Ohioans on Medicaid warily watch D.C. debate – The Blade – Toledo Blade

Amy Russell’s “million-dollar baby” is today a feisty, 4-year-old who loves watching Dora the Explorer and Elmo, playing outside, and getting into everything.

But when Allison Russell celebrated her birthday last week, it was on a day that still sometimes sounds off to her mom, because as she says, she was expecting her in July. Allison arrived early — too early: born at 26 weeks, 1 pound, 3 ounces, and with a host of medical complications.

“You’ve never seen a baby that small with so many tubes and a ventilator,” she said, recalling her daughter’s “spaceship” incubator and other equipment. “It was a lot.”

Allison spent the first 8 months of her life in hospitals in Toledo, Cincinnati, and Ann Arbor. She’s undergone multiple surgeries and at one time needed a ventilator and a tracheotomy. In the middle of all this, Mrs. Russell realized she couldn’t keep working full time. Allison needed full-time care, and the family struggled to find an in-home nurse who was a good fit and understood her daughter’s care needs.

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Amy Russell, left, watches Allison, 3, work with Laurie Reed, an occupational therapy assistant, during a weekly rehab session. While Allison has made great progress, she will need costly medical care for the foreseeable future, her mother said.


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Finding coverage

Leaving her full-time job as a licensed practical nurse meant losing Mrs. Russell’s employer-offered insurance. She was able to enroll Allison and her three older daughters in Ohio Medicaid’s Healthy Start program, the state program for the Children’s Health Insurance Program, something she said has been a huge relief for her family. Without insurance, they could not pay for Allison’s care that Mrs. Russell estimates has surpassed easily $1 million.

“It’s huge. If we don’t have that, I don’t know what we would do,” Mrs. Russell said about the coverage. “She will probably need care — hopefully not forever — but at least for the foreseeable future.”

Allison is among a combined 3 million Ohioans who receive Medicaid or CHIP. Many of them are warily watching developments in Washington as lawmakers debate how to reform the nation’s health-care laws and entitlement programs.

Though the first iteration of Congressional Republicans’ replacement for the Affordable Care Act stalled without a vote — and with it stalled proposed cuts to Medicaid — lawmakers have signaled in recent weeks a new effort to craft a replacement to former President Barack Obama’s signature legislation.

Ohio is one of 31 states and the District of Columbia to expand Medicaid under the Affordable Care Act, according to the Centers for Medicare and Medicaid Services. In the expansion, which allowed for the first time low-income single adults to enroll, 700,000 Ohioans got coverage.

Gov. John Kasich has criticized proposals to roll back the expansion, which he said has been good for Ohioans.

“In a nutshell, we don’t want to lose coverage for 700,000 people in our state, a quarter of whom have chronic conditions, a third of whom have problems with mental illness and drug addiction,” Mr. Kasich said in January, as reported by the Cincinnati Enquirer.

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Amy Russell’s million-dollar baby, Allison, was born at 26 weeks and has needed costly medical care.


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Ohioans get help

In fiscal year 2018, Ohio’s financial contribution to the state’s Medicaid expansion is $281.6 million, according to the Ohio Department of Medicaid; it will be $338.6 million in fiscal year 2019.

In Lucas County, more than 146,000 people were enrolled in various forms of Medicaid as of February, according to the state Medicaid department, including nearly 35,000 from the expansion and nearly 55,000 children across various coverage programs.

The expansion has helped people like Laura Shaffer, 27, who enrolled in Medicaid when she left her parents’ insurance last year. She was working two part-time jobs that did not offer insurance, and she said she knows many young cohorts in a similar situation.

“I simply didn’t make enough to get it through the marketplace though I worked 40 hours a week,” she said. “We all graduated [from college] into a pretty rough economy, and the job market hasn’t bounced back in a way we would have hoped.” Ms. Shaffer now has coverage through the insurance marketplace.

Antoinette Banks, a certified application counselor specializing in Medicaid at Neighborhood Health Association, worries for the patients she’s enrolled over the last few years.

“You would be thrilled when people got their health insurance,” she said. “They came in with their card, waving and showing us, [saying] ‘Got my insurance so I can see the doctor.’ We were just as thrilled for them as they were because it makes such a difference in people’s lives. It’s something a lot of people take for granted, but if you don’t have your health, you don’t have very much.”

Bracing for change

Many told her it was the first time they had health insurance in years, if ever.

“It has meant a lot to people to get the care they have put off for so many years, not getting treated for their high blood pressure or cardiac conditions,” she said. “They wanted to see the doctor, they wanted to take care of themselves, they wanted to feel better.”

She said she will continue her work enrolling patients until something changes.

“The Affordable Care Act and the Medicaid expansion are still here today, and so we function that way,” she said. “It’s still the law.”

Miranda Hoffman, chief financial officer for Neighborhood Health Association, said Medicaid changes directly would affect work the association does at a dozen clinics and health centers around Toledo.

In 2012, before the expansion, 38 percent of approximately 10,000 patients were on Medicaid, she said; it’s now 68 percent. The uninsured population was 47 percent before the expansion. It is now 10 percent. Agency leaders breathed a sign of relief when the first version of the Republicans’ health-care bill failed, Ms. Hoffman said.

Though Ms. Banks, Ms. Hoffman, and others in the health-care field are closely following potential legislation, she said knows many patients have too many pressing life concerns to track every twist and turn in Congress.

Mrs. Russell said she too follows updates out of Washington, but the back-and-forth sometimes gets to be too much.

“I had to turn it off a bit,” she said of the news and social media. “It’s stressful to me thinking, ‘What is going to happen? Who is going to resolve these issues here?’”

She knows changes are coming, and said she hopes the politicians keep patients like Allison in mind.

“This is important that people have access to medical care,” Mrs. Russell said. “Everybody should have it, and it should be easily accessible and affordable.”

Contact Lauren Lindstrom at llindstrom@theblade.com, 419-724-6154, or on Twitter @lelindstrom.

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