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Hands Off My ObamaCare: Advocates mobilize for six-month sign-up period

Fri, Sep 27, 2013

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Pat Riley, 64, could be among more than 500,000 Chicagoans to benefit from President Obama’s health care reforms set to begin Jan. 1, 2014. Following a teach-in at the Metropolitan Apostolic Community Church (MACC) in Bronzeville, Riley said she is ready to tell everyone in her nearby senior citizen building about Medicaid expansion and signups for affordable health insurance exchanges that begin October 1.
“If we don’t do the legwork, it won’t get done,” Riley said. “We have our work cut out for us. I don’t want to wait until October and get bombarded by confusion.”

A five-time great-grandmother, Riley said she is worried about other children and their parents, some of whom may only have part-time jobs.

“I not only want to see mine covered. I want to see everyone covered, because they need it to help live and the money they spend on co-pays could be spent elsewhere: the light bill, buying shoes, buying groceries.”

Two of her own health worries might also be alleviated by health insurance expansion promised by ObamaCare, also known as the Affordable Care Act. She has a hernia that is inoperative because of acid reflux; the medication that controls it is not currently covered.

“And I can’t rub my leg because of busted veins,” Riley said. “They want to do surgery before deciding to pay for it. How dumb is that? I could be walking down the street, one of these could bust and I would bleed to death before the ambulance could get there.” She has been treated at a private hospital.

After the teach-in, Dr. Leon Finney, pastor of MACC and president of the Woodlawn Community Development Corporation, said, “It is imperative that all Chicagoans know how ObamaCare will benefit them. We need to help our President help us.”

Organized by Protect Your Care/Americans United for Change, the teach-in was attended by senior citizens who walked from nearby residential centers and others who were bused there. Many in the 1,000-capacity crowd wore red Acts of Kindness T-shirts handed out for the event.

Among key points made at the forum:

Individuals and families in Cook County will be able to choose among five carriers and dozens of plans.
More than 90,000 applications have been filed for CountyCare, an expanded Medicaid program in Cook County under Obama-Care. Intended for people who do not currently qualify for Medicaid or Medicare, CountyCare is open to people 19-64 with income of $15,282 for individuals or $20,628 for couples.

Applicants must be US citizens or legal immigrants for at least five years. You can sign up by calling 312.864.8200 or by visiting http://www.cookcountyhhs.org/patient-services/county-care/.

Those already in enrolled in Medicaid will not have to re-enroll.

Young people can stay on their parents’ plans until age 26. In Illinois, veterans can also remain with their parents’ coverage until age 30.

Wild applause greeted Cook County Health and Hospital Systems CEO Dr. Ramanathan Raju when he told a woman on disability with 12 medications that she might be eligible for CountyCare, where she could also have her prescriptions filled.

Although the state now limits Medicaid recipients to four prescriptions, Dr. Raju said of the expanded Cook County program that, “If you come for 10 medicines, we will give them to you,” at any of its facilities.

“If somebody comes and says ‘I can’t pay the co-pay,’ it is given to you,” Dr. Raju added. Medicare recipients who can’t afford their prescriptions are also welcome, he said.

Among 1.74 million Chicagoans age 19 through 64, roughly 506,340 (29 percent ) are uninsured, according to “Enroll Chicago! A Profile of the City’s Uninsured.” The Chicago Department of Public Health and Health & Disabilities Advocates published this report online in preparation for January’s implementation of the Affordable Care Act (ACA). Undocumented residents, however, are not eligible, which leaves 108,403 residents without coverage.

Most of the other 506,340 Chicagoans will be covered under the ACA in either of two ways:
Medicaid expansion could encompass 235,000 individuals who earn roughly $15,000 (138 percent of poverty level) or more for families. The new coverage was authorized by the Illinois General Assembly in May and went into effect with Gov. Quinn’s signature on July 22.

Health insurance “exchanges” — the Illinois Health Insurance Marketplace operated by the state in partnership with the federal government — could cover roughly 220,000 more Chicagoans. These people could earn 139 to 400 percent of the federal poverty level ($45,960 for individuals and $94,000 for a family of four). They will be eligible for federal tax credits on a sliding scale to help pay their premiums to commercial insurers.

