Students affected by health care gap could see a change come November

By Jordan Erb, The Arbiter

When Jennifer Clifford, a senior social work major, discovered a blood clot in her leg over the summer, she found herself faced with two options: see a doctor to have the clot treated, or stay home and pray that it dissipated. Clifford, gripped by the fear of high out-of-pocket medical costs, chose the latter.

For Clifford and the 62,000 other Idahoans who fall into the health care gap, this is a common sentiment. Those who fall into the gap make too much money to qualify for Medicaid under the current system, and too little money to purchase their own private insurance plan. This occurs despite some working two jobs, like Clifford, who works with the Boise Rescue Mission and as a Certified Nursing Assistant. What ensues is an inability to afford health care, or paying lofty tabs once medical conditions become too much to bear.

In November, Medicaid expansion will be one of the items on the ballot for Idaho residents to vote on. Voting to pass Medicaid expansion would extend coverage to those in the health care gap, including Clifford and other Boise State students, including some veterans, who take the risk of being uninsured. A coverage extension, though not agreed upon by all Idahoans, could help students facing the gap in a number of ways.

Students

Opting not to seek medical attention out of a concern for covering the bill is an occurrence seen periodically at University Health Services. Students, unable or unwilling to afford health care, often push themselves to their physical or mental limits to avoid incurring medical costs. According to Tara Brooks, assistant director of patient and business services at University Health Services, this theme bears heavy consequences.

“What we see are definitely people who put off seeking care, and then that impacts their academic success, their school life and perhaps their work life,” Brooks said. “I think that whether it’s a physical or mental health condition, if you let it go on for too long, odds are it’s just going to get worse and maybe more costly—not only in money, but in time and your progress here at school.”

While Clifford works towards graduating this spring, falling behind in school is a concern for her. But more worrisome than that is the thought of missing a few days of work. Taking time off her jobs means less income, and less income means less resources to pay for a trip to the doctor if necessary.

This summer, time and prayers were on Clifford’s side. But this is the game she plays, the “crap shoot,” as she called it. When she feels sick, or in the case of this summer with her blood clot, she takes the gamble between getting better and getting far worse.

“I’ll tell you, before I go do anything, I’m hesitant,” Clifford said. “If I go break a leg, I can’t afford to get it fixed. That’s going to be a huge bill that I can’t deal with right now. I’ve got student loans. I’m hesitant to do certain activities. I think about it all the time when there are colds going around the (Boise Rescue Mission). If I get sick, I can’t miss a few days. Between all these different responsibilities, I just can’t. It is an issue.”

Of the 24,154 students enrolled at Boise State, only about 330 were enrolled in the voluntary Student Health Insurance Plan (SHIP) in 2017. That leaves the remaining 23,824 students either without health care, on their parents’ plans, or paying for private insurance. Per month, SHIP costs students $306.43.

After paying her rent, student loans and other necessities, Clifford can’t afford SHIP, which is comparable in price and coverage to other insurance plans on the market. To her, the inaccessibility of the current healthcare system stifles advancement and penalizes those who are trying to get ahead.

The full-time student and single mother of three works 30-35 hours a week in in-home care. She spends 16 hours of her week at the Boise Rescue Mission, working with the teen program to break the cycle of poverty. Her time away from work and school is spent at her internship, where she helps with the memory care unit of a veterans’ home. To top off her extra-curricular luggage, she is applying to master’s programs.

The current Medicaid system, according to Clifford, doesn’t incentivize working hard to get an education and support oneself.

“I almost feel like it’s kind of a punishment to try to better myself, because if I was working full time and just staying how I was, I could afford health insurance,” Clifford said. “But I want to go to school and do bigger things because I am capable, and because I have a lot to offer, but during this time, it’s like I’m playing craps. It’s a crap shoot.”

Veterans

According to Liz Woodruff, assistant director of programs at Idaho Voices for Children and coordinator of Close the Gap Idaho network, there are currently 3,800 Idaho veterans in the health care gap, and 1,200 spouses of veterans facing the same problem. Boise State is home to a number of student veterans, some of which may be eligible for coverage if Medicaid expansion is passed in November.

“By closing the healthcare gap, it would make sure that people who have served our country bravely have health coverage when they come back and are living here in Idaho,” Woodruff said. “It would help their families and the people that they’re married to who are currently in this gap.”

Veterans in Idaho are entitled to services at the Boise VA Medical Center, but the level of coverage they receive is dependent upon a number of factors. Beth Sabrowsky, outreach coordinator at Boise State Veteran Services, hasn’t encountered too many student veterans on campus who fall into the gap. She credits this to the notion that if student veterans are already engaged with Veteran Services, they are likely in touch with the community and the resources that are available to them.

Veterans who are less engaged, however, may not have the same experience.

“It’s just getting people in the doors, but nobody wants to ask,” Sabrowsky said. “I think there’s a few reasons behind it. I think one of them is that when people separate from the military, it’s kind of a bumpy transition, and a lot of it can be overwhelming, especially those that joined when they were 18 and were never adult civilians. All of a sudden they’re dealing with bills and insurance and all these different kinds of things, and they don’t really know where to start. Another part is that it can kind of be a pride thing.”

Not knowing where to go or how to ask for help, for many, might be standing in the way of getting health coverage. For some, the VA may be the solution. For others, however, the answer may come with the passing of the Medicaid expansion initiative, otherwise known as Proposition 2.

Proposition 2

A student group closely involved with getting the vote on the ballot in November is the Young Democrats, which worked last school year to get the signatures needed to have it considered. For Joe Goode, president of the Young Democrats, the issue comes down to compassion.

“It’s not a right or left thing, it’s just a human thing,” Goode said. “At the end of the day, it’s just about doing the right thing to help people get the health insurance they need and deserve, and it’s about doing the financially responsible thing, which is saving the state money so we can use that money to invest in critical things, like education.”

According to Goode, the state is already paying for health coverage of those who fall into the health care gap. When people wait to take preventative action on their health conditions, and don’t improve in the way that Clifford did with her blood clot, the trips to the doctor come out of the taxpayers’ pockets.

Caroline Merritt, communications director for the Idahoans for Health Care campaign, corroborated this statement. The Idahoans for Health Care campaign was the main campaign that stood up in favor of the Medicaid expansion initiative.

“For us, it’s a no-brainer. Not only (will) we provide health care to Idahoans who need it, but we’re going to save money in the long run,” Merritt said. “Right now, those Idahoans are forced to access care through the emergency room when their health reaches a critical point. That’s the most expensive point to access care. By providing primary preventative care, that will save taxpayers money by not having to fund care through the state catastrophic fund.”

Though the campaign does have bipartisan support–with a republican co-chair and a democratic co-chair–it’s not supported by all people on each side. Pryce Robinson, the chair of the College Republicans, looks at the potential for Medicaid expansion with a discerning eye.

“As a republican, obviously we’re for small government and states’ rights,” Robinson said. “That’s one of the big tenants of the republican party, and Medicaid expansion puts a huge amount of what is usually an issue that is handled by the states, in charge of the federal government. The federal government would have a much larger grip on saying what the state can and can’t do with their health care programs.”

Despite disagreeing with Medicaid expansion, Robinson encouraged students to research and decide for themselves what they believe, and then take action in November. He urged students to become informed voters, then show up on Nov. 6 to make their voices heard.

The Arbiter, in accordance with this sentiment, will be teaming up with Your Voice Matters, Idaho, a non-profit and non-partisan organization, to register voters in the Quad on Oct. 11, from 10 a.m. to 6 p.m.

Jordan ErbJuly 23, 2019