It’s Time to Pull People Out of Coverage Gap

Senate Vote Thursday Would Help Our Friends, Neighbors and Co-Workers

The state Senate will vote next week on a plan to expand health coverage to about 42,000 Granite Staters, accepting federal money to pay for the expansion. Under the Affordable Care Act, everyone was supposed to have a way to get affordable health insurance. People with low incomes would get low-cost or free health insurance so long as their state leaders accepted the federal funds set aside for this purpose.

But because our state hasn’t yet accepted the federal funds available, about 42,000 Granite Staters don’t have affordable health insurance and have fallen into a coverage gap.  These hard-working people also make too little money to get discounted health insurance in the Marketplace. This federal funding is essential to provide them with access to low-cost insurance.

Lorri Sault, an SEA member who works at the West Chesterfield State Liquor Store, is one of those people who has fallen into the coverage gap – she doesn’t qualify for NH’s current Medicaid program and doesn’t earn enough to get subsidies to buy coverage in the ACA Marketplace. For her, this is a life or death issue.

“When I tried to get coverage through the Marketplace, it first told me to apply for NH Medicaid,” said Sault, who has worked part-time for the Liquor Commission since last summer. “I did and was denied.”

Sault said the most affordable health plan she could find would cost her $346 a month. “This is too expensive for me to pay,” she said. “Working part time, this is one-third of my income.”

This might not be so much of a problem for Sault if she was in perfect health, but she’s been sick for several years. She’s been without health coverage since she started a small business in 2009, she said.

“In 2009, I opened a daycare out of my home and couldn’t afford health insurance,” she said. “I didn’t learn that I was sick until 2010, and that’s when health insurance became more important for me.”

Sault said she was diagnosed with hypertension in 2010, but she’d been sick for a while before that.

“Because it went undetected for so long, it caused kidney disease,” Sault said. “I’m now a patient at the dialysis center in Keene. I’m considered a hardship case there, and therefore my appointments are paid for, but the medication I’m supposed to take to slow the progression of the kidney disease is too expensive, so I elect not to take it at this time.”

“Eventually, my treatment will reach a point where dialysis or kidney transplant will be needed, and without health insurance, I won’t be able to pursue either,” she said.

Last year, Gov. Maggie Hassan and the House supported Medicaid expansion, but the Senate rejected the plan. A second attempt to come to an agreement last year fell short, but lawmakers continued working together, and earlier this month, they announced a bipartisan compromise. The Senate will vote on this plan, SB 413, on Thursday. It would allow Sault and others like her to access coverage she can afford in the Marketplace using federal Medicaid funds.

“If coverage was expanded, I would qualify and be able to receive the medications I need to treat the kidney disease now, and possibly prolong my life,” she said.

Sault works hard, yet she still can’t afford health coverage, let alone the medicine necessary to treat her condition. We encourage you to reach out to your senator and ask him or her to support SB 413, so we don’t continue to leave 50,000 Granite Staters in the Medicaid gap. You can find your senator’s contact information here.

 

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