Insure the Poor or Let Them Suffer: A Case Study

I came across this article from the Houston Chronicle a few weeks back and wanted to share it as an illustration of the good Obamacare is doing, and of what we will be throwing away if we allow our representatives to end it.

Texas, Arkansas take opposite directions insuring their poor

By Jenny Deam, December 10, 2016

Cheryl Nunn in her home just outside Texarkansas, Arkansas, but on the Texas side on Saturday, Nov. 12, 2016. ( Elizabeth Conley / Houston Chronicle )

TEXARKANA – An invisible boundary runs down the center lane of State Line Avenue. A flick of a turn signal one way is Texas, the other way is Arkansas.

 

That turn matters these days. Living on one side of the street rather than the other can mean the difference between getting better or staying sick.

 

Erika Castaneda lives on the Arkansas side, just outside Texarkana, in a small house in the country with a faded hobby horse out front. Some days, the nerve damage in her legs from diabetes was so bad she couldn’t stand. But a doctor over at the clinic cost $75, so she put off going. Like so many around her, she was uninsured.

 

Until suddenly she wasn’t anymore, becoming part of a grand experiment in the time of Obamacare.

 

In her red state of Arkansas, where the Affordable Care Act is often cursed, lawmakers found three years ago a politically palatable way to use an underpinning of the law and expand Medicaid to cover hundreds of thousands of people without actually calling it that.

 

Soon, the state’s uninsured rate began to plunge – faster and more dramatically than any other in the nation except Kentucky, which it tied. In 2013, the Arkansas uninsured rate for adults was 22.5 percent. By 2015 it was 9.6 percent, according to a Gallup-Healthways Well-Being Index.

 

People in Arkansas began to go to the doctor more because they could.

 

Cheryl Nunn lives up the road on the Texas side, a place where lawmakers won’t consider expanding Medicaid.

 

As a nurse, she knew that taking the nine steps from bedroom to kitchen in her narrow trailer should not leave her collapsed against a table struggling to breathe. But she would pull herself up and head for the door anyway.

 

“I am the only breadwinner,” she thought. “If I don’t work, we don’t eat.”

 

Her husband, Jimmy, 56, is disabled after a heart attack. Without insurance, the medical bills were already stacked tall. She promised herself a checkup soon at the clinic a few miles away in Texarkana, by coincidence the same one Castaneda uses.

 

Then came the day in July when her breath turned ragged and her calf swelled so much she could not roll up her pant leg. Her daughter drove her to the emergency room, where tests found a potentially fatal blood clot had traveled to her lungs. She had undiagnosed heart disease, too. The doctor worried for her life. She worried about the money. She checked herself out the next day.

 

A month later, the 51-year-old was back, this time by ambulance after blacking out at work.

 

“It was scary for me,” remembered Dr. James Miller, the second-year resident who treated her. “I can only imagine how scary it was for her.”

 

This is what being uninsured can look like in Texas. The latest estimate is that 4.6 million people, the most in the nation, dwell on that dangerous cliff, put there, in part, by politics, kept there by the whim of geography.

 

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