The General Assembly’s refusal to expand Medicaid leaves Teresa Jackson, 37, an 18-year Warrensburg resident, with astronomical medical bills compared to her income.
Without being able to afford a doctor, Jackson said she goes often to the emergency room. Emergency room visits might be avoided if Missouri Medicaid expanded, she said Saturday.
Missourians grow sick and die for lack of Medicaid expansion, Martha Stevens of the Missouri Rural Crisis Center, Columbia, said.
“The estimate is that 700 people die every year in Missouri because they’re going without health care,” she said.
A joint study by City University of New York and Harvard University found the failure to expand Medicaid in Missouri and other opt-out states will mean from 7,000 to 17,000 deaths per year. National estimates include 712,000 more people diagnosed for depression, 241,000 more people suffering catastrophic medical expenses, such as those Jackson has amassed, and 423,500 fewer people receiving diabetic medication.
Jackson said Medicaid covers her three sons living at home – ages 15, 5 and 8 months – but not her. She makes a few hundred dollars per month as an in-home health service provider for four clients.
“I cook for them, do laundry and clean the house, and make it so they can stay at home as long as possible,” she said. “I’m not a nurse, but I would like to pass my ‘meds’ for this job.”
Jackson said her hand-to-mouth existence is tough. “I was in the homeless shelter twice in the last three years,” she said. “It’s a struggle, but I always make it, because when God shuts one window he opens another.”
Between her part-time job and child support, Jackson said, her income is about $1,500 per month. The income is supplemented by government programs that include income-based housing, food stamps and support from Warrensburg School District that benefits children. What is not covered is Jackson’s health care bills, because she makes too much money. “The government includes my child support (as income),” Jackson said. The money to support her children puts her out of range for Medicaid.
“I’m in the gap,” she said. Illness and debt plague her, she said. “I get staph infections a lot, and so that’s where I’m racking up my hospital bills, because I go straight to the emergency room and get an antibiotic,” Jackson said. “My medical bills are pretty high. It’s probably $50,000, maybe a little more. …
“I just live paycheck to paycheck, so I can’t really make any payments on it.”
Rural Missouri has much to gain if lawmakers expand Medicaid, Stevens said. “Of the 300,000 Missourians who fall into this gap, over 50 percent of them live in rural Missouri, so they have the most to gain by having access to health care,” she said. “If we expanded Medicaid, we’d have more hospitals and the hospitals’ infrastructure would be more robust in rural communities.”
“Our eligibility standards were dropped dramatically and as a result, since then, it’s very hard to qualify for Medicaid under Missouri law,” Stevens said. “A mom that has two children, who is working two or three part-time jobs, if she makes more than $300 a month, that’s deemed too much for Medicaid to get health insurance in Missouri – too much! …
“But it’s not enough to get the subsidies in the private marketplace. It’s so stingy. These are hardworking families.”
Knowing the facts makes lawmakers’ rejection of Medicaid a difficult pill to swallow, she said.
“Their communities and their constituents are going to be impacted the most,” Stevens said. “We’re frustrated, but we also believe in this cause. There are over 1,000 organizations in Missouri that support Medicaid expansion and we have to keep fighting for it.”
Explaining how lawmakers can ignore the need is difficult, Stevens said. “There are a lot of people who don’t want to see the Affordable Care Act be successful and Medicaid expansion is part of the Affordable Care Act. I do think it’s political,” she said.
Jackson said what matters to her is that not having health care hurts. “It’s sad and scary. I don’t know what to expect,” she said. “I don’t get my hopes up.”
(Excerpted from Daily Star Journel 4/06/15)