Medicaid Stories

When we first met Kelsey in November of 2018, she had not been eligible for help through West Virginia’s Medicaid Expansion because she made just over the income limit.  Kelsey wants to be financially independent and stand on her own two feet, so she started taking all the extra hours she could get at her job.  At $11.00 an hour and even with the extra hours, she could barely cover all her bills and she could not afford health insurance.

Without health insurance Kelsey could not afford her medications and coverage for her behavioral health therapy sessions. So that made it harder to keep working.

Then about a month ago Kelsey’s hours were cut back. So, she reapplied for Medicaid and heard back from Medicaid earlier this month that she qualified and was approved for health insurance.  But if her hours increased again, she would cycle back off Medicaid because she makes too much money.

Ironically, Kelsey wanted to work and wanted to gain financial independence, but she faced the “catch 22” choice of working less but having health insurance or working more and losing health insurance.

Kelsey lost a sibling to the opioid crisis, supports her nephew when she can, and is trying to move on in her life – past traumatic experiences as a child. Her medication and her therapy help her keep her life on track.  The frustration and anxiety over the risk of losing her health care coverage shows when she shares her story.

Recently Kelsey lost her job.  As is true for many West Virginians, a stable job with stable hours is hard to come by.  With a “go get it” attitude she has already applied for three local jobs at several larger chain stores in the Parkersburg area. But competition for any minimum or low wage jobs is tough. But for right now she is grateful to be covered by Medicaid while she looks for a job. Kelsey can rest easy temporarily, “I’m now unemployed and that [HB 3136] would impact me – like, I thought to myself ‘I just got in there [back on the Medicaid program] – I don’t want to lose it again.”

Kelsey says that with Medicaid coverage, she can look forward to receiving her much-needed mental health services – the services that help her cope with past trauma along with staying healthy and ready for the challenge of job interviews and the stress of starting a new job.

Medicaid is the helping hand up for West Virginians like Kelsey and her family, who are trying to move forward and lift themselves out of poverty.

HB 3136 would have taken that helping hand away from Kelsey and many others like her.  Special thanks go to the allies, partners, storytellers, and decision makers who stood in opposition to HB 3136 during this 2019 legislative session in West Virginia. 

West Virginians Together for Medicaid also thanks Kelsey for standing up for Medicaid by sharing his personal story. 

If you are interested in sharing your Medicaid or CHIP story, reach out to us on Facebook (https://www.facebook.com/WVTFM/) or Twitter @WVTFMedicaid by sending us a message or give our Story Collection Coordinator, Lara Foster, a call 304-702-6708. Your story can help more West Virginians understand how important Medicaid is to our state’s families.

Forest grew up with divorced parents and health care coverage came and went with his father’s job changes. 

At the age of fifteen, he was diagnosed with narcolepsy and cataplexy.  Narcolepsy is a neurological disorder that causes persistent sleepiness and additional symptoms such as brief episodes of muscle weakness known as cataplexy; vivid, dreamlike hallucinations; brief episodes of paralysis when falling asleep or upon awakening (sleep paralysis); and fragmented nighttime sleep. Symptoms last a lifetime. Cataplexy is often triggered by strong emotions and causes weakness of the face, limbs, and trunk, sometimes leading an individual to slump to the ground, awake but unable to talk or move for up to one or two minutes. About half of all people who have narcolepsy have episodes of cataplexy.

 After his diagnosis, Forest’s mother took care of him with help from Medicaid which covered his sleep disorder testing and medications. Narcolepsy is a manageable condition, and with an array of treatment strategies, people with narcolepsy can live full and rewarding lives.

Twenty-three-year-old Judith Burnham never thought the opioid crisis would affect her, because her parents taught her better than to get mixed up in drugs. When she graduated high school, however, Judith became pregnant by her boyfriend, who struggled with addiction.

The couple tried to move forward, but the boyfriend’s addiction caused financial turmoil, which led to Judith gaining full custody of her son in 2018. Now a single parent, Judith is determined to move forward and create a better life for her son. Judith lives with her grandmother and was a participant of the West Virginia Workforce placement program. She now works at the local library and relies on Medicaid coverage for her and her son’s healthcare. 

“It helps a lot not having to worry about paying for his doctor visits.”

 

“Looking back, if I did not have Medicaid, I would be dead.  It saved my life.”

Meeting Jenny during her lunch break at her public service job was inspiring to say the least.  As I listened to her story of pregnancy, cancer survival, job challenges, raising children, and taking care of her aging mother, I was reminded of so many other West Virginians who face multiple choices and challenges to keep their family and themselves healthy.

