Do you remember when the ACA Marketplace opened in 2013, and the whole thing was so complicated that special roles like “navigators” and in-person counselors, aka IPCs, had to be created to help people enroll? Even though few assisters remain due to significant funding cuts from the federal government, people still need help with healthcare choices, especially in our Medicaid program.
Most people have access to expert help figuring out their healthcare choices. With an employer, you have an HR person or representative to help you sort through your healthcare choices. On the private market, you have brokers and agents. In Medicare, you have Senior Health Insurance Program counselors and brokers. Granted, all those systems have their shortfalls, but the common thread is that there is a person you can reach for help.
Not so for Medicaid recipients – the people likely to need it the most. Continue reading “Imagine Medicaid with Informed Consumer Choice”
When a woman goes to the doctor, or to a clinic, intake typically fails to ask her if she is veteran or an active member of the Armed Forces. Screening for military status is a way to obtain a vast amount of information. Failing to screen leads to poor health outcomes, because providers miss the fact that service heightens the likelihood of certain kinds of injury, stress, trauma, and other health conditions.
We envision: healthcare systems that routinely identify female veterans at 100% of all screenings and use this information to guide appropriate treatment.
Women who serve have needs for gender-specific care that many healthcare facilities are not able to provide. The deficiency lies in both lack of scientific knowledge of battlefield injury and trauma-informed care, as well as an absence of awareness of military culture and how it relates to health and well-being. Continue reading “A Vision: Proper Care for Women Vets”
For many Americans, being able to afford medications is critical, and just one paycheck can be the difference between life and death – even with health insurance.
The other day, we heard about a furloughed federal worker who was forced to ration insulin because of the government shutdown. “I can’t afford to go to the ER. I can’t afford anything,” she told NBC News.
With type 1 diabetes, the Wisconsin resident, who works for the Department of Interior, had recently been hospitalized for sepsis and respiratory failure during a bout of pneumonia. Afterward, her blood sugar had hit levels that made her worry about ketoacidosis and the risk of diabetic coma. Continue reading “Government Shutdown Exposes Americans’ Vulnerability”
As people age, they typically need more help doing everyday things, whether it’s getting the groceries or taking a shower or remembering to take their meds. In many cases, even limited assistance can allow a senior to remain in their home for many years, even decades.
The logical program to provide in-home services is Medicare, which pays for most of seniors’ medical care. But Medicare does not cover them. Medicare does cover skilled medical services like physical therapy or nursing care when you’re ill or recovering from an illness or surgery, but you must be certified by a doctor as homebound, and even then it will not cover non-medical home services such as help bathing or dressing or preventive aids such as grab bars. The result is that many seniors end up spending down their resources to be eligible for Medicaid to get the non-medical care they need in order to live at home. Our system makes middle class people become poor to get the care they need – and, ultimately, states pick up the tab. Medicaid has been covering a growing portion of long-term care in the U.S. – 53% in 2018.
But 2019 ushers in help at home services for Medicare – and the change may be the catalyst for a more dramatic transformation in healthcare delivery and effectiveness.
“They say that you’re my battle buddy, they say that you’re my friend, that I’ll never have to make you answer to business end, of this weapon I was issued, to give terrorists their due – but what if the terrorist is you?”
That’s Emily Yates singing a song of her own composition on a new album released in November. The album, Women at War: Warrior Songs Vol. 2, is a full-length CD devoted solely to the experiences of women in the military, and created by women. It is a work, as the promotional material says, “by women, about women, for women.” The 15 tracks tell the stories of 18 women veterans and two Gold Star family members.
Women make up more than 15% of the US military, but their presence and their contributions can be all but invisible in the public mind. And although they are subject to the same hardships, risks, and physical and mental traumas as their male comrades, those scars and harms are not on the radar of most people when they picture what a soldier has to face. This album makes it concrete for us. Continue reading ““But What If the Terrorist Is You?””
Click to enlargeWhen Governor-elect JB Pritzker and incoming legislators take office a few days from now, we hope among the top-of-mind issues for them will be healthcare – and the possibility of creating a public option that would allow Illinois residents to purchase a premium to participate in the state’s Medicaid program. Candidate JB Pritzker talked about his vision for such an initiative, which he called “IllinoisCares,” and his platform included a public health insurance option that would be available to all residents.
IllinoisCares would allow Illinois residents to purchase health insurance from the state, rather than a commercial plan. Forty-two states – including Illinois – already have Medicaid buy-in programs, but they are limited to working people with disabilities who have not been able to purchase affordable health insurance coverage that meets their health needs in the private market. Continue reading “Will 2019 Bring a Medicaid Buy-in to Illinois?”
“These women are hurting my soldiers’ careers. You’re wasting OUR time.” A major lambasted me during a training’s break. He continued: “My soldiers would never do that. Can we get back to our real work.” Although worded like a question, his last sentence spewed at me with such authoritative, deep guttural tones, that I clearly knew he meant it as a command.
Here I was, my very first training working with military victim advocates. Green as can be and the highest-ranking figure in the course commanding me to release the class. Of course, I couldn’t dismiss the class; and he technically didn’t have any authority over the matter. Continue reading “Challenge prejucice, change minds”
It was a delightful surprise to hear from our cohort member Jody Verble last month that she had just created a website that offers tips and help on disability employment. Jody took part in our “research readiness” training. This course was put together for people with traumatic spinal cord injury to have a greater voice in the scientific studies that are done about that condition.
We invited our research readiness graduates and expert panel members to an On The Table event – one of the many gatherings held citywide in May as part of the Chicago Community Trust’s initiative to bring people together to spark conversations and projects for the public good.
“The message was TAKE ACTION,” Jody told us. “So I went home that day and bought this domain.” Continue reading “From Research Readiness to Empowering Action”
Whether you wait three hours or three decades, you’re damned if you do and damned if you don’t.
Politics aside, the media and others should be incredibly ashamed of their behavior.
The reckless victim-blaming appalled me.
In no case have I ever seen one’s unwillingness to come forward affect one’s credibility. Continue reading “Would You Wait Three Decades?”
Recent guidance from the Centers for Medicare and Medicaid Services encourages states to take new steps to circumvent the ACA. Specifically, it invites them to apply for Medicaid Section 1332 waivers in order to use ACA subsidies for short-term insurance and association health plans. These plans, originally intended only to tide people over between periods of more-permanent coverage, are little more than flimsy stop-gaps that scarcely merit the name of real health insurance. Continue reading “Feds Will Subsidize Junk Health Coverage”