Democrats' bill would cover uninsured poor adults, up to a point

ALBANY, Georgia – After abandoning their goal of creating a new Medicaid program to cover two million poor adults, Democrats aim to prov...


ALBANY, Georgia – After abandoning their goal of creating a new Medicaid program to cover two million poor adults, Democrats aim to provide them with free private coverage as part of the party’s social policy bill. But there’s a catch: the benefits would only last four years.

Even with this expiration date, legislation cannot come quickly enough for people like Evelyn Davis, who has suffered two heart attacks and suffers from high blood pressure and diabetes. A former home care aide, she lost her coverage when she divorced two years ago. She has chest pain and heart palpitations, but said she couldn’t afford to see a cardiologist.

“If I can’t get meds, I just take Tylenol PM when I sleep,” said Ms. Davis, 63, “and I just pray to God when I wake up that it doesn’t hurt.”

It is part of an estimate 2.2 million American adults who don’t have insurance because they live in one of the 12 states where Republicans have refused to develop Medicaid, which is jointly funded by the federal government and the states, under the Affordable Care Act. Too poor to qualify subsidized private insurance through Obamacare exchanges but not poor enough for Medicaid, they navigate a Byzantine system of charitable care – and often ignore care altogether.

Now, these patients can get what many have been hoping for since the Affordable Care Act was passed over a decade ago – but with no guarantee that the new benefits are here to stay. The framework announced last week by President Biden for the $ 1.85 trillion social policy bill includes the biggest extension of health care since the Obama-era health care law, patching loopholes in historic law that had long seemed unrepairable.

However, the framework is tenuous. Monday, Senator Joe Manchin IIIWest Virginia Democrat dashed hopes for a quick Senate vote by refusing to approve the measure, whose health care provisions had already been cut under pressure of M. Manchin and other centrists to keep the price low.

The “public option“, promoted by Mr. Biden during his presidential campaign as a way for people to sign up to a Medicare-like plan, was never even considered. The language allowing the government to negotiate prices with the pharmaceutical companies was abolished.A plan to give dental, the visual and hearing coverage of Medicare beneficiaries has been reduced to mere hearing.

And finally, negotiators ditched the idea of ​​a new fully federally funded Medicaid plan for residents of the 12 recalcitrant states, which would have been complicated to create, in favor of fully subsidized private coverage – but only until 2025.

The free plans would be comparable to Medicaid coverage, with minimal fees for doctor visits and enhanced benefits like transportation to medical appointments. In total, it is estimated that 4.4 million people, including uninsured adults and other low-income adults, could benefit.

For Democrats, who took over the House in 2018 and took control of the Senate this year in part by promising to expand access to affordable health care, the bill is a political necessity. And maybe no Democrat needs it more than Senator Raphael Warnock, Georgia’s first black senator, who won a special election in January on a promise to expand Medicaid.

Mr Warnock will be on the ballot again in 2022, a year that looks set to be dark for his party, and the contest could determine control of the Senate. In Washington, closing the coverage gap remains Mr. Warnock’s main question.

“I believe that health care is a human right, and if you believe it is a human right, you don’t believe that it is a human right for 38 states”, a Mr Warnock said. in an interview in September.

But some Democrats, notably Mr. Manchin, see solving the problem only with federal dollars as unfair to states that have extended Medicaid and continue to pay 10% of the cost; why, they ask, should Republicans be rewarded for resisting? Republicans oppose the entire social policy plan, calling it a “tax and spending spree”.

The profile of those who fall into the gap is about the same as that of those hardest hit by the coronavirus pandemic: the colored poor. Most are in the South; Texas alone has more than a third of the people in the gap, according to the Kaiser Family Foundation.

Della Young, 49, a kidney transplant recipient with lupus, was doing well when she lived in New York. As a patient with end-stage kidney disease, she is covered by Medicare, which paid 80 percent of her medical bills. Medicaid took the rest.

But when Ms. Young moved to McDonough, Georgia, in 2015, she lost her Medicaid coverage and couldn’t afford the drugs to stop her body from rejecting her donated organ. Her transplant failed in 2016, and she has been waiting for a new kidney, while undergoing dialysis three times a week. She sends the dialysis center a check for $ 5 a month – a small offer for a much larger bill.

Because the personal expenses associated with transplants are so high, the Emory Transplant Center, where Ms. Young is a patient, advised her to fundraise on her own. She opened a GoFundMe account, hoping to raise $ 100,000. She has raised $ 5,077 so far.

“This whole fundraising thing is crazy,” she said. “Health care should be the same everywhere, no matter what state you live in. “

In Albany, a small town about three hours south of Atlanta, patients like Davis are eager to get all the help they can get. She and about a dozen other uninsured people shared their stories in the stripped down waiting room of the Samaritan Clinic, founded 15 years ago by Rev. Daniel Simmons, senior pastor of Mount Zion Baptist Church, who declared to have followed the will. of God.

“People were suffering, dying in our garden,” he said. “I said, ‘Lord, what do you want me to do? “”

Still, there is little the clinic can do. Lisa Jones, 59, lost her employer-sponsored insurance when she quit her job at a chicken processing plant to care for her ailing husband. He put her on his plane, but when he died she fell into the blanket gap. She gets blood pressure and cholesterol medication through the clinic, which works with companies that provide free medication.

But when Ms Jones requested treatment for Covid-19, she received a bill for $ 150. “It went to collections because I didn’t have the money to pay for it,” she said.

Volunteer doctors provide primary care at the clinic, but Nedra Fortson, nurse practitioner and executive director of the clinic, said it was difficult to refer patients to specialists because many refuse to offer free care.

Some patients, she said, can afford to go to the community health center, which has a low user fee of $ 25. “But often once they go to a provider and have to run labs, the patient ends up with a bill,” Ms. Fortson said. “And once they can’t pay that bill, they can’t get a date, so they come to us for help.”

The issue of Medicaid expansion has permeated Georgian politics for much of the past decade. The Affordable Care Act aimed for states to expand Medicaid to cover adults with incomes up to 138% of the federal poverty line – currently about $ 17,800 per year for an individual. Republican states took legal action, and in 2012 the Supreme Court upheld the law but made the extension of Medicaid optional.

In 2014, Georgia Republicans went even further. Fearing that a Democrat could win the governorship, they passed a law requiring lawmakers to approve any expansion plans. In 2018, Democratic gubernatorial candidate Stacey Abrams hit Republicans hard on health care. The following year, the state sought to partially expand Medicaid, with requirements for recipients to work.

The Trump administration approved the plan, which would have covered only a fraction of the state’s uninsured low-income adults, just days before Mr. Trump lost the 2020 election. The Biden administration, opposed to labor demands, suspended.

In the meantime, those with the coverage gap are trying to cope – now with new hope that the social policy bill becomes law. Ms Davis, the former home health aide, pays $ 90 out of pocket to see a primary care doctor once a year and gets annual mammograms from the county health department, where they are free. Her children help her, but she doesn’t like to accept it.

The Democrats’ plan to fully subsidize four years of coverage would allow Ms. Davis to retire until she turns 65 in two years and becomes Medicare eligible. She applied for Social Security disability benefits, hoping to qualify for Medicare, but to no avail.

“I applied for disability and they turned me down,” she said, “and I’m like, ‘Oh Lord, it’s not so much about a check.’ If I could just get insurance to see my doctors that’s all I want. She added, “If I could get four years old that would be great.”

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Newsrust - US Top News: Democrats' bill would cover uninsured poor adults, up to a point
Democrats' bill would cover uninsured poor adults, up to a point
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