I oversee the Medicaid enrollment program of a social services agency that primarily serves homeless and low-income Portland residents. Having been uninsured most of my life, I wanted to help simplify the health care system for people who can easily feel confused and excluded by its complexity.
Last week, I met a man who lost his front teeth in a car accident over three years ago. I'll call him Jerry. At the time, Jerry was ineligible for health insurance through his employer, and couldn't afford either private health insurance or dental implants out-of-pocket. After losing his job, he found it impossible to find work due to his appearance and eventually became homeless. Soon after, he developed a heroin addiction and contracted hepatitis C. Jerry was coming in to renew his Oregon Health Plan insurance before an appointment at our clinic.
Last July, the Oregon Health Authority decided to offer dentures as a covered benefit of the Oregon Health Plan. Suffice it to say, it was not the most remarkable development of my day. But I take for granted the fact that I'm a relatively healthy millennial.
Adult dental care isn't listed as one of the minimum essential benefits now required by the Affordable Care Act, but the state of Oregon voluntarily decided to cover basic dental services for low-income adults because it's the smart thing to do. Oregon has also opted to offer prenatal care to undocumented pregnant women and transportation to appointments for the elderly.
Many states chose not to adopt these practices nor to expand Medicaid, which allowed Oregon to increase income eligibility from only those making below the federal poverty line to those earning up to $16,700 per year. Almost 40 percent of all Oregon Medicaid members are eligible only because of this new provision. Under the Senate health care bill unveiled last week, Medicaid eligibility will be rolled back, basic services will be defunded, and minority and vulnerable populations will bear the brunt of the damage.
Never in my life have I seen anyone more excited to get dentures than Jerry. He already had scheduled his initial consultation with a dentist and was fantasizing about job interviews. Despite being homeless, chronically ill and addicted to drugs, he finally has hope. And he finally has a chance.
Denying people access to health care is denying them a future. By making it financially and physically impossible for individuals to take care of themselves, you make it impossible for them to contribute to society. Jerry won't have access to drug and alcohol treatment as one of the ACA's required essential benefits, insurance companies will be able to charge him higher premiums due to his pre-existing condition, and, to add insult to injury, Jerry won't be able to afford his dentures and get back to work.
The repeal of the Affordable Care Act will affect us all. Oregon can only go so far in taking care of its people without federal legislation to fund its efforts. So if you care about the future of our state, have everyone you know call their U.S. senators and ask them to halt all Senate business until the Republicans allow for public hearings on their proposed bill.
We can't let the rug be pulled out from under us without a fight.
Christina Lacy is a native Oregonian and works for Outside In.