People with income above 400 percent of the poverty level could also buy insurance in the Marketplace but would not be eligible for a tax credit. An estimated 50,569 people in this salary range could be newly insured.

The Illinois state budget can afford Medicaid expansion because the federal government will completely pay for its first three years, says Heather O’Donnell, vice president of advocacy and public policy at Thresholds. The state will never pay more than 10 percent of its cost, unlike the 50-50 cost-sharing since Medicaid’s inception in the 1960s.

Both O’Donnell and John Bouman, president of the Sargent Shriver National Center on Poverty Law, said that health care reform helps the federal budget through better management of expenditures that leads to healthier citizens.

“When you have access to coverage, access to a regular source of care, to prevention, early detection of conditions, strong care for chronic conditions to keep them under control, it leads to better outcomes and control of costs,“ Bouman said. Cancer detected early rather than late, for example, is less deadly and costly. Diabetes that is controlled means fewer amputations and loss of eyesight.

“I am excited about it as someone who does a lot of work to help low-income people because it will mean a major change in employability, productivity, quality of life, family bottom line and chances for entrepreneurships: you don’t necessarily have to stay in a job just to keep the health insurance,” Bouman said. “Hopefully it will reduce the amount of medical-related bankruptcies.”

“We have lost sight of why health care reform was passed in the first place,” O’Donnell said. “Health care costs were rising three times faster than inflation, far exceeding wage growth. And private health insurance was moving farther and farther out of reach of the average working family. We were all paying for people who were uninsured and who went to the emergency room or were treated in hospitals as charity care or uncompensated care. All of these costs were passed on in terms of higher insurance costs and premiums. We’ve been paying a very high price for a broken health care system. Health care reform will address this by providing coverage and access to care when they need it: primary care, preventive care when you get sick so you don’t have to delay and delay until it’s an emergency.”

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One in 4 people who are homeless have behavioral health needs such as mental health and substance abuse. In the past they were isolated and prone to repeated institutionalization or incarceration, O’Donnell said.

“Many of these people have been seeking care in emergency rooms when it becomes a crisis. But emergency rooms do not treat mental or psychiatric conditions over the long run, they only treat the immediate crisis. With health care coverage, they can get treatment for their mental illness, medication for schizophrenia, bipolar disorder and get their mental illness under control, stabilize their lives so they live healthy full lives. It absolutely could prevent homelessness for mental illness.”

“As a program officer for LISC Chicago’s Healthy Communities campaign, Dominique Williams said that advocates should be mobilized by October 1 because signups only extend through March. “The six-month window is going to fly by. It’s important for people to prioritize it.”

LISC is one of 44 community organizations that will share $27 million in federal money to help uninsured people across the state enroll in the Illinois Health Insurance Marketplace. Gov. Quinn named the appointees in July.

Williams said LISC is working with an “established and trusted network of community-based organizations” in 10 communities such as Auburn-Gresham, Greater Grand Crossing, Back of the Yards, Archer Heights, Bridgeport, Brighton Park and McKinley Park. “The main message we want to get across is that someone will help you. You will have one-on-one support.”

Some LISC partners are centers for working families such as St. Sabina’s Employment Center, Instituto del Progreso Latino or Metropolitan Family Services at Kennedy King College where the clientele has already received help with credit counseling or job services. Other agencies such as the Greater Auburn Gresham Development Corp., Back of the Yards Neighborhood Council and Teamwork Englewood will do “heavy-duty outreach, from knocking on doors to establishing partnerships that give entrée to schools, shelters and churches,” Williams said.

LISC is also partnering with citywide agencies focused on specific populations. The Center for Changing Lives in Logan Square helps people who are homeless; Jane Addams Resource Corp in Ravenswood helps dislocated workers and The Safer Foundation assists people with criminal records.

LISC sees health care signups as the first step in its work toward creating healthy communities, Williams said. “A lot of people think of health in terms of clinical care – going to a doctor,” she said. “But it is also about having a healthy physical environment, about education and employment, community safety as well as health behaviors such as not smoking. We take a more comprehensive view of what it means to be healthy. This enrollment piece is extremely valuable. We see it as part of a bigger puzzle.”

By Suzanne Hanney
StreetWise Editor-In-Chief

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