By Connie Berry
The U.S. Census Bureau recently reported figures that paint a dismal picture of the current economic climate. The newest numbers revealed that more than 43 million Americans live in poverty — one out of every seven people you might see while walking down the street. And the number of uninsured Americans rose to more than 50 million last year. The Patient Protection and Affordable Care Act (PPACA) was signed by President Obama in March, along with the Health care and Education Reconciliation Act of 2010. One of the glitches of the new health care laws is that they won’t entirely take effect until 2014. The complete health care reform package is well over 2,000 pages long.
A trip to the Poverello Health Clinic, one of the Franciscan Northside Ministry’s ventures, illustrates the challenges facing many who are meant to benefit from the reform package.
One of the clients on a recent Wednesday night said he can’t read, so how is he supposed to understand what to do about any changes in health care coverage? Another one said she used to be on Medicaid but she couldn’t get to her appointments so she was disqualified and lost her coverage. The circumstances surrounding the majority of the clients served at the free clinic leads them to be the proverbial folks who “fall through the cracks.”
“I’m not sure it [health care reform] will affect them,” said Sister James Peter (JP) Ridgeo, OSF, coordinator of medical services at the clinic. “It certainly hasn’t yet. We see 35 to 45 people in a session.”
And, Sister JP said, “How can people apply for a program when they have no address or telephone number? Or if they don’t know how to fill out paperwork?”
Fidelis Care is a New York State Catholic Health Plan offering free or low-cost health insurance through Child Health Plus, Family Health Plus or Medicaid Managed Care through its Fidelis Care program. The organization currently serves people in 55 of the 62 counties of the state.
They report there are 92,000 uninsured people between the ages of 19 and 64 just living within the seven counties of the Syracuse Diocese. The number for children is around 18,000.
According to Mark Lane, president and CEO of Fidelis Care, his company is already gearing up for the projected impact from the health care reform bills. “Fidelis Care will need to examine and expand its services. We’re already preparing our infrastructure to accommodate our current growth and our future growth. The New York bishops are very intent on us serving the uninsured,” Lane said.
Lane explained that the federal government issued a basic health care plan and then left it up to the states to follow those guidelines with the ability to enhance coverage. With the economic struggles many states are facing, Lane said, he doubts there would be much “enhancing.”
“By 2014, the law requires each state to have an insurance exchange and there will be variations between states. People without health insurance will go and get enrolled in a plan and, depending upon their income level, subsidies will be provided. How this will all happen in New York State remains to be seen,” Lane said.
The program presents a huge financial responsibility, he said. “The Feds start it and the states have to take over.”
Rumblings of future increased coverage costs by insurance providers are already being heard. There was a scare last week when it was reported that McDonald’s would drop its limited insurance coverage for its low-wage workers. The limited coverage plans usually cover doctor’s visits and prescription costs but not major medical catastrophes. This version of employer-offered benefits has become more popular over the last few years because of the increasing health care insurance costs. The new health care law will require insurers to pay high minimum percentages of the premiums they collect toward medical care.
Sister Dolores (Dolly) Bush, OSF, is director of Franciscan Northside Ministries and she echoed Sister James Peter’s statement that they have not noticed much difference in their numbers. She added that they likely wouldn’t — at least for a few more years.
“One of our clients actually walked to St. Joseph’s [Hospital] while he was having a heart attack,” Sister Dolly explained. “He can’t afford an ambulance ride or a cab. He couldn’t manage a bus. He was working part time at two jobs and then he lost one of the jobs. You can’t live on a part-time job.”
The clinics exist through the generosity of many people, namely the doctors who donate their time. Dr. Jeffrey Kirshner, along with doctors Julianne Dubiel and Dennis Ehrich and others, spends time volunteering at the Poverello Clinic. The people they treat range in age from babies to the elderly. They can offer low cost medication and lend a sympathetic ear.
Kirshner treated Suzanne Dube on a recent Wednesday night. Dube is a regular visitor to the clinic. She lost her insurance coverage.
“We always had health insurance until almost two years ago. I was injured on the job,” she said. “I’m diabetic and there are many things I need to take care of but I just don’t have the money to do it. I owe the hospital $13,000 now and I can’t pay it.”
Until the health care plans are implemented, and likely afterwards, the church will continue to provide services either through low-cost health care coverage or through clinics serving the poor and under-served. Hopefully, as the reforms begin to take hold, there will be teaching sessions and educational presentations to help people navigate the process.
“Health care reform is good if it means more people will have access to health care through health care insurance. Right now there are millions nationwide, not necessarily the poor, who don’t have access,” Lane said.