By CHARLIE BOOTHE
Bluefield Daily Telegraph
PRINCETON — As politicians ponder the fate of the newest version of the national health care plan, for Ashleah Owens of Princeton, the debate about the plan and any reductions to Medicaid is far more than political.
It’s personal and could mean whether her young daughter receives treatment she desperately needs, and now receives, through the Medicaid Expansion part of the Affordable Care Act (Obamacare).
When Owens was growing up in Wyoming County her father had a good job and the family was stable.
“My father was a welder in the coal mines,” she said, adding that her mother worked in home health, but eventually had to get on disability because of health problems.
“I was brought up not to be dependent on anything,” she said. “We never had to have any public assistance.”
Even after her father died of a heart attack in 2012 at only 55, Owens, 21, and now a resident of Mercer County, said the family picked up the pieces and moved on.
After finishing Wyoming East High School and attending trade school to be a CNA (Certified Nursing Assistant), Owens said she found a job and everything was going well.
About a year and a half ago she became pregnant, and was expecting to have her baby and return to work as most mothers do.
Her baby daughter, Addi, was born six weeks early and only weighed 4.27 pounds.
“My placenta had died, but no one found out about it right away,” she said. “When they did, I had to be induced.”
Addi seemed to be okay, but about a month after her birth, they realized she was not gaining weight as she should.
Owens took her to see Dr. Mohammed Ashir in Pineville and he found a heart murmur and sent them to Charleston for a closer examination.
“They found she had two holes in her heart,” Owens said.
Addi needed surgery, but when she was sent to Morgantown for the surgery (at WVU) they decided it could possibly be fixed with a heart catherization procedure, she said.
“They tried, but her heart went into afib (atrial fibrillation-irregular heartbeat), so they didn’t do it,” she said, adding that she is taking Addi to Pittsburgh in September for an evaluation about what the next step is in Addi’s treatment.
Not only did Addi have serious health issues, Owens also developed some health problems and needed to recover.
“I couldn’t go back to work,” she said. “And I had to take are of Addi. I am scared to leave her with anyone and I didn’t feel safe leaving her in a day care center. I also have to take her to doctor’s appointments, tests and screenings. There was no way I could miss that much work.”
Owens, who did not marry the father of her child, said she has no insurance and, for the first time in her life, had to ask for help.
“I had no choice,” she said of enrolling in Medicaid for herself and Addi and receiving other public assistance. “It if had not been for that (Medicaid), I don’t know what I would do. I needed peace of mind that she will get the treatment she needs.”
Owens’ family doctor in Wyoming County was Dr. Joanna Bailey, who referred her to OB-GYN Dr. Lori Tucker of Princeton for the delivery.
Since Owens had to see Tucker often, she moved to Princeton, where she lives now.
“I had to get a roommate to help with expenses,’ she said.
Addi is now 11 months old now and active, but still weighs only 12 pounds.
“Without this help (Medicaid), who knows if my baby would have a chance to get better,” she said. “I would not be able to do this on my own.”
Owens said it hasn’t been easy accepting help.
“But this could happen to anybody,” she said. “And there is nothing you can really do about it.”
The fear of losing any Medicaid benefits is difficult for her.
“I don’t know what we would do,” she said.
Owens and her daughter are among about 700,000 state residents now on Medicaid and Medicaid Expansion.
In fact, 510,067 West Virginians are on Medicaid, including 166,985 on Medicaid Expansion, as of July 3, said Allison Adler, director of communications with the state Department of Health and Human Resources (DHHR). In Mercer County, 6,630 children and 9,489 adults receive Medicaid benefits, she said. In McDowell County, 2,821 children and 3,687 adults receive Medicaid benefits.
Some of those benefits could be cut if the proposal to replace Obamacare passes.
“Any dramatic reduction to funding the health care infrastructure of West Virginia by curtailing federal matching dollars for Medicaid would have a devastating effect on our citizens,” Adler said.
That’s a sentiment shared by both Bailey and Tucker.
“Some families are completely dependent on Medicaid,” Bailey said. “If federal cuts were made, the state would have to make decisions about how they spend the federal dollars they do have.”
Those decisions would be tough, she said.
