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For One Senior, Medicaid Provides Model Care

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For One Senior, Medicaid Provides Model Care

Health Care

For One Senior, Medicaid Provides Model Care

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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.

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