WELCH, W.Va. — Sharon Mills, a disabled nurse, long depended on other people’s kindness to manage her diabetes. She scrounged free samples from doctors’ offices, signed up for drug company discounts and asked for money from her parents and friends. Her church often helped, but last month used its charitable funds to help repair other members’ furnaces.
Ms. Mills, 54, who suffered renal failure last year after having irregular access to medication, said her dependence on others left her feeling helpless and depressed. “I got to the point when I decided I just didn’t want to be here anymore,” she said.
So when a blue slip of paper arrived in the mail this month with a new Medicaid number on it — part of the expanded coverage offered under the Affordable Care Act — Ms. Mills said she felt as if she could breathe again for the first time in years. “The heavy thing that was pressing on me is gone,” she said.
As health care coverage under the new law sputters to life, it is already having a profound effect on the lives of poor Americans. Enrollment in private insurance plans has been sluggish, but sign-ups for Medicaid, the federal insurance program for the poor, have surged in many states. Here in West Virginia, which has some of the shortest life spans and highest poverty rates in the country, the strength of the demand has surprised officials, with more than 75,000 people enrolling in Medicaid.
While many people who have signed up so far for private insurance through the new insurance exchanges had some kind of health care coverage before, recent studies have found, most of the people getting coverage under the Medicaid expansion were previously uninsured. In West Virginia, where the Democratic governor agreed to expand Medicaid eligibility, the number of uninsured people in the state has been reduced by about a third.
America ranks near the bottom of developed countries in health and longevity, and many public health experts believe that improving that ranking will be impossible without paying more attention to poor Americans. It is still an open question whether access to health insurance will improve the health of the disadvantaged in the long run, experts say, but the men and women getting the coverage here say the mere fact of having it has drastically improved their mental health.
Waitresses, fast food workers, security guards and cleaners described feeling intense relief that they are now protected from the punishing medical bills that have punched holes in their family budgets. They spoke in interviews of reclaiming the dignity they had lost over years of being turned away from doctors’ offices because they did not have insurance.
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