Whitesburg KY

New health care law appears popular here

A middle-aged woman who works for one of Letcher County’s two public school districts walked into Mountain Comprehensive Health Corporation’s Whitesburg Medical Clinic earlier this week hoping the new federal health care law would offer some type of affordable insurance coverage for her jobless husband.

The woman, whom we’ll call Jane Doe for the purpose of patient confidentiality, walked into the MCHC clinic around 3 p.m. Monday unsure as to whether her husband would qualify for help under the new Patient Protection and Affordable Care Act. About an hour later she walked out of the MCHC building as a new fan of “Obamacare,” the term most often used when referring to the new law that is now open for patient enrollment.

Not only did “Mrs. Doe” learn that her husband will qualify for Medicaid coverage under the expanded eligibility requirements Obamacare is bringing to that program for low-income residents in Kentucky, it appears that Mrs. Doe herself may also qualify to have the government pay most of the cost associated with her health-care after Jan. 1, 2014. That’s the date coverage is set to begin for Kentuckians who sign up for the Affordable Care Act before Dec. 15.

“I’m tickled even if I don’t get it. That’s why I came was for him,” Mrs. Doe said after being told the Kentucky Office of the Health Benefit Exchange (KHBE) must further review her case before determining if she also qualifies for coverage under the state’s expanded Medicaid program or whether she will be offered financial assistance with one of four levels of health insurance policies being sold through “kynect,” the state’s health benefit exchange.

Although Mrs. Doe has worked in public schools here for more than 20 years, she still earns less than $20,000 a year. She now pays $19.30 for insurance coverage through her employer every payday, but her husband has had to do without any coverage since his job with a mining company ended several months ago.

“It’s okay to be sick now,” MCHC employee Teresa Fleming told Mrs. Doe at the end of a 30-minute computerized application session through kynect.ky.gov which showed that Mr. Doe will qualify for Medicaid coverage and Mrs. Doe probably will too.

In addition to her job as MCHC’s chief financial officer, Fleming is in charge of a group of 22 MCHC employees who are trained to help members of the public negotiate the application process for coverage under the Affordable Care Act. Since enrollment began Oct. 1, the demand for assistance has been so great in the four eastern Kentucky counties served by MCHC that 10 additional employees are being trained to become “Certified Application Counselors.”

“I’m honestly shocked,” Fleming said. “I didn’t think we’d have this kind of response.”

Fleming said that during the first four days of enrollment, a large number of people left MCHC’s Whitesburg Clinic building extremely happy after learning they will qualify for free Medicaid coverage. Others have left pleased to know they can finally afford health insurance, many of them for the first time ever.

Fleming said one couple now qualifies for Medicaid under Obamacare even though the wife works in a restaurant and the husband works in retail sales. A 62-year-old widow who wouldn’t have qualified for any health-care assistance at all before the Affordable Care Act wept after learning she will now qualify for assistance through the expanded Medicaid rules.

“When that first woman cried, that really got to me,” Fleming said. “She just heard about it and came in to see if she was eligible. She was living off her late husband’s Social Security. What would she have done if she’d gotten sick?”

Fleming said she and other MCHC workers were also touched by the story of a laid-off coal trucker who will now get coverage through Medicaid for himself and his three young children thanks to the new health-care law.

“I keep saying hope,” said Fleming. “That’s what this is.”

Among the 22 counselors now available at the not-for-profit MCHC facilities are four specialists known as “kynectors.” Two of them, Zach Sturgill and Malinda Sexton, are on staff at the Whitesburg Medical Clinic.

“It brings me happiness to help people in my community that don’t have health insurance,” said Sturgill. “Each person has his or her own story about how they don’t have health insurance and need it. I helped an older lady who hadn’t had health coverage in over 30 years. She had tried to purchase private insurance before, but she couldn’t afford the monthly premiums so she simply didn’t go to the doctor unless she absolutely had to. This particular lady doesn’t have any income and because her income is lower than 138 percent of the federal poverty level, she qualifies for the new MAGI Medicaid, which provides free health insurance to low-income adults ages 19 to 64 who fall under the 138 percent guideline. She was overwhelmed with excitement because she was able to get health insurance for the first time.”

MCHC counselors are available to help people apply for health-care coverage whether or not they have been seeing a doctor at an MCHC clinic. Fleming said the clinic’s Affordable Care experts would also be happy to schedule appointments to provide assistance to businesses with 50 or fewer employees who are interested in providing coverage to employees.

“We’re doing this because of what we are — a community health center,” Fleming said.

Since Oct. 1, nearly 175,000 people have gone online to visit the Kentucky Health Benefit Exchange to review information about health insurance coverage.

Gov. Steve Beshear’s office said in a news release this week that nearly 7,000 of those people have purchased health insurance policies that will go into effect on Jan 1. As of Monday afternoon, more than 155,000 people had completed pre-screenings to determine if they qualify for federal subsidies and discounts for insurance policies or to determine if they qualify for Medicaid.

Nearly 15,000 people have completed applications for health coverage so far.

Premiums range from less than $50 a month for a healthy single person to more than $700 a month for a family for four. Beshear has said four out of five Kentuckians will be eligible based on income cutoffs for federal subsidies, which range from less than $100 to more than $500 a month to help pay premiums.

State officials say about 640,000 Kentuckians lack health insurance in a state that ranks at or near the top nationally for many health problems.

The governor said the online marketplace offers the chance for a “transformational change” that he said will improve the state’s health and productivity.

“For the first time in history, we’re going to have the ability to let every Kentuckian have access to affordable health care,” he said.

Beshear also decided this year to expand Kentucky’s Medicaid program to cover an additional 300,000 people, most of them the working poor who have lacked health insurance coverage. The federal government will pick up the entire cost of the expansion for the first three years, and 90 percent over the longer haul.

Referring to critics of the health-care law such as Kentucky’s Republican U.S. senators, Mitch McConnell and Rand Paul, Beshear predicted that by this time next year, Kentuckians will wonder what all the fuss was from the law’s critics.

“I think the critics are going to end up with a little egg on their face,” he said.

Persons who wish to apply for coverage on their own may visit kynect’s website at kynect.ky.gov or call by phone at 1-855-4KYNECT. MCHC’s Zach Sturgill may be reached at 634-5180. Malinda Sexton, also of MCHC, may be reached at 634-8613.

Compiled from Mountain Eagle and Associated Press reports.

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