Cathy Sherwin was 16 and pregnant in 1993. Her dad’s insurance didn’t cover maternity care, but with Medicaid she delivered a healthy baby.
“Medicaid for pregnant women was there to fill the gap,” Sherwin said. “I saw no other option, and the fact that Medicaid came through was an absolute lifesaver.”
Since then, Sherwood has thought about Medicaid’s importance many times, especially when she underwent treatment for what was diagnosed six years ago as terminal brain cancer. She had coverage through her employer then and retains it now after taking early retirement, but she thinks about people who aren’t so lucky because they earn too much to qualify for Medicaid but not enough to pay for health insurance on their own. And she worries about her 27-year-old son who hasn’t landed a job in his field after graduating from college and currently has no insurance, now too old to be covered on his mother’s policy.
The Catholic bishops of Missouri, Catholic Charities of the state’s four dioceses and other Catholic entities are supporting Amendment 2, a measure on the Aug. 4 ballot to expand Medicaid. Archbishop Robert J. Carlson said expansion “is consistent with our commitment to life.”
Missouri is one of only 13 states in which non-disabled adults between the ages of 19 and 64 are generally ineligible for Medicaid no matter how low their income. Even custodial parents raising children are often ineligible: a single parent raising two children, for instance, qualifies for Medicaid only with annual income below $4,778. This is the third-most restrictive eligibility requirement for custodial parents in the country.
“Expansion would help my son and many other young people who are struggling as well as a lot of other people,” Sherwin said. “It’s personal to many people in Missouri who care about other people who have no health care.”
She was among the people of her parish, St. Peter in Kirkwood, who helped obtain signatures on the initiative petition that put Medicaid expansion on the ballot.
Maryn Olson, program director of Catholic Charities Pathways to Progress, said many of the program’s clients have jobs as health care aides, school bus drivers, retail sales or other positions with the public. “They work at great risk to themselves to support their families” during the pandemic, Olson said, and they have no safety net because they often don’t have insurance.
Other clients in the program — which develops clients’ skills and builds financial assets which lead toward stability and long-term economic independence — have significant chronic medical issues such as heart disease, anxiety or breathing issues that could be managed well with access to treatment. They may have an asthma attack, for example, and end up in an emergency room.
“We all end up paying for that through higher medical costs,” Olson said.
It has a direct impact, she said, in the dignity and quality of life.
Karen Wallensak, executive director of St. Francis Community Services, tells of working with people who were homeless and did not qualify for Medicaid. A few died because they did not access health care, Wallensak asserted. For example, she said, while serving with the Housing Resource Center of Catholic Charities, she met a man “who was so thin and sickly looking. It turned out that he had esophageal cancer that had gone undiagnosed and untreated.”
The center helped him get admitted to a skilled nursing center where he died about a month later.
“Had he been able to see a physician on a regular basis or gone to a clinic, it’s possible that his disease might have been diagnosed much earlier and perhaps he would have lived longer,” she said.
The center also sought nonpaid slots in treatment centers for homeless people with substance abuse problems who had no insurance and didn’t qualify for Medicaid. “For many people, their willingness to enter into treatment is like a window that opens and shuts,” Wallensak explained. “If you’re not able to act when the window opens, it shuts again and it may never reopen.”
Wallensak cited a client who died of an overdose in a parking lot Downtown who couldn’t access treatment when he sought it.
Often today, she said, families in the Catholic Charities Pathways to Progress program have Medicaid coverage for their children but they defer treatment for their chronic conditions such as diabetes that become a crisis that sends them to the emergency room. “Again, they don’t have easy access to medical care. In the end, it’s so short-sighted. The cost of preventive care is so much less than the cost of emergency care.”
In the Pathways program, the majority of clients have jobs that don’t include medical benefits, and they don’t qualify for Medicaid, Wallensak said.
“It shortens people’s lives. People die in their 50s and 60s because they have not had adequate medical care. There’s no question in my mind that a lack of access to medical care leads to deaths.”
>> Bishops support Medicaid expansion support
Missourians will vote on Medicaid expansion on Tuesday, Aug. 4. The Missouri bishops, as stated in their materials, support Amendment 2 because:
• It upholds the dignity of the human person in accord with Catholic social teaching
• In Missouri, many working poor continue to pay the price of going without health care coverage, delaying seeking treatment for their chronic conditions, some even dying prematurely because they can’t afford and don’t have access to healthcare coverage. Being denied health coverage at the expense of your health, your ability to continue to work and support your family, and even at the expense of your life, is a life issue.
• The Catechism of the Catholic Church states that concern for the health of its citizens requires society to “help in the attainment of living conditions that help citizens grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance” (CCC No. 2288).
• The Medicaid program is governed by the Hyde Amendment and does not pay for abortions except to save the life of the mother or in cases of rape or incest. Expanding Medicaid in Missouri would not change these Hyde Amendment restrictions.
Currently public opinion polls show that the majority of Americans do not support publicly funded abortions. The Missouri Catholic Conference believes this would have to change before the Hyde Amendment would be eliminated, or for states to be prevented from excluding abortion services in their Medicaid programs. MCC believes that it would not be politically viable or sustainable for Congress or a future administration to force states to pay for abortion in their Medicaid programs.
For information, visit mocatholic.org/resources/medicaid-resources.
Health care needs
One of the volunteers at Feed My People a few years ago had high blood pressure and refused to see a doctor because of lack of money. She went home, then died of a cause related to her health condition.
Karen Lanter, executive director of Feed My People, one of the area’s largest food pantries, cited that example in pointing out the importance of Medicaid expansion, which is on the Aug. 2 ballot in Missouri. Lanter said that lack of availability of Medicaid has meant that people on the margins often avoid going to the doctor.
“We see people with high blood pressure and even sometimes diabetes who do not get the basic care they need because they do not have insurance,” Lanter said. “Preventive care is the first thing a cash-strapped individual will forego, leading to a deteriorating quality of life and increased health care costs, when he is so sick he must go the emergency room. Medicaid expansion will save lives.”
Father Bob Sieg is one of two Franciscan priests who operate Franciscan Connection, a ministry that connects people with utility assistance and other resources. He also volunteers at the St. Anthony of Padua Parish food pantry operated by the Society of St. Vincent de Paul. He said medical care is an important unmet need — as recently as July 27 he met with two people at the pantry who had back problems and are struggling to get care. He referred them to health clinics that provide medical care to indigent people.
Expanding Medicaid “would be beneficial to a lot of people,” Father Sieg said.
Franciscan Connection is not open to visitors because of the coronavirus pandemic, but is answering phone calls. Many people are seeking help with utilities, including some who have big medical bills to pay, he said.
For more information on Medicaid expansion, visit mocatholic.org/resources/medicaid-resources.