Death in Dallas: A Family Experience at the Medicaid Gap

For many years, Millicent McKinnon in Dallas had no health insurance. She was one of about a million Texas people who were too many to qualify for Medicaid in the state, but too few to buy their insurance. In other words, until he died in 2019. She was 64 years old and couldn’t find a consistent cure for breast cancer.

McKinnon’s daughter-in-law, Lorraine Villaville, said she was still saddened by the loss.

“She was a very lively woman,” she said. “Always full of energy and joy.”

Health insurance for about 2.2 million Americans is being considered as Congress is considering a spending bill that could reach $ 3.5 trillion over the next decade.

The plan extends health insurance to residents of 12 states who have not yet expanded Medicaid to the working poor through affordable care laws. In these states, people who earn too little to qualify for Medicaid but cannot afford insurance in individual markets are left behind in what is called the Medicaid Gap. Like McKinnon, most of these people work in jobs that don’t offer affordable health insurance.

If Congress approves this measure, those individuals will have access to health insurance through the federal government.

This could be a lifeline for some of the 17.5% of uninsured Texas, the highest percentage in the country.

McKinnon was a descendant of a runaway slave who settled in Chicago. As an adult, she moved to Dallas and engaged in healthcare throughout her career. Her last job was as a home medical assistant caring for the elderly and disabled. Villaville, however, said she didn’t make much money and didn’t have health insurance.

And that’s why she postponed going to the doctor when McKinnon began to feel sick.

“She wasn’t interviewed,” said Villaville, a short-term lawyer in the Texas House of Representatives. “She was doing everything she could to lead a healthy lifestyle, so when she realized something was wrong and went to find out what it was, it could be stage 4 breast cancer. got it.”

The year after the diagnosis, she flew around the hospital. The doctor stabilized her and sent her home. Without coverage, it was difficult to find a consistent treatment. Her family looked for insurance but couldn’t find anything.

She died slowly, so all they could ultimately do was be there.

“When we knew, we were pregnant, as you know,” Villaville said. “And she kept saying,’I just want to see my grandpa,’ and she didn’t do that.”

McKinnon died a month before her granddaughter was born. She was a few months away from getting Medicare.

Villaville said the medical system in which her mother-in-law worked her life eventually failed.

Laura Gera Cardas, deputy director of the Texas Children’s Defense Fund, said supporters like her have been appealing to state legislators for years to cover the uninsured Texans. rice field.

“But purely political opposition from our Supreme Leader, Governor and Vice-Governor is enough to prevent the development of the issue, which is a fundamental right,” she said.

That’s why Gera Cardas and other health advocates across the country are looking to President Joe Biden and Congress to solve this problem. The Democratic Party’s $ 3.5 trillion spending bill (Biden’s “Human Infrastructure” bill) includes funding to cover uninsured people through the health insurance market and the state’s Medicaid program.

Most of the beneficiaries are of southern color.

“We are asking them to choose to make America a country that does not interfere with medical care from anyone,” Gera Cardas said.

Racial disparities are prominent in Texas, with approximately 70% of people in the coverage gap being Latino or black.

This is the first Jesse Crosscall with the Center for Budget and Policy Prioritization since the enforcement of an affordable care law that Congress may have enough votes to address this issue. said.

“This is really ACA’s unfinished work to give poor people and everyone in this country of medium income access to affordable health insurance,” he said.

However, this insurance lifeline is competing for money and attention with other priorities.

Politico reported that the plan could be reduced as the Democratic Party negotiates a reduced version of the spending bill.

For example, some lawmakers have suggested that people in the Medicaid Gap are ready to reduce their health insurance to just five years.

US Congressman Lloyd Doggett (D-Texas), chair of the House Ways and Means Health Subcommittee, said in a statement Tuesday that Congress “must fill this coverage gap forever.” care.

“Breaking the coverage gap means having access to your doctor, essential medicines, and other health care. [millions] It has been left behind for more than a decade, “he said.

Some Democrats also raised political concerns that increased coverage in non-expanding states would reward state Republican leaders who had blocked the expansion of Medicaid for years.

Guerra-Cardus said the debate was “far from the point” as to why Congress should address the press gap.

“This is about people dying in the 21st century in our rich country and suffering from preventable and curable illnesses,” she said.

The expansion of Medicaid has been approved by voters in all the states voted for, most recently in Oklahoma and Missouri.

This story is part of a partnership that includes KUT, NPR, and KHN.

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Death in Dallas: A Family Experience at the Medicaid Gap

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