clear
Friday May 22nd, 2015 4:35AM

Affordable Care Act only chips away at a core goal

By The Associated Press
SACRAMENTO, Calif. (AP) - Swan Lockett had high hopes that President Barack Obama's health overhaul would lead her family to an affordable insurance plan, but that hasn't happened.

Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack.

``If I don't have the money, I just let it go on its own,'' Lockett said.

The federal health care overhaul has provided coverage for millions of Americans, but it has only chipped away at one of its core goals: to sharply reduce the number of people without insurance.

President Barack Obama announced last week that 8 million people have signed up for coverage through new insurance exchanges, but barriers persist blocking tens of millions of people around the nation from accessing health care. Questions of eligibility, immigrant coverage and the response from employers and state legislatures mean considerable work lies ahead for health care advocates and officials but cost remains a particularly high hurdle for low income people who are most likely to be uninsured.

``We think that most people will get insurance once it's affordable to them,'' said Cheryl Fish-Parcham, of Families USA, a health advocacy group.

There are myriad ways people fall into coverage gaps. Some are eligible for discounted policies but say they still can't afford their share of exchange plans. Others earn too much for subsidies. Immigrants living in the country illegally can't obtain care under the law. Dozens of states haven't expanded Medicaid. And some employers have reduced staff hours to avoid being mandated to provide care.

``I'm a nurse, but my employer doesn't offer health insurance,'' said Gwen Eliezer, 32, who lives north of Asheville, N.C.

Eliezer works an average of 29 hours a week at a nursing home, so her employer isn't required to cover her. She qualifies for a subsidy but says the plan she found with a $200 monthly premium and $6,500 deductible is too expensive. So while her 6-year-old son qualified for Medicaid during open enrollment, she goes without. She pays cash to see a doctor for gastrointestinal pain but says she can't afford to get the problem diagnosed.

``If I went through an emergency room, I can claim acute pain,'' she said. ``But then I'd end up with a lot of debt to a hospital.''

Before the launch of the Affordable Care Act, about 48 million people, or 15 percent of the population, went without health insurance, according to the U.S. Census Bureau. The number of people recently enrolled includes those who switched from previous plans, and it's not clear how many previously uninsured people are now covered.

The share of adults without insurance shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014, according to a Gallup-Healthways Well-Being Index released this month. The decline would translate to about 3.5 million people gaining coverage, according to the study. Another study by RAND Corp. shows a larger number of adults gaining coverage.

U.S. Department of Health and Human Services spokeswoman Erin Shields Britt said Monday that the law has brought greater security for millions of Americans but more work remains. In addition to 8 million people who signed up for private insurance through exchanges, Medicaid enrollment has increased by at least 3 million.

``As we look to next year's open enrollment, we will continue to target outreach efforts to encourage the uninsured to explore their coverage options and enroll in a plan that meets their needs and fits their budget,'' Britt said.

For hair salon owner Lola Smith of Palo Alto, in eastern Pennsylvania coal country, budget is her chief concern. She said she couldn't afford a policy from the federal exchange. Instead, she bought a cut-rate plan for $148 a month that helps pay for hospitalizations and doctor visits. ``It doesn't cover very much. It's just basic,'' she said.

The plan doesn't qualify as health insurance under Affordable Care Act regulations, and Smith expects to be hit with a fine until she qualifies for Medicare next year.

Immigrants living in the U.S. illegally are ineligible for coverage. The Migration Policy Institute estimates that more than 7.5 million people fall into this category and rely on emergency rooms and safety net clinics. About 1 million members of this population are from California.

``When I see there are American citizens who don't have access to health care because they can't pay for it, I figure that I'll have even less of a chance to have access to health services,'' said Jose Diaz, a 67-year-old day laborer in Pomona, Calif., who came to the U.S. illegally from Mexico City nearly a decade ago. ``It's very sad.''

Nearly 5 million low-income, childless adults are without health care, according to a December survey by Kaiser Family Foundation.

A Medicaid expansion could help close that gap, and the federal government has offered to pay states nearly all of the costs for covering individuals who earn up to $16,000 a year, 138 percent of the federal poverty wage.

However, 24 states have opted against it, saying they don't trust the federal government to deliver on its promises and don't want to be stuck with a program they can't afford.

Health advocates say getting those states to expand would reduce hospitalization and emergency costs across the system.

``That affects all our pocketbooks, because we all pay for uncompensated care when people don't have timely access to preventative care,'' Fish-Parcham said.