Jenny worked as a public service employee with Public Employee Insurance Agency (PEIA) health coverage for more than 12 years. Jenny went on medical leave in the fall of 2015 for her second pregnancy.  Jenny and her husband and teenage son had carefully planned ahead – they saved and budgeted to pay her PEIA health insurance premiums while she was at home without income. 

The successful pregnancy brought a beautiful baby girl into this world.  But with bills and financial obligations beginning to pile up, Jenny felt the need to help provide for her family by going back to work after six weeks.  Her choice was made easier with support from her own mother who was willing to watch the newborn while Jenny and her husband were working.

Unfortunately, like many of us have experienced, the best plans do not always work out.  Jenny’s mother fell and shattered her femur at 64 years of age.  Jenny had to think about how to best take care of her family.

Jenny decided she had no choice but to reduce her work hours to part-time so she could care for her newborn baby and her mother. With the reduction in hours, Jenny lost her PEIA health insurance.  According to Jenny, they couldn’t put the baby girl on her husband’s insurance because they couldn’t afford the increase in family premiums with the change in income.  At this point, Jenny wasn’t sure what her options were, but she knew she and her family needed health insurance protection.

In December of 2015, Jenny like many individuals trying to navigate the health insurance world, signed up through healthcare.gov and discovered she qualified for Medicaid thanks to the West Virginia Medicaid Expansion.  Jenny was thrilled to learn that “It covered everything.”

With coverage for her baby girl and herself, Jenny and the baby were able to continue regular visits to their doctors.  Jenny is clear that “I would not have gone to the doctor” without Medicaid.  Even routine medical visits are expensive and Jenny – like most people – worry about being able to pay the doctor even for the cost of a basic doctor’s visit and screening tests. 

And in this case, going to the doctor for a regular check-up saved Jenny’s life.  A gynecological exam and pap smear in August of 2016 found a rare form of cervical cancer (a rare 85/20 combo of adenosarcoma and Squamish). Thanks to the care from her physician Dr. Ellie Hood at Valley Health, her life was saved. 

Medicaid covered the robotic DaVinci surgery in 2017 for her hysterectomy to battle the cancer.  Now, in January 2019, she can celebrate being cancer free, enjoy raising her children, and being back to work full time in the public service sector.

Jenny wants to remind her fellow West Virginians, “If it can happen to me….”

It only takes one unexpected event to derail a West Virginian’s plans to care for their family. Jenny is proud of her college education and she thought she had achieved middle-class financial security.  Now Jenny understands that a single stroke of misfortune can wipe out a family’s peace of mind - of knowing they can afford to go the doctor to take care of themselves so they can take care of their family. 

Today, Jenny’s daughter is covered by the West Virginia Children’s Health Insurance Program (CHIP).  With her CHIP coverage, Jenny’s daughter was able to see the doctor for a serious ear infection.  With CHIP, the trip to the doctors and prescription for the ear infection cost $15 -  “which is a reasonable amount for a family” according to Jenny.

If Jenny had not had Medicaid, she would have gone without health insurance and health care during the three years she worked part-time so she could care for her mother and her daughter.  The consequences would have been tragic. As Jenny states, without Medicaid, “I would have been dead.”

Jenny from Barboursville, wants everyone to understand one important thing - Medicaid Matters.

West Virginians Together for Medicaid thanks Jenny for standing up for Medicaid by sharing her personal story.  If you are interested in sharing your Medicaid or CHIP story, reach out to us on Facebook (https://www.facebook.com/WVTFM/) or Twitter @WVTFMedicaid by sending us a message or give our Story Collection Coordinator, Lara Foster, a call 304-702-6708. Your story can help more West Virginians understand how important Medicaid is to our state’s families.

 

 

It is official, school is back in session!  While some schools are going towards tablets instead of trapper keepers one thing hasn’t changed, children’s health.

Jeorgia and Jackson are some of our West Virginia youth who are back to studying, playing sports, dancing, and performing arts.  Many parents, and grandparents, can relate to the following story shared by Deena Ellison (one of our storytellers in Charleston), “If you were to add up the hospital stays, a finger surgery, trips to med express [kids will be kids], doctor visits, dentist visits, ortho, braces, and therapy, I’m sure we’re talking tens of thousands of dollars in medical expenses just since the kids came to live with us.”

Deena is the grandmother and legal guardian of both Jeorgia and Jackson.  As with many families in the mountain state, custody and responsibility for the children fell on the grandparents because of the opioid crisis. 

Mary Kesecker worked at Fleetwood Travel Trailer’s plant in Hancock, Maryland (on the West Virginia border). Her job provided good health insurance.  When the plant closed in 2004, Mary found work at part-time jobs and started her own horse boarding business.  This meant that Mary had no job-based health insurance for 10 years.  While part-time jobs and horse boarding fees allowed Mary to make ends meet, it did not provide enough income to pay for a private, individual market health insurance plan.