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Why Medicaid matters -- help and hope

Posted by John McDonough  January 20, 2014 09:51 PM

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Why does expansion of Medicaid, as permitted by the Affordable Care Act, and as now being implemented by 25 states and the District of Columbia, matter?  Is it politics? Ideology? Partisan advantage?

How about people?

The New York Times is out with a must-read story on the way Medicaid expansion in West Virginia is helping to improve the lives of real-life West Virginians. Please check out the whole article. Here are a few excerpts that struck me:

Sharon Mills, a disabled nurse, long depended on other people's kindness to manage her 21wva1_cnd-master675.jpgdiabetes. She scrounged free samples from doctors' offices, signed up for drug company discounts and asked for money from her parents and friends. Her church often helped, but last month used its charitable funds to help repair other members' furnaces. Ms. Mills, 54, who suffered renal failure last year after having irregular access to medication, said her dependence on others left her feeling helpless and depressed. "I got to the point when I decided I just didn't want to be here anymore," she said. So when a blue slip of paper arrived in the mail this month with a new Medicaid number on it -- part of the expanded coverage offered under the Affordable Care Act -- Ms. Mills said she felt as if she could breathe again for the first time in years. "The heavy thing that was pressing on me is gone," she said.

Waitresses, fast food workers, security guards and cleaners described feeling intense relief that they are now protected from the punishing medical bills that have punched holes in their family budgets. They spoke in interviews of reclaiming the dignity they had lost over years of being turned away from doctors' offices because they did not have insurance. "You see it in their faces," said Janie Hovatter, a patient advocate at Cabin Creek Health Systems, a health clinic in southern West Virginia. "They just kind of relax."

But Gina Justice, a social worker with the Mingo County Diabetes Coalition, said many of her patients have to choose now between medicine and food, so access to critical medications through new coverage will be a lifeline. "People tell us, 'This is the food month,' " Ms. Justice said. "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." And there is a high price for being uninsured, she said. One patient, a coal truck driver in his 30s with diabetes, came in for treatment whenever he was insured, which was not often. Last summer, he had a stroke after a stretch when he had no coverage; he now walks with a cane and cannot drive. Another patient, a woman with diabetes, is now legally blind because she could not find an endocrinologist who would treat her, or a lab that would run tests, without insurance, Ms. Justice said.

The reason so many Americans have fought so long and so hard to win health care for all our fellow citizens -- these people and their stories, that's why.

And most leading national Republicans are all on record wanting to repeal the ACA and put these people back where they were before January 1. That's a disgrace.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »

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