that so much of the program is supported by state-only dollars -- about 80 percent of the cost.

Further, the cost has been going up. When welfare reform went into effect in Rhode Island in 1997, the total cost was $19 million, and as of this year, the price tag is $70 million.

Carcieri is inclined to keep this program, which relies heavily on state funds, because it's a key factor in moving people from welfare into the workforce. But as with FIP, the core welfare program, Carcieri wants to see whether it's effective.

If the overall welfare program, childcare included, is costing the state extra money without the results seen by other states, he might question it.

"I'd come down on the side of trying to keep the adult working, because the longer they are working, the more skills they are going to develop, and the more their income will grow, and that's what you really want to happen," Carcieri says.

A long-time liberal involved in women's issues, York does not appear to mention welfare and childcare on her Web site. A position paper entitled: "Fighting for Change to Help Rhode Island Families/ Families First," does not refer to the program that serves more than 12,000 children.

Rhode Island Pharmacy Assistance Progam for the Elderly (RIPAE)
* Cost: $13.5 million, all in state dollars
* Change: $1.5 million increase over last year.
* Number of participants: 40,362

RIPAE is currently an all-state program, and one that's growing. Because older voters are the key to any election, it is unlikely any governor would propose cuts. Moreover, a new governor will benefit by work that's been going on for months to make the program much more effective, and less costly.

The plan is to put much of the program under Medicaid, the state-federal program. This will have two benefits, according to Maureen Maigret, policy chief for Lieutenant Governor Charles J. Fogarty, a Democrat, who chairs the state's Long Term Care Coordinating Council.

First, it will sharply cut the costs that seniors now pay in filling prescriptions, between 40 and 85 percent of the costs. Instead, the co-pays will become a flat $2 to $20, depending on whether it's a generic or brand name drug.

Further, many more drugs will be included under the Medicaid program. With RIPAE, there is a limited array of drugs covered. Gastro-intestinal drugs, for example, are excluded.

The documents available on York's campaign Web site do not specifically mention senior citizen drug costs, and there is no pledge to exempt RIPAE from cuts or to expand it.

York focuses on the high cost of drugs.

In a recent forum about senior citizen issues, she noted that she had worked as a legislator for greater use of lower-cost generic drugs. "These are not just seniors' issues," she said when asked about health costs. "The high cost of prescription drugs . . . impacts every taxpayer in the state."

A position paper on "health care" commits her to making prescription drugs more affordable. "Myrth will negotiate tough deals with the pharmaceutical companies to lower prices," the paper says, "and she will have the state join the tri-state purchasing pool that allows us to increase our purchasing power."

Carcieri supports using Medicaid funds to broaden the program for most participants, and says he would like Medicaid prescription rates made available to "fixed-income" seniors.

Carcieri says he urged the Almond administration to "expedite" use of Medicaid funds, something being pushed not only by the Republican incumbent's Department of Human Services, but also by the Long Term Care Coordinating Council.

Carcieri did not discuss the program in cost-benefit terms, as he had some of the other social service programs, and did not specifically question the millions being spent in state-only funds. "The most vulnerable population that I see, frankly, is a lot of our senior citizens, and they have not been getting the kind of attention and support on a number of funds," he says. "Everywhere, you talk to any senior group: 'It's prescription drug costs. It's prescription drug costs.' It's just like a constant refrain."

Rhode Island Public Transit Authority (RIPTA)
* Cost: $58.9 million, of which 50 percent, or $29.4 million, comes from the state's gasoline tax, and 20 percent from the federal government. The rest is from fare-payers and state and federal subsidies to those who ride free.
* Increase: About $1.3 million over last year.
* Number of participants: 19.7 million rides annually.

Chronically short of cash, RIPTA gets huge subsidies from the gasoline tax, from RIte Care, whose participants ride free, and the from Department of Elderly Affairs, which pays for senior and disabled riders.

In the next fiscal year that starts in July, RIPTA is projecting a $6.7 million deficit.

