A stigma of shame stalks government health care for the poor and could affect the education children receive in school. That was the outcome of a study presented this month at international convention of the National Association for Multicultural Education. Researchers with Tennessee Tech University in Cookeville, Tenn., examined TennCare, their state's version of Medicaid. The program has been in place since 1994 and serves more than a million low-income residents. But recipients said they feel saddled with shame, disgrace and blame because they must depend on TennCare. It comes from harsh questions, severe limitations and transportation challenges getting to physicians.