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W.Va.'s uninsured urge Medicaid expansion

Read it here: The sooner, the better, advocates say

CEDAR GROVE, W.Va. -- Tammy Roberts works five to six days a week as a housekeeper for a nursing home. She's been there almost three years.

"We've been short-handed," Roberts said. People take the job "thinking it's easy and quit when it's not."

When she was married, the lifelong Sissonville resident had health insurance with her husband's plan. She lost it three years ago in the divorce.

Her company offers health insurance but, on $9.50 an hour, the 41-year-old can't afford it.

Roberts takes medication for high blood pressure and gets regular checkups, but she's concerned about not having insurance in the case of an emergency.

"You never know what might happen," Roberts said. "To be able to afford it and go to the doctor when you need to go, it would be such a blessing."

Roberts and an estimated 120,000 other West Virginians would be eligible for Medicaid, should Gov. Earl Ray Tomblin choose to expand the federal program.

Under the Affordable Care Act, states have the option of expanding their Medicaid programs to cover those who earn up to 138 percent of the federal poverty line -- about $26,300 for a family of three.

Currently, West Virginia's Medicaid program doesn't cover childless adults, and only covers parents if the family makes less than 35 percent of the federal poverty level -- about $6,700 for a family of three. (The program also covers children and pregnant women at higher levels.)

For now, Roberts has access to low-cost care through the West Virginia Connect program. Connect participants get care in exchange for having their medical data anonymously folded into a 10,000-person database intended to help health-care leaders make more informed decisions as health-care reform unfolds. The program will end in August.

Should the state participate in Medicaid expansion, the federal government would pay 100 percent of the cost for the expansion population during the first three years. After that the federal match would gradually drop to 90 percent.

Tomblin is awaiting results of an actuarial study -- due this month -- about the state's costs of expansion.

Officials at Cabin Creek Health Systems have collected stories from Roberts and more than 100 other West Virginia Connect participants in the hopes of meeting with Tomblin to advocate for Medicaid expansion.

So far the community-based health center has collected 112 letters from West Virginia Connect participants who would qualify for Medicaid if it's expanded.

"I think the expansion of Medicaid is one of the most important things that we can see happen," said Amber Crist, Cabin Creek's education and program development director. "Connect was supposed to be the bridge to expansion. We felt it was important [participants] know the importance of expansion and that they be advocates for themselves."

Dennis and Melody Barton's story is also included in the letters. The Glasgow couple moved in with Dennis' mother to help make ends meet after health problems forced him to stop working.

"We couldn't even afford to live by ourselves anymore because of the fact that he can't work," said Melody Barton, 52.

Dennis Barton had made good money as a pipelayer before the injury and later a heart attack. Now he's tried to get disability assistance. He had been on Medicaid but was recently notified he is no longer eligible, Melody Barton said.

She works 30 hours each week as a produce manager at the Cedar Grove Save-A-Lot.

The couple lives near the store and she walks to work to save money on gas.

Her workplace doesn't offer insurance and, on $8.50 an hour, she can't afford it otherwise.

"Before we could help the kids at any time," Melody Barton said. "He has two kids, I have two kids. We can't even do that now. It's just one of those things."

Barton takes medication for restless leg syndrome and Prozac for menopausal symptoms. On the West Virginia Connect program's sliding scale she pays around $30, but that cost will jump to $400 when the program ends in a few months, she said.

Barton isn't eligible for Medicaid now, but she would be if West Virginia were to expand the program.

Another Connect participant, Debra Cook, works 39 hours a week for $9 an hour at an adult daycare for patients with dementia and Alzheimer's disease.

A hairdresser for 25 years, the 54-year-old Witcher Creek resident needs knee-replacement surgery. She needs surgery on her hands, too, because of carpal tunnel syndrome, but her knees are worse, she said.

"They ache like a toothache," she said. "Both are bad but the left kneecap is basically gone. The winter is worse than the summer because of the cold. The carpal tunnel is like needles shooting up and down your arm."

Cook said she isn't looking for a handout -- she's worked since she was 16 years old. But she wants Medicaid to be expanded not only for her but for the seniors she works with -- some of whom must choose between medicine and food some weeks.

"Charity begins at home," Cook said. "We need to help our people before we go out of the country. I have worked since I was 16 years old and there's no help for us."

Reach Lori Kersey at lori.kersey@wvgazette.com or 304-348-1240.


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