Texas is among the states to reject the expansion, and Lockett says she's been shut out.

The Houston woman earns too much for Medicaid or a subsidy but can't afford a full plan. She earns $1,225 a month and takes her children a 5-year-old daughter, 18-year-old twin boys and a 19-year-old son to the emergency room or a clinic when they need care.

``I was disappointed,'' Lockett said, ``because I was kind of excited about getting on the Affordable Care Act on the marketplace.''
© Copyright 2015 AccessNorthGa.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Judge denies motions to move, delay Tsarnaev trial
Lawyers for Boston Marathon bombing suspect Dzhokhar Tsarnaev asked a federal appeals court Wednesday to overturn a judge's decision to not move his upcoming trial out of state.
10:02PM ( 4 months ago )
High court to adopt electronic filing of cases
The Supreme Court is belatedly developing an electronic filing system similar to those used in courts around the country, Chief Justice John Roberts said Wednesday in his annual end-of-year report.
7:57PM ( 4 months ago )
Storm brings snow, cold to West for New Year's
A blustery winter storm dumped snow and ice across the West on Wednesday, making driving treacherous in the mountains from California to the Rockies and forcing residents and party-goers in some usually sun-soaked cities to bundle up for a frosty New Year's.
5:19PM ( 4 months ago )
U.S. News
State DOT awards $48M contract for NE Ga. road project
The state Department of Transportation has awarded a $47.8 million contract for nine miles of work on a northeast Georgia road.
9:37AM ( 4 months ago )
Business News
Grass fire impacts rush hour traffic on 985
Rush hour traffic on I-985 was slowed by a grass fire Wednesay afternoon with one lane closed while firefighters fought the blaze.
10:19PM ( 4 months ago )
Hall County conviction, sentencing to be reviewed by SCOGA
The State Supreme Court has agreed to hear the appeal of a Hall County man when they reconvene in January.
2:37PM ( 4 months ago )
Maysville man dies from Banks County wreck
The Georgia State Patrol reports that alcohol and/or drugs were factors a single-vehicle wreck that claimed the life of a Maysville man in Banks County Tuesday night.
11:07AM ( 4 months ago )
Local/State News
GOP leader regrets talk to white supremacists; party leaders rally around him
House Republican leaders rallied around one of their own, Whip Steve Scalise, on Tuesday after he said he regrets speaking 12 years ago to a white supremacist organization and condemns the views of such groups.
6:08PM ( 4 months ago )
Conviction of Putin foe sets off protest in Moscow
President Vladimir Putin's chief political foe was convicted along with his brother on Tuesday in a fraud case widely seen as a vendetta by the Kremlin, triggering one of Russia's boldest anti-government demonstrations in years.
6:03PM ( 4 months ago )
More Georgians signing up for health insurance
A federal report says more Georgians have selected health insurance plans through a federally facilitated marketplace.
4:16PM ( 4 months ago )
Politics
Obama again avoids calling 1915 Armenian killings 'genocide'
WASHINGTON (AP) — President Barack Obama will once again stop short of calling the 1915 massacre of Armenians a genocide, prompting anger and disappointment from those who have been pushing him to ful...
1:00PM ( 4 weeks ago )
Ex-NFL star Hernandez convicted of murder, sentenced to life
FALL RIVER, Mass. (AP) — Former New England Patriots star Aaron Hernandez was convicted of first-degree murder and sentenced to life in prison Wednesday for a deadly late-night shooting, sealing the d...
8:54PM ( 1 month ago )
Clinton kicks off 2016 campaign online, heads next to Iowa
WASHINGTON (AP) — Hillary Rodham Clinton jumped back into presidential politics on Sunday, making a much-awaited announcement she will again seek the White House with a promise to serve as the "champi...
7:56PM ( 1 month ago )
Hall, White, Jefferson schools recognized nationally for use of technology
Three school districts in northeast Georgia - Hall, White, and Jefferson - have received national recognition for their use use of innovative technologies. They earned top spots in the Center for Digital Education's and the National School Boards Association's 10th annual Digital School Districts Survey.
By Staff
1:00PM ( 1 month ago )
US Capitol lockdown lifted after man fatally shoots himself
WASHINGTON (AP) — A precautionary lockdown of the U.S. Capitol was lifted after about two hours Saturday following a suicide by a man carrying a protest sign.The man died after shooting himself on the...
6:15PM ( 1 month ago )