Typically, quick fixes involve fare increases or route cutbacks, both of which make public transportation less viable for commuters, and out of reach from many low-income persons who depend on it.

"Obviously we need a public transit system," Carcieri says. "I haven't had an opportunity to dig in deeply enough to know what is the problem.

"Are we transporting too many people free of charge?" he asks. "When I look at the fleet, I still see a lot of big buses with not too many people on them. So, have we got the right-sized fleet for the routes that we are running?"

York told a recent forum for elderly residents that she understands the importance of transportation, which she says is so vital that some patients make decisions on a course of medical treatment solely on the basis of whether they can get to a particular place.

"I have a fundamental commitment to ensuring that people can get where they need to go when it comes to their basic needs," she says. But York did not address the deficit or cutbacks.

Housing
* Cost: About $5 million each of two years in money borrowed from seven banks under a line of credit arrangement, will be paid back over eight years from the state's general fund.
* Change: The item was removed from the annual budget.
* Number of units: Some 233 affordable apartments are planned over two years.

One of the biggest controversies of Almond's administration developed when he sliced $5 million that housing advocates had worked for years to include in the state budget. After demonstrations, and the arrest of ministers sitting in State House, Almond and the legislature agreed to borrow the money for two years.

The question now is whether $5 million will be restored to the budget as a permanent, if token, annual commitment to what housing advocates say is a wrenching need.

In a letter last summer to the Statewide Housing Action Coalition, of which she has been a board member, York outlined the housing crisis in detail and promised to treat it seriously. But York did not commit to state financing.

"Because of bad budget decisions, the state is now in a fiscal mess," she said. "We have to get the state's fiscal house in order and make sure we have the resources to address the critical challenges ahead. Chief among these is addressing affordable housing for all Rhode Islanders."

Carcieri is critical of fellow Republic Almond for failing to fund the housing program out of tax dollars, instead of borrowing, which then runs up interest charges. He says the administration could have used money gleaned this year from cashing in early on tobacco settlement funds.

But Carcieri thinks housing is too big to be solved by state spending, and he would like to see Rhode Island Housing and Mortgage Corporation, the quasi-state housing agency, develop more programs with private developers. Already, Carcieri says, RIHMFC is able to create 300 units of affordable housing a year, and he would like to see that continue.

"You just can't put the state in the business of somehow trying to create affordable, subsidized housing as a line item in the budget," he says. "If RIHMFC could, in fact, sustain through their programs, which are as I say a combination of public private partnerships . . . I would prefer to go in that direction."

KIMY McGUY has been following the campaign, and she says she can't tell precisely what candidate is most likely to support the programs on which she depends. Instead, she says she'll have to decide on her general feel for the candidates.

McGuy is an example of the challenge the candidates will face in office. The programs that have helped McGuy these past six years are expensive; they also have helped her get into and to be able to stay in the workforce; they make her life affordable -- but barely.

On welfare for three years after she gave birth to her daughter, who is now six, McGuy has worked in a variety of temporary clerical and secretarial jobs for the past three years, and now has a permanent job in state government.

Her pay appears still low enough to qualify for childcare subsidies. She pays $25 a week, instead of the full $110 weekly cost. Any hike in co-pay, or other reduction in the program, will send her tumbling. "I would do what I had to do," McGuy says, when asked what would happen if suddenly increased childcare costs wiped out her $50-a-month surplus.

She is unconvincing, though, talking about how she might be able to lean on her own mother for a loan or childcare duty. She notes how her mother works nights, and a 17-year-old cousin is looking for work, too, and won't be available to baby-sit.

"They control our money," McGuy says of the people who sit in the State House. If the winner pulls the plug on day care, children and parents will suffer, she says.

Asked what she expects of York and Carcieri, McGuy says: "I hope both of them can use their heads and hearts at the same time."

Brian C. Jones can be reached at brijudy@ids.net.

Issue Date: October 25 - 31, 2002