Bailey, who practices in Pineville and in Gary in McDowell County, said there is a “very good chance” children would lose some coverage if the proposed cuts are made.
“What it comes down to is the state DHHR will have to make some really difficult decisions if the federal funding is decreased,” she said. “The state may have to offer fewer services overall to children in order to be able to see more children.”
Those services that could be lost include dental and eye coverage, she added.
Another major issue when services are lost is the impact of a lack of screenings, Tucker said.
“If cuts occur, fewer people will seek those annual exams where preventative medicine occurs,” she said. “The screenings done at those visits include mental health, cholesterol screens, cancer screening, smoking cessation, domestic violence, diabetes screening.”
If these issues are not caught early, the severity will increase.
“All of these things are at a greater cost once disease occurs,” she said. “Immunizations will be missed especially in the elderly and children.”
Tucker said those who don’t receive that care often end up in a hospital emergency room for care “which is always a great expense.”
“Disease such as cervical cancer should never occur in medicine today,” she said. “It is preventable by vaccination and screening.”
It’s also a social/political issue, she said of health care.
“Sadly, in one of the richest countries in the world, we are in the poorest health,” she said. “It seems the poor are neglected and the rich get tax breaks and the middle class pays for everything.”
Del. Joe Ellington, R-Mercer County, who is also an OB-GYN physician in Princeton, said during this year’s legislative session that many state residents benefit from Medicaid Expansion.
“About 175,000 West Virginians are impacted by that,” he said. “We will have to deal with the people in our state that will be covered. We are waiting to see what the feds are going to do with it. We don’t know what we are going to have.”
Another possible result of any cuts, Bailey said, is the lack of an ability to adequately tackle what has become a major health problem here and around the country.
“It could impact treatment for opioid abuse,” she said, a problem that is prevalent, and deadly, in McDowell County, which leads the nation in overdose deaths.
One concern already expressed related to a cut in Medicaid funding is a successful program for addicts that uses a drug called Vivitrol, which blocks the receptors in the brain that are impacted by opioids, preventing the person from feeling the “high” associated with the drugs.
An injection is required each month, but at a cost of $1,600 each.
Jennifer Ball, drug court case manager in Mercer County, said in a previous story about the drug that most clients are covered under the Medicaid Expansion.
Mercer County Prosecuting Attorney George Sitler said at that time he has been impressed with the effectiveness of the program.
“From what I know about the program, I approve of it wholeheartedly,” he said. “People who have worked with the injection in the drug court have good things to say about it.”
Sitler agrees that the “downside” is the expense.
However, the Affordable Care Act, which basically expands the Medicaid program in the state, pays the cost of the drug, he said.
“But we don’t know how that will be affected (with coming changes from the federal government on possibly repealing Obamacare),” he said.
Rep. Evan Jenkins, R-W.Va., also said he supports the program and he wants to make sure it continues to be a provision of any Obamacare replacement.
“As we craft a replacement, we will work to make sure prescription medications are truly affordable and that treatment options are available for those battling addiction,” he said earlier this year.
Jenkins said he has also heard positive comments from physicians and others that Vivitrol can be an effective tool in battling addiction for some.
“If it helps, and it looks like it does, then it needs to be covered,” he said.
Sen. Shelley Moore Capito, R-W.Va., said last week that residents who need treatment for drug addiction should not be left out of any changes made.
“Any health care bill to replace Obamacare must provide access to affordable health care coverage for West Virginians, including our large Medicaid population and those struggling with drug addiction,” she said. “I opposed the previous draft because it did not ensure access to affordable health care in West Virginia, did not do enough to combat the opioid epidemic that is devastating my state, cut traditional Medicaid too deeply, and harmed rural health care providers.”
Capito said she was looking forward “to reviewing the revised Senate health care legislation and forthcoming CBO (Congressional Budget Office) report to determine the impact on West Virginians.”
She said she continues to have concern about Medicaid provisions.
That revised report was released Friday and the CBO report is expected to be finalized this week.
Senate leaders have called for a vote on the revised health care plan later this week.
Leaving Medicaid benefits intact will be on Owens’ mind until a decision is made, she said, adding that many people may make negative assumptions about recipients of Medicaid benefits.
“I don’t even drink,” she said. “I just want help for my daughter.”
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