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Low-income residents can’t afford health plans

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A Bargersville man looked for health insurance plans on the federal marketplace, but the least-expensive plan he could find was $160 per month.

Ron Karn has been making about $1,000 per month since being laid off in October as a truck driver from FedEx, where he was making four times that.

He’s been getting bad headaches that are affecting his vision; and he’s flunked two eye tests, meaning he can’t get another job driving a truck. He’s eaten through all his savings and is about $500 behind on bills, so there’s no way to feasibly squeeze a health insurance premium into his monthly budget.

He’s now exploring whether he can enroll in a government health care plan so he can get some tests done to figure out what’s affecting his sight, as well as have a doctor look into a skin condition that’s leaving pink splotches on his hands and head. But he’s not expecting to find much help.

More adults in Indiana and nationwide now have health insurance compared with last year. But many uninsured residents still have the problem they had before the Affordable Care Act: They can’t afford to pay a premium, and they don’t qualify for a government program.

About 11 percent of Johnson County residents didn’t have insurance as of 2012, the most recent U.S. Census Bureau data available. Statewide, 13 percent of Hoosiers don’t have health insurance, according to the Kaiser Family Foundation.

Residents were able to sign up for health insurance earlier this year through the healthcare.gov website and even get subsidies that would help pay for part of their monthly premiums. Some residents found they could get health insurance for as little as $25 per month, WindRose Health Network enrollment specialist Abby Garcia said.

But about a quarter of the people Garcia helped search for insurance earned less than the federal poverty level — about $12,000 per year for a single person — so they didn’t qualify for any kind of subsidy. In order to buy insurance, they might have to pay premiums of $400 to $1,000 per month, she said.

Indiana didn’t expand its Medicaid program last year, so low-income earners couldn’t qualify for that program. At the end of the July, the state also closed enrollment for its Healthy Indiana Plan, which provided health insurance for some low-income residents. So now even more people don’t have access to insurance.

“If you’re not pregnant or have a disability, it’s almost impossible to get on Medicaid,” WindRose enrollment coordinator Cindy Helmich said.

WindRose navigators, who helped people sign up and search for health insurance on the government exchange, met with about 3,600 people but enrolled just more 1,000 of them. Of 675 patients who get care at the free St. Thomas Clinic in Franklin, staff were able to get only 16 people qualified for the Healthy Indiana Plan since mid-October, according to Jane Beers, administrative director of the St. Thomas Clinic.

‘Coming out of the cracks’

The state closed enrollment to the Healthy Indiana Plan at the end of July, but is getting approval for its Healthy Indiana Plan 2.0, which would expand coverage to more low-income people and serve as an alternative to expanding Medicaid in Indiana. The new program would cover more people than ever before and potentially fill the hole for people who can’t get government subsidies on the national exchange, Beers said. But the program will require people enrolled to make a payment toward their coverage, so people who have no income still might have problems getting signed up for it, Helmich said.

States that expanded their Medicaid programs as part of the national health care law had more people insured, according to the Health Reform Monitor Survey. In those states, uninsured rates dropped from 16.5 percent to 10.1 percent. In states that didn’t expand, such as Indiana, the decrease in uninsured was smaller, 21.1 percent to 18.3 percent.

“If HIP 2.0 goes through it would be awesome and would help all of our people. What we are still seeing, there are a lot of people who are coming out of the cracks and never had insurance and are saying, ‘Maybe I should take care of my health,’” Beers said.

Representatives from Claim Aid help people at the St. Thomas Clinic apply for medical programs, but health care options have become extremely limited since the Healthy Indiana Plan closed. The Medicaid program also has changed, so people who were making more than the federal poverty level who are also disabled aren’t eligible any more, Claim Aid executive vice president Beth Overmyer said.

Claim Aid works for Johnson Memorial Hospital, and getting people signed up for insurance not only helps the hospital get paid but allows patients to see a doctor when they need it and stay on top of chronic problems, she said.

‘How can you pay for it?’

The free clinic is the only way Mary Parton of Franklin can see doctors about leg and hip problems that cause her to limp. She had been out of work since 2012, received food stamps and lived with her parents because she had no income. But she couldn’t get into the Healthy Indiana Plan and couldn’t get Medicaid. She hopes her new full-time job will come with health benefits.

Parton didn’t bother to browse the health care exchange over the winter because she couldn’t have paid for a plan even if she wanted to.

“Nope, didn’t bother. How can you pay for it?” she said.

Sarah Quackenbush of Greenwood is trying to apply for state assistance now, but she’s more likely to get health insurance for her three kids than she is for herself.

Beers said the state’s Medicaid program does a good job of providing insurance for children, but often their parents are left uninsured.

Quackenbush said she has been living off $400 per month in child support. She lives in an apartment on her parents’ property and cares for three boys, so she’s trying to get food stamps, Medicaid and housing assistance while also interviewing for jobs again.

“Insurance is still really expensive through any job you have,” she said. “I wish there was a way to afford it right now and still pay for the kids.”

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