Helping Those in the Healthcare Coverage Gap

by Sandra Carpio
2-1-1 Project Manager

As a United Way 2-1-1 Navigator, I have been able to assist many people looking for information about health care reform and information about how to enroll for health coverage. Our team has faced many challenges. Despite the many problems we faced connecting individuals through the website, nothing was more frustrating than talking with individuals and families who fell into the coverage gap—those adults who don’t currently qualify for Medicaid, but for whom there are no options available through the Health Exchange Marketplace. It was so difficult to sit across from someone and hear their story and understand their immense need for healthcare, only to find out that there is not a solution for them until Utah decides whether to take action on this issue.

The individuals and families my team and I encountered who fell in the coverage gap are individuals in great need of healthcare. We encountered students looking for health coverage while they are in school. We spoke to single parents who work and need health security because they have little ones that depend on them. There were many individuals who are very ill and can no longer work because their health has deteriorated, and without access to affordable healthcare, they can’t get better and go back to work. There were many many examples, because unfortunately, the majority of people who came to us fell within this gap.

One of the hardest situations I faced was when I was assisting a family of three. It was a young woman in her early to mid-twenties with two very ill parents. Her mother had a chronic health condition that was barely being cared for through low-cost clinics and prescription assistance. She previously had access to doctors when her husband was working, but then he too became very ill. Because they were both denied social security disability, they did not qualify to receive assistance through Medicaid. Currently in the state of Utah, this family has no options. If there is no Medicaid expansion, this young lady must watch her parents continue to get sick because they can not get the care they need. Right now, their only option is to cross their fingers and hope.

As a 2-1-1 Navigator, my greatest hope is that the healthcare gap is covered, so, if I ever encounter anybody in this situation again, I can let them know that there is help available. They don’t have to remain unemployed because they are too ill to work. They don’t have to cross their fingers and hope for the best — because Utah took action on a solution.

The legislature can take action on this issue by adopting Governor Herbert’s Healthy Utah plan. It is a unique Utah solution to the Medicaid expansion question, and closes the healthcare coverage gap. Email your legislators now to urge them to support the Governor’s Healthy Utah plan!

If you have questions about getting access to healthcare, dial 2-1-1 for answers and information.