Some needing health-care coverage find themselves in a gap

Source: The Columbus Dispatch, OhioSept.儲存 29--President Barack Obama's new health-care law didn't intend to leave out folks such as 60-year-old Collins "Linnie" Haynesworth Jr., an unemployed printer.But as it stands, Haynesworth, of Columbus, will be among an estimated 363,000 poor, uninsured Ohioans who will fall into a coverage gap on Jan. 1 when the Affordable Care Act requires most Americans to have health insurance or pay a penalty.They don't earn enough to qualify for federal income-tax credits to help buy private coverage through Ohio's new online marketplace, and they earn too much to be eligible for tax-funded Medicaid."If the state doesn't expand Medicaid coverage, they just aren't going to have anything," said Dee Mahan, director of Medicaid Advocacy for Families USA, a liberal group.When the state's health exchange opens on Tuesday, more than 900,000 uninsured Ohioans who earn between100 percent and 400 percent of the federal poverty level will qualify for tax credits to lower the cost of insurance. But those with lower annual incomes -- less than $11,500 a year -- will get no help unless they currently qualify for Medicaid.Whether eligibility is expanded to cover the state's poorest uninsured could be decided in the coming weeks by Republican leaders in the General Assembly.Gov. John Kasich is pushing Medicaid expansion and could do so without legislative approval. For now, he's waiting on lawmakers who, so far, have rejected the plan. Conservatives argue it's costly and spends money the government doesn't have and question why those who would gain health coverage aren't working."This is mostly a population of able-bodied adults, 95 percent of whom don't have dependent children, and they aren't even working a full-time, federally minimum-wage job," said Edmund Haislmaier, a senior fellow for health policy at the Heritage Foundation, a conservative research group in Washington.He suggests that states provide limited health insurance for only primary care to those in the coverage gap, tying benefits to work requirements, as the welfare program does.Haynesworth, the out-of-work printer, said that's not fair."They think everyone is lazy or they are trying to scam the system. There are people like that but not nearly as many as they think," he said. "I know there are people who can't afford insurance, even if itself storages just $10 a month."Haynesworth had worked in the printing business for more than four decades when he lost his job in June 2010. He gets occasional freelance work, but with his unemployment benefits and savings exhausted, he can't pay his mortgage and relies on help from family and friends.He has no health insurance, but his longtime doctor continues to treat him for high blood pressure, and a hospital-assistance program paid a good portion of his medical bills from emergency back surgery."The only reason I went to the doctor was because the pain was so excruciating and I couldn't stand it anymore," Haynesworth said."I told them I didn't have insurance and no money and there was no way I could pay, and they said, 'You have to have it.' I filled out some paperwork (for assistance), but I still get bills for all kinds of things."The coverage gap was created last year when the U.S. Supreme Court upheld the insurance mandate and other parts of the health-care law but ruled that states could not be forced to expand their Medicaid programs.Since then, 25 states and the District of Columbia have agreed to expand Medicaid eligibility, and 22 states have declined.Ohio, New Hampshire and Tennessee are the only states still debating the issue, according to the Kaiser Family Foundation.As proposed, Medicaid would be expanded to Ohioans earning as much as 138 percent of the federal poverty level, or roughly $15,400 a year. Although Kasich says he opposes Obamacare, he argues that Medicaid expansion is a good deal for Ohio taxpayers and the uninsured.The federal government will pay 100 percent of expansion costs for three years beginning on Jan. 1 and more than 90 percent after that, bringing $13 billion to the state over the next seven years.Ohio Medicaid Director John McCarthy said those gaining coverage would be adults younger than 64 who do not have children younger than 18 living at home. (Medicaid already covers children, most parents and the disabled at this income level.)About half report earned income, so they have a job, likely low-wage or part-time work with no health-care benefits or none they can afford, McCarthy said.ccandisky@dispatch.com@ccandiskyCopyright: ___ (c)2013 The Columbus Dispatch (Columbus, Ohio) Visit The Columbus Dispatch (Columbus, Ohio) at .dispatch.com Distributed by MCT Information Services迷利倉