“Beneath the loud debate” about the Patient Protection and Affordable Care Act, it is “quietly starting to change the health care landscape,” writes Abby Goodnough of The New York Times
, in the latest installment of her series looking at the law through the lives and businesses of Kentuckians.
“In Kentucky alone, more than 350,000 people — about 8 percent of the state’s population — have signed up for coverage,” Goonnough notes. “Insurers and medical providers are reporting steady demand from the newly covered for health care, ranging from basic checkups to complex surgical procedures.” About 80 percent of the signups in Kentucky are for Medicaid, and that number is likely to increase, because while open enrollment in private plans for 2014 closes tonight at midnight, Medicaid accepts enrollees year-round.
Goodnough’s story looks at a new Medicaid enrollee, a man who is having difficulty affording his subsidized policy, and a woman whose income is so high that she couldn’t even get subsidies for a new policy through the state health-insurance exchange — but who, like the other two, came to one of the Family Health Centers in Louisville because her doctor wasn’t in the network for her new policy. The centers “primary and preventive care in low-income neighborhoods where private doctors are scant,” and just over half their patients last year had no coverage, Goodnough reports.
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Donna Morse, 61, is a widow who “lost her insurance last year because it did not meet the new law’s standards. Now she has a new plan with much higher premiums, and which few doctors and hospitals will accept,” Goodnough writes. “She is paying $448 a month for a new Humana plan, up from the $258 monthly premium she paid before,” an increase of 74 percent. And when she took her prescription to her neighborhood Walgreens, she “discovered that the chain did not accept her new Humana policy, a so-called narrow network plan with a limited number of providers.”
Nevertheless, Morse, a dental hygenist, told Goodnough that she was “very pleasantly surprised”
by her experience at the clinic and “I’m really thankful that a lot of people are getting health care that couldn’t have it in the past.”
That describes David Elson, 60, “a self-employed businessman with a multitude of health problems and medical bills,” and forgot to pay the first month’s premium for his subsidized policy; and Tamekia Toure, 40, a diabetic and single mother who moved to Louisville from Alabama and got on Medicaid but found a job at Amazon
soon after her clinic appointment. “She
was elated to find work so quickly . . . but also a little scared,” Goodnough writes. “Would her new income make her
ineligible for Medicaid, so soon after she had signed up? With the
expanded program, this so-called churning in and out of Medicaid, based
on changes in income, is expected to be common, and for many,
problematic.” (Read more