Faces of the uninsured: five years later

In 2009, the Journal-World profiled four Douglas County residents who lacked health insurance. Since then, a lot has changed: The Affordable Care Act passed at the federal level, with the aim of expanding insurance to most of those who previously went without it. What has that meant for the four people the Journal-World wrote about five years ago? We revisit their stories today.

Uninsured in Douglas County

In 2008, Health Care Access, the Lawrence safety-net clinic for the uninsured, served a record 1,703 patients, the Journal-World reported at the time. The clinic has broken that record several times since.

But even with the passage of the Affordable Care Act in 2010, the need for the clinic’s services doesn’t appear to be decreasing.

“There are 14,000 uninsured in Douglas County,” said Shelly Wakeman, Health Care Access executive director. “If we’re seeing less than 3,000 of them, we know there are people out there who aren’t accessing care.”

Nearly 30,000 Kansans selected a plan on the Affordable Care Act’s health insurance marketplace through March 1, though it is unknown how many of them were uninsured. Even if they all were, it wouldn’t put a big dent in the estimated 350,000 uninsured Kansas residents.

Kansas Insurance Commissioner Sandy Praeger, a Lawrence native who helped found Health Care Access, said that even the Obama administration predicted that only a small fraction of the estimated 48 million uninsured Americans would sign up for coverage in the first year.

“I am more optimistic than I was five years ago,” she said. “At least now we have something. While it’s far from perfect, it’s at least moving us in the right direction.”

Praeger said the real game-changer would be if Kansas were to participate in the law’s Medicaid expansion, which was supposed to extend coverage to tens of millions of low-income Americans. Twenty-five states, mostly with Republican governors opposed to the law, have opted out of it. In Kansas, as many as 80,000 people now fall into a coverage gap: too poor to earn tax subsidies on the insurance marketplace but not poor enough to qualify for Medicaid.

Wakeman estimates that 61 percent of Health Care Access’ roughly 2,500 patients fall into that “gap.” “For that 61 percent of our patients, nothing has changed, except the perception that everyone has insurance now,” she said.

Five years after her story was told in the Journal-World, Linda Wilson, formerly Linda Gleasure, still isn’t insured. But it’s perhaps less of a worry for her than others.

Linda Wilson

She will turn 65 in September and become eligible for Medicare, the universal health-care program for seniors. Even so, she worries about the chunk of money Medicare will take out of her already limited income.

Wilson no longer cuts hair, as she did five years ago, having given up her longtime profession because of back problems. She believes surgery might have been able to fix her degenerative disc disease. “I’ve never looked at surgery because you’ve got to have insurance to even think about it,” she said, adding: “I’m a believer in the lord, and I have to trust in God that I’ll be able to get around.”

For now, she lives off $500 a month in Social Security benefits. She expects Medicare premiums will deduct $100-150 a month from that check. She’ll also likely need a supplemental policy that will cost even more.

Her husband, Mike, gets about a day of work a week through a local temp agency. But because he’s a military veteran, his health care is covered through Veterans Affairs. Linda, meanwhile, currently gets free asthma medication through Lawrence safety-net clinic Health Care Access, saving her more than $200 a month.

One thing that has changed in Wilson’s life is that her family has grown. Besides getting married, she now has three grandchildren, with a fourth on the way. “They keep me limber, you might say,” she said. “They’re very active, and movement is good in my condition. If you sit too much, you get stiff.”

Still relying on the safety net

Not a whole lot has changed for Steve Pitnick in the past five years. He’s still working construction with his brother. He still gets his medical care through Health Care Access. And he’s still uninsured.

Steve Pitnick

Pitnick, 56, and his wife, Marilyn, had planned to research the coverage options at HealthCare.gov, part of the Affordable Care Act, but haven’t gotten around to it yet. Until they do, they will continue to rely on Health Care Access for their care.

“Health Care Access is just a blessing,” he said. “It costs us $10 for a visit. For me to pay $120 a month and $120 for my wife for insurance when we only to go to Health Care Access twice a year doesn’t make a lot of sense. We’ve been lucky. We haven’t any health issues.”

But even when Pitnick did — he was diagnosed with hepatitis C several years back — the Lawrence clinic provided a year’s worth of treatment and medications, all for a negligible rate.

What he would do without Health Care Access?

“I’d be in trouble honestly,” he said. “Maybe it would force me to get health insurance, I don’t know. I like going there. They’re exceptional people.”

Insurance out of reach

Paul Halford knows he probably needs insurance. He just can’t afford it, he says.

Not everything about the Baldwin City native’s life is the same as five years ago. For one, he moved to Chicago last April, to get a fresh start after years of living in small-town Kansas. He’s working as a full-time, live-in nanny.

Paul Halford

But the 25-year-old is still a type 1 diabetic. So before he left Douglas County last spring, he got a year’s worth of insulin from Health Care Access. Now that his supply is running low, he plans to look for a safety-net clinic in Chicago. “Clinics are so much easier than insurance, and cheaper,” he said.

Halford did have a job for a time that provided insurance but he cancelled it after feeling like he couldn’t afford the premiums. He has had some kidney issues over the past few years but neglected to follow up with doctors because of his lack of insurance.

Even so, Halford says he is not a fan of the Affordable Care Act, which requires most Americans to carry health coverage (the fine for not having it in 2014 is $95, deducted from next year’s tax return). “It’s better that people have insurance so they’re ready for anything,” he said. “At the same time, it’s also demanding, especially for someone like me who struggles financially.”

“I agree that when the government sets a law, you should follow it. I follow the speed limit for a reason — it’s the law,” he added. “I just did my taxes this past year and (the tax preparers) mentioned something to me about insurance. I told them this year is probably going to be the year I pursue it.”

A success story

After her husband died in 2003 after a long fight with cancer, Anna Doktor and her two children would get health insurance for a while, then lose it. Now, thanks to Doktor’s job at U.S. Bank in Lawrence, they are once again insured. And she plans for them to stay that way.

Five years ago Lawrence resident Anna Doktor and her two children were living without health insurance. Doktor has since obtained insurance through her job at a local bank and believes she is on steadier ground than before despite its high cost.

Doktor, a native of Poland who hasn’t lost the accent, had for years worked at Lawrence coffee shop Signs of Life, a job she loved, but it was hard supporting her family on a part-time salary.

“When my daughter’s Social Security was over and my Social Security was over, I couldn’t make ends meet anymore,” she said. “I had to go and look for something that paid real money.”

A couple years ago, she got the job as a personal banker and, with it, insurance. Even with coverage, the 56-year-old continues to go to Lawrence’s Heartland Community Health Center, which serves patients regardless of their insurance status. “It’s helpful that if I go there with insurance, it opens a spot for someone without insurance,” she said.

So, how much has having health coverage altered Doktor’s life?

“It doesn’t change much. In my situation, if something big strikes, I would still have to be very resourceful,” she said. “But being resourceful is part of being American. You can’t fall into a victim personality, because then you’re going to lose yourself.”