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Practioner's Outlook - August 2020

Michelle McMullen from Huntington, WV knows a thing or two about health care and insurance.  Not only has she had her own personal experiences with Medicaid and other forms of insurance, she is also a supervisor for a mental health program in the region giving her expertise and insight into the medical and insurance systems.

Her knowledge of the system is comprehensive and yet pretty darn frank, “I’m so glad we have Medicaid expansion.  (Traditional) Medicaid is still the easiest

insurance to deal with and covers the most services (though mental health and substance use treatment parity remains a problem).” She sees the struggles, costs, and time it takes to have billing specialists go through the varying Managed Care Organizations (MCO) that Medicaid relies upon and acknowledges a universal process and electronic medical record (EMR) could help streamline treatment.

Every week Michelle and her teams work with a diverse group of patients/clients who vary in ages.  Health insurance issues are problematic for all ages, according to Michelle, and are impacted by other public policies which are sometimes forgotten.  Her example of a patient reliant on Medicare who received a cost of living adjustment (COLA) at the federal level resonates throughout West Virginia:

“With one patient, the extra $40.00 a month from the COLA impacted her as woman in her 50s on Social Security.  When your income is fixed at $800.00 a month - $80.00 is too much for four $20.00 copay treatments for mental health therapy sessions.  So, people stop going to treatment.  The woman was covered by both Medicare and Medicaid but with the COLA she no longer qualified for Medicaid and 10% of her income in co-pays was too much for her budget.”

As a supervisor, Michelle sees the costs of health care rising and the changes COVID-19 have brought on as well, which might be helping West Virginia transition into the future. When it comes to paperwork, “I can’t tell you how much time we spend with this stupid fax machine.  COVID-19 brought out the scan and email…” which goes right along with the capability of telehealth for some folks, of course who have broadband and a reliable internet source.

On a personal note, Michelle remembers when she was struggling for assistance and support as a single mother in graduate school, “They wanted me to work 20 hours a week for childcare assistance.  I couldn’t win.” Because of her own experience and knowledge of health care, Michelle provides a solution, “You have to create policy to where people can actually do what’s expected, you have to make it practical.  There needs to be people in positions (policy makers) who can understand that change.”

As a member of a local Health Care for All West Virginia group, Michelle and her fellow advocates are working to make those changes and share their stories to impact policy.  Being the boots on the ground Michelle knows, “There are people who would do a great job at Burger King and who would have a fulfilling life if they could get there (transportation).” She, like many West Virginians, takes pride in the value of work but also acknowledges the many barriers our fellow mountaineers face.

Advocates across the state are creating and proposing policy for the Health Care for All Campaign to address issues such as transportation and environment as social determinants of health.  They celebrate the wins from last year, such as expanding adult Medicaid benefits to dental care which will begin in January of 2021.  As for Michelle and many other practitioners their comments are similar and have been for years, “In what world is your rotted-out mouth not a freaking medical emergency.”

Again, the time is now for frankness and public policies

that will finally make the changes we need in the health care system, Michelle acknowledged, “Our system is not working for most people.”

Thanks to Michelle for sharing her story and experience within the health care system.  If you are willing to join in the advocacy work or want to share your health care story with us, reach out. Learn more about the campaign at www.healthcareforallwv.org and if you want to share your story, email our story collection coordinator at foster@wvahc.org.

 


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