For One Senior, Medicaid Provides Model Care
Health Insurance: Are You Covered?
Lela Petersen thinks about health care a lot these days. She's a small business owner who pays $1,150 a month to an HMO, covering her and her husband. Petersen doesn't have any other option, but her 94-year-old mother, Gracie Scarrow, is another story.
For the past four years Scarrow has been receiving long-term care at the Lincoln County Hospital and Nursing Home in Hugo, Colo., paid for largely by her Medicaid coverage. Medicaid is the federal and state-funded program for the poor and disabled. Both mother and daughter say they are very satisfied with the program. Petersen says her mother is getting exactly the care she needs.
A Comfortable Life
At the nursing home, in her room she shares with another woman, Scarrow has decorated nearby shelves with stuffed animals she won playing bingo. She has a keyboard next to her bed, and with only a little prompting Scarrow will turn it on and play the old hymn "What a Friend We Have in Jesus."
Most days Scarrow seems to get along fine at the nursing home. She always carries an oxygen tank with her, even when she moves slowly down the hall to the dining room for lunch.
"I have congestive heart failure," says Scarrow, sitting on the edge of her bed. Before arriving here, she was living by herself until she passed out one night. "I had a heart pill in my hand, but I didn't take it."
Petersen says her mom couldn't afford the nursing home on her own. Her Social Security income is $600 a month and after selling her house she cleared only $3,500. A doctor suggested signing up for Medicaid to pay the $80,000 a year bill for her long-term care. Scarrow is left with about $50 of her Social Security check each month for spending money.
Petersen said, at first, her mother was embarrassed about accepting government help, because she's always been independent and supported herself. Much of her life was spent in facilities like this one, as a nurse's assistant.
"Mom worked in an era when health care was what it was called. It was called care. Kindness and care. In today's world, health care is money," said Petersen.
States Feel The Pinch
Colorado has nearly a half-million people on Medicaid and, like in a lot of other states, that number rose dramatically in the past year, increasing by more than 10 percent. The economy and unemployment are largely to blame.
Typically states and the federal government split the cost of Medicaid, though with the recent stimulus money the federal government is picking up a larger share now. Even with that help, Colorado has difficulty paying its share. Recently the governor trimmed payments to doctors and hospitals to help balance the state's budget.
Hoping For Overhaul
Politically, Petersen says she typically votes Republican. But last year she voted for Obama, and she's excited about efforts to overhaul health care in the United States. She's frustrated with the costs of her own coverage, but very happy with the Medicaid coverage her mother receives.
She doesn't have a specific solution for health care overhaul, but she does support things like tort reform and tighter regulations for insurance companies. In coming months, she'll watch closely to see what solutions policymakers in Washington come up with.
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ROBERT SIEGEL, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
MELISSA BLOCK, host:
And I'm Melissa Block.
Today, for our series Are You Covered, we're going to hear about health insurance from the perspective of a woman in Colorado. She's a business owner who buys her own health coverage. And a few years ago she became familiar with Medicaid, after her mother needed to move to a nursing home.
Medicaid is the federal and state-funded program that helps provide health care for the poor and disabled. About a third of Medicaid dollars go toward long-term care in facilities such as nursing homes.
NPR's Jeff Brady takes us to Flagler, Colorado.
JEFF BRADY: Lela Petersen's business is called the Anything & Everything Store for good reason - the shelves are packed with a mix of new and secondhand items.
Ms. LELA PETERSEN (Owner, Anything & Everything Store): Yeah. We've been referred to as the Flagler Wal-Mart.
(Soundbite of laughter)
BRADY: In this small town of 600 people, Petersen considers her business as much community service as profit-making enterprise. Still, she has bills to pay, like the monthly premium for her and her husband's HMO.
Ms. PETERSEN: Right now we're paying 1,150 for just two people, and I don't have a choice. I have to pay that because no other insurance company will take us.
BRADY: Petersen and her husband are in their 50s. There are some preexisting conditions, such as her husband's diabetes. It feels to her like their health care options are limited. Politically, Petersen says she typically votes Republican, but last year she picked President Obama. And she's excited about efforts to overhaul health care in the U.S.
While she's frustrated with the cost of her own coverage, she's very satisfied with the care her mother receives under Medicaid - that's the government program for the poorest and most in need.
Ms. GRACIE SCARROW: Hello.
Ms. PETERSEN: How are you?
Ms. SCARROW: Well, pretty good.
BRADY: Several times a week, Lela makes the 30-mile drive to Hugo, Colorado to visit her mother, 94-year-old Gracie Scarrow.
Ms. PETERSEN: This is a double room. She has all of her stuffed animals that she wins at bingo. And then she likes her dolls and the flowers.
Ms. SCARROW: I like to kind of pick along on that.
BRADY: Oh, so you have a - it's a keyboard here, it looks like.
Ms. SCARROW: Yes.
(Soundbite of music)
BRADY: Scarrow apologizes for her shaky hand, but says playing the keyboard helps pass the time. She came here nearly four years ago after an incident at home.
Ms. SCARROW: Well, I have congestive heart failure. And I guess I did pass out one night and I had a heart pill in my hand, but I didn't take it.
BRADY: Petersen says her mom couldn't afford the nursing home on her own. She had Social Security income of $600 a month and cleared only $3,500 from the sale of her house. So a doctor suggested they apply for Medicaid.
Ms. PETERSEN: And at that point, I would say there probably was not a choice of what you had to do.
Ms. SCARROW: Well, I just wasn't able to work.
BRADY: Medicaid pays the $80,000 a year bill for Scarrow's care. She's left with about $50 of her Social Security check each month for spending money.
Colorado has almost a half million people on Medicaid. That number went up more than 10 percent in the last year alone, thanks in large part to the poor economy. The federal government typically splits the cost of Medicaid with Colorado, though with the recent stimulus money the federal government is picking up a larger share now. Even with that help, Colorado's governor was forced to trim payments to doctors and hospitals to help fill the state's budget gap.
Petersen says at first her mom was embarrassed about accepting government help because she's always been independent and supported herself. Much of her work life was spent in facilities like this one as a nurse's assistant.
Ms. PETERSEN: Mom worked in an era when health care was what it was called. It was called care, kindness and care. In today's world, health care is money.
BRADY: Petersen believes the health care system in the U.S. needs fixing. She doesn't have a specific solution, but she does support things like tort reform and tighter regulation for insurance companies. In coming months, she'll watch closely to see what solutions policymakers in Washington come up with.
BRADY: Jeff Brady, NPR News, Denver. Transcript provided by NPR, Copyright National Public Radio.
