Mississippi blues: The cost of rejecting Medicaid expansion

Fri Oct 4, 2013 4:08pm EDT
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By Julie Steenhuysen

PASCAGOULA, Mississippi (Reuters) - As Americans across the nation begin to find out what Obamacare has in store for them, many of Mississippi's most needy will find out the answer is nothing.

That is likely the case for William and Leslie Johnson of Jackson County, since the state decided not to expand the Medicaid program for the poor under President Barack Obama's Affordable Care Act. As a result, nearly 300,000 adults there will fall through the cracks of healthcare reform.

Many are the working poor - truckers, childcare workers, mechanics - who make too much money each month to qualify for Medicaid under Mississippi's existing criteria but not quite enough to get government help buying private health insurance on an Obamacare exchange.

Nationwide, 25 states have rejected the Medicaid expansion, leaving nearly 7 million adults who would otherwise have qualified for coverage without benefits. These states, many of them Republican-led, have declined government funding for an expansion largely because they say initially generous subsidies would eventually be reduced, leaving them with an unacceptably large burden in a few years' time.

Among those states, Mississippi faces one of the most dire situations. It tops the charts for poor-health indicators: highest in poverty, second-highest in obesity, highest in diabetes and highest in pre-term births.

For the Johnsons, the struggle for health coverage has been a years-long battle. In the 16 years since her birth, their daughter, Mackenzie, has already had 10 major surgeries to treat her club foot, dislocated hips and malformed spine, all due to a rare form of spina bifida that causes the spinal cord to split. (The Johnsons also have an 11-year-old son, Tyler.)

A major operation to insert two metal rods helped to straighten a 70-degree curve in Mackenzie's spine that was collapsing her lungs and making it difficult for her to breathe. It improved her condition to the point where she no longer qualified for a special Medicaid program for disabled children living at home. She hasn't had health insurance since last June.

"At this point, we're still fighting to get her on Medicaid, but being self-employed, if I gross a certain amount of money per month, they kick her off the program," said William.   Continued...

Registered nurse Paige Duracher checks Jacqueline Parker's vitals in the cardiac step-down area of the University of Mississippi Medical Center in Jackson, Mississippi October 4, 2013. Jacqueline Parker is a retired state employee who receives her heath insurance through Medicaid. Mississippi is one of at least 20 states that has decided not to expand Medicaid under the Affordable Care Act, better known as "Obamacare". REUTERS/Jonathan Bachman