Does This Sound Familiar???

From Democratic Underground

That's what my partner and I will be faced with shortly. As soon as all of this starts, I'll be able to let you all know firsthand what the experience is like for a truly poor family--except that since nobody wants to "push" for GLBT equality right now, we'll be a family living under the rules for a single person with no dependents.

My partner and I have a soon-to-be-ten year old son. She's 43, I'm 30, and we're both full-time college students. I go to school and then stay home in the evenings with our son (because childcare would cost about as much as I'd make at the jobs available around here anyway.) Rhythm goes to school during the day, then works evenings as a cook in a local pub for $8.00 an hour. It was the best job she could find that is walkable, because we don't have a car and the bus service in the evenings around here is not adequate for anything better. It's part-time; on a good week, she might get 25 hours.

We live as a married couple with a child--a family--but the government considers us to be two single people, one of whom has a dependent, while the other (legally) does not. Our son and I receive Medicaid (for now) because the government considers my school attendance to be a "good enough" excuse for not having a job right now, although as soon as my son is considered old enough to be home by himself in the evenings, that will change. Rhythm has no health insurance at all. She hasn't seen a doctor in years, even though her eyesight is diminishing and she has an acute family history of diabetes and rheumatoid arthritis. I live in terror that the diabetes and the eyesight problems are related, but we have no way to know for sure right now, and no way to DO anything about it even if we DID know.

Rhythm is not eligible for Medicaid because she's physically capable of working and does not have any *legal* dependents. We know this, because we've already tried applying for it (and my thanks to Midlodemocrat for doing her best to help us, even though it didn't work out.) She was denied. I've heard that the new rules raise the income qualification level, which is great, but thanks to the 1996 PRWORA Act (welfare reform), each state gets to decide its OWN qualification rules. The federal government's guidelines are not universally adhered to, nor do they need to be thanks to that act. On a side note, if Obama REALLY wants to make a difference for the poor, overturning PRWORA would be the most effective, humane thing that he could ever, ever do.

Anyway--here's what West Virginia has decided about who they consider "qualified" for Medicaid:
Determining Eligibility for Medicaid

Except in the case of pregnant women and children up to age 19 years, eligibility for Medicaid is based on categorical relatedness, income and assets.

Categorical relatedness means that an applicant must be a member of a family with a child who is deprived of support due to the absence, incapacity or unemployment of a parent(s). If the applicant has no children under age 18, the individual must be age 65 or over, blind or disabled.

The second factor considered is an applicant's income and assets. Income is any money a family or individual receives such as wages, pensions, retirement benefits or support payments. Assets include money in the bank, property other than the homestead, and the cash or loan value of certain life insurance.

When applying for Medicaid, you will be asked about your income and assets you own. DHHR staff will inform you of any documentation needed at the time of your application.

The eligibility of pregnant women and children up to age 19 for Medicaid is determined solely on income. There is no asset test. Pregnant women must provide a medical statement confirming pregnancy.

http://www.wvdhhr.org/bms/oMedPolicyCor/bms_hcpc_Guide_...

Since the law doesn't recognize Rhythm as part of a family with a child (even though she IS), and since she isn't blind, disabled, or over 65...she's not eligible, no matter HOW low her income is. So Medicaid is not a possibility. When the time comes that Rhythm is forced to buy health insurance through the exchange, she will receive a subsidy in an amount meant for a single, able-bodied adult with no children--in other words, $1,384 for an entire year. (I got that number here: http://www.democraticunderground.com/discuss/duboard.ph... . I assure you, she is not eligible for any kind of "family" rate.)

Her income is about $800 a month. Hers is the ONLY income we have, for reasons I explained above. We get a little extra in financial aid to help out, but not very much--it's enough to pay most of the rent every month. We have a boarder in our third bedroom who pays the rest of the rent for this place. Rhythm's income pays all utilities, a third of the groceries (my Food Stamps take care of the other 2/3's) and all of the household item expenses (like toilet paper and soap--not stuff we can just stop buying.) That's it. We have no savings, no expendable income, and no "extra" money ANYWHERE. If you want to see a family that is LITERALLY living from one paycheck to another with nothing else to spare, well, welcome to my world.

So how are we going to afford an extra $219 a month for her health insurance? The short answer is that we CAN'T, so she'll have to apply for the hardship exemption--and if we're lucky, she'll get it. Which will leave her with no health care at all. Just the same as now. If the other "proud liberals" in this country could be bothered to put forth HALF of the money, time, and internet "activism" toward GLBT equality as they do toward forcing this bill through, maybe it would be different. Maybe the higher subsidy for someone who's taking care of a legally-recognized FAMILY would be enough to offset our actual costs, and she could have healthcare--even if only a crappy policy that covers little and has a huge deductible. Half a loaf is better than none at all, right?

Well not for us, because Rhythm's getting nothing whether the bill passes or not. All we can expect is the addition of some more red tape, made necessary because she'll have to prove that she's too poor to afford insurance. And IF the government decides that Rhythm appears to be capable of affording her premium "on paper" (where our family doesn't exist and therefore doesn't matter), she'll get rejected for the hardship exemption and end up forking over money to the IRS. I think she'll be approved for it, but you'll have to forgive me if I'm more than a little bitter about the fact that the BEST my beloved partner can hope for is that she WON'T get smacked by the IRS.

And other members of my family are screwed too, just in different ways. We're all poor, and this is going to hurt every single one of us with the exception of my dying Mom, who was approved for disability Medicaid today (thank god) although there's some red tape that might hurt us there, too. I really wish people would stop pretending like this bill is meant to help the poor. It isn't. It's meant to help certain select elements of the middle class, and a few poor people who meet strict guidelines and live in compassionate states with lenient Medicaid qualification rules MIGHT benefit too. Just as many (if not more) poor people stand a fair chance of getting nothing at all at best, or royally screwed at worst. GLBT and certain hetero couples (unmarried, cohabitating, with kids that are only the "legal dependents" of ONE partner) are getting the worst deal of all.

So I guess we'll just keep using the emergency room as the only healthcare available to us, and hope like hell that maybe SOMEDAY everyone else who's supposedly on "our" side will find it politically expedient to actually fight (which means RISKING something) for the equality and social justice that this nation SORELY lacks. I won't be holding my breath, but I suppose it's theoretically possible--IF we can elect some leaders who care more about doing the right thing NOW than about getting re-elected later. And that is probably the biggest and most unlikely IF of all.