Thursday, January 23, 2014

Amid continued debate, expansion of Medicaid is dream come true for many poor people

Though enrollment in private insurance plans under federal health reform has been slower than advocates hoped, Medicaid enrollment has skyrocketed in states that chose to expand the program. In West Virginia, which has high poverty rates and short life spans, more than 75,000 people have enrolled in the federal-state program for the poor and disabled. Although some who have signed up for private insurance through the new exchanges had some type of health insurance before, most signing up for Medicaid were not previously insured. In West Virginia, the number of people lacking health care coverage has gone down by a third, Sabrina Tavernise writes for The New York Times.

"America ranks near the bottom of developed countries in health and longevity, and many public health experts believe that improving that ranking will be impossible without paying more attention to poor Americans," Tavernise writes. That is being debated, but in the short-term, many who have gained coverage have shown improvements in mental health, because they don't have to worry about paying unmanageable medical bills or finding a doctor's office that will accept the uninsured. "You see it in their faces," said Janie Hovatter, a patient advocate at Cabin Creek Health Systems, a southern West Virginia health clinic. "They just kind of relax."

Some in rural areas resist signing up because they don't like President Obama; in West Virginia, he is blamed for decimation of the coal industry. "Recruiters trying to persuade people to enroll say they sometimes feel like drug peddlers," Tavernise writes. However, many people are putting their need for healthcare over their dislike of the president. Rachel Williams, a McDonald's worker from Mingo County who didn't have insurance, would not fill out insurance forms when she went to the emergency room because of kidney stones. But later, when she found out she qualified for Medicaid, she signed up right away.

Studies show that 10 percent of premature deaths in the U.S. are caused by lack of access to medical care, while 40 percent are caused by behaviors like smoking and eating unhealthy food. "The rest is linked to genetics and social and environmental factors," Tavernise reports. Lavetta Hutchinson, a nurse in McDowell County, told her the law won't do much to improve health, especially that of the many people who have turned to drugs because of a lack of education and economic opportunity. "People don't see the value of prevention," Hutchinson said. Living better is more expensive, Tavernise notes: "Poverty is short-term thinking—what can I do today to survive," said Sister Janet Peterworth, a charity worker in Mingo Country who is enrolling people.

Others see the new accessibility of health coverage as a stepping stone for increased health among the poor. Many Mingo County Diabetes Coalition patients could previously afford only food or medicine, social worker Gina Justice told Tavernise. "If you can take away that stress because now you've got a medical card, then you can focus on healthier eating that will help with these medical issues," Justice said.

The old income limit for Medicaid eligibility in West Virginia was one-third of the federal poverty threshold, a meager 4,000 per year. That limit left most people out of luck, such as former nurse Sharon Mills, who could no longer work after suffering a back injury at work; she had been surviving on $12,000 per year in worker's compensation and the generosity of others to pay for treatment of her diabetes and eventual renal failure. The new limit is effectively 138 percent of poverty, which is about $15,200 for an individual. For Mills, "permanent eligibility for Medicaid was a godsend," Tavernise writes. "It's going to change her life," said Hutchinson, the nurse who sometimes treats Mills. (Read more)

While there are success stories in West Virginia, 21 states decided not to expand Medicaid, leaving millions of people without access to health care. See story below.

1 comment:

Unknown said...

Read so much about ACA that now i feel a comprehensive health insurance is just a dream.
Someone or the other will loose.