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My view: The Medicaid gap is a life or death issue

By Vaughn Davis

For the Deseret News

Published: Wednesday, March 19 2014 12:00 a.m. MDT

Fourth Street Clinic checks all patients to see if we qualify for Medicaid. Some of us qualified for Medicaid Disability, and we do pretty well due to the help of health insurance.

Courtesy Fourth Street Clinic

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We are members of Fourth Street Clinic’s Consumer Advisory Board (CAB). Fourth Street Clinic is a nonprofit that provides health care and support services for very low-income Utahns who struggle to secure permanent housing. CAB is a group of current patients who are in various stages of transitioning out of homelessness. We volunteer our time to do outreach to other homeless people and help link them into Fourth Street Clinic’s services. We also advise the Senior Management Team and full Board of Directors.

For most of us — as well as for most Utahns who are homeless — Fourth Street Clinic is our only source of health care because they do not require health insurance or payment. Most of us don’t have health insurance, because we can’t pay for it on our own and Utah’s Medicaid Program requires that you be poor and have dependents or be disabled. It is the 60,000 people like us that Utah is calling the “coverage gap.” If Utah doesn’t eliminate it’s Medicaid restrictions and include all poor Utahns, we will be the only group to remain uninsured under the new health care reform law. We do not qualify for any of the law’s discounted plans or government subsidies to buy health insurance.

For each of us, regular health care visits were our first step in moving out of homelessness. Fourth Street Clinic became our support and our family as we began to understand a life with diabetes, hypertension, mental illness, seizures, Hepatitis C and addictions. You name it, and we have been diagnosed with it. These illnesses are a part of how we ended up homeless. None of us had jobs that carried health insurance, and there was never any hope of being able to pay to go to a doctor. So we got sicker and poorer and became homeless. It wasn’t until Fourth Street Clinic that we really understood what was happening and what we could do about it.

Fourth Street Clinic checks all patients to see if we qualify for Medicaid. Some of us qualified for Medicaid Disability, and we do pretty well due to the help of health insurance. More of us are told that we don’t qualify for Medicaid, because we don’t have kids or aren’t disabled enough. We still get health care services at Fourth Street Clinic, but are told “no” or “wait” for other things like mammograms, colonoscopies, certain drugs, surgeries, mental health services and dental care.

While we “wait,” we start to lose toes, our eyesight, our teeth, our minds, our ability to walk, our dignity and our hope as we slowly become “disabled” and eligible for Medicaid. We all know people who died “waiting.” Our friends died because they didn’t have the money or insurance to get the help they needed when they needed it. Sadly, death qualifies as a disability, so when our friends died, their wait was over and their Medicaid applications were automatically approved. Medicaid didn’t pay for their lives, but it sure did pay for their deaths.

Gov. Herbert and the Utah State Legislature now have the opportunity to do the right thing and change this. Right now, Utah can affordably open up Utah’s Medicaid program to us and all other poor Utahns — closing the coverage gap. Gov. Herbert’s Healthy Utah Plan is a step in the right direction, and we encourage him to continue his efforts until all Utahns can get health insurance coverage at the lowest cost to Utah taxpayers. All we ask is that our lives be considered. After all, we aren’t asking for anything special: We just want to live.

Vaughn Davis, John Wilkes, Gwen White, Russell Flowers, Rachel Santizo, Pam Evans and Mary Hogle are members of Fourth Street Clinic’s Consumer Advisory Board (CAB). All have struggled with lack of housing, poverty, and poor health. Through CAB, they link others who are experiencing homelessness into services and lend a public voice to housing and health care issues.

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