Because Missouri has not expanded Medicaid I am not able to offer much to those in Linn County who, even though they are going to work every day, cannot receive tax subsidies or cost sharing reductions due to being below 100% of poverty level.

I hear many complain about the Affordable Care Act and what it does and does not do but if I were able to change one thing with the law, it would be for Missouri to expand Medicaid!!.  

The greatest joy I receive from my job is to be able to help my friends and family finally enroll in an affordable, quality healthcare plan.  Many of these people have not had the opportunity to have health care in many years.  Now, in 2014 they are able to make appointments with their Primary Care Providers knowing that if further investigation is required, they can now afford to also see a specialist.

The saddest part of my job is having friends come in hopeful that I will be able to help them find an affordable plan, and due to my past experience, knowing that I will not be able to help them due to their low income.  The other day I had a young single mom of 2 who wanted healthcare.  Even though she was working everyday for minimum wage, she was required to have an income of at least $19,530. Minimum wage provides an annual income of around $15,000.  If she could figure how to boost her income to $20,000 she would have been able to find a plan for $0 to $50 a month with her cost sharing reduction allowing her to have a very low deductible and out of pocket cost.  Her only option is to see a Dr. at a Federally Qualified Health Center like Family Health Center of Marceline where they have a sliding scale fee or the Emergency Room at a much higher cost to her and the state.  If Missouri had expanded Medicaid this year, all three of them would have qualified for Medicaid and she would have one less worry about how she was going to care for herself and her family.

A single person would require an income of above $11,490 to be above the 100% Federal Poverty Level to qualify for affordable care.  In Linn County many of the jobs, especially for women, are the  caregivers who care for our friends and families at either a nursing home or as a home health aide.  While many of these people would like to have full time work, many are unable find a job that would provide either full time work or a job with benefits like health insurance.  

This could also be a couple who one person is working a full time, minimum wage job while the spouse is laid off and looking for work.  In this case a family of two would need an income of $15,510  to qualify for tax subsidies and CSR to make health insurance affordable to them.  Once again, expanding Medicaid would have provided a little relief for them.  

Expanding Medicaid is paid 100% by the Federal Government for the next three years and than no more 90% from then on. It has been interesting to watch Iowa and Arkansas as they were able to come up with a plan that they can use the Federal money in very creative ways to provide health insurance for their most needy people.  

My New Year's Wish is that the Missouri Legislature would decide to find a way to provide Medicaid for everyone who is not able to participate in the Affordable Care Law due to their low incomes.

Please give me a call at 573-823-9518 or drop by the Family Health Center of Marceline on Tuesday from 9-5.