New Medicaid enrollees show better mental health already, from relief of stress, after getting their first health coverage

Though enrollment in private insurance under federal health reform has been slower in Kentucky and other states than advocates hoped, Medicaid enrollment has skyrocketed in the state and others that chose to expand the program. In West Virginia, which has even higher poverty rates and shorter life spans than Kentucky, more than 75,000 people have enrolled in the federal-state program for the poor and disabled. Most were not previously insured, so the number of West Virginians without health coverage has gone down by a third, Sabrina Tavernise writes for The New York Times, in a story that could be replicated in Kentucky.

"America ranks near the bottom of developed countries in health and longevity, and many public health experts believe that improving that ranking will be impossible without paying more attention to poor Americans," Tavernise writes. That is being debated, but in the short term, many who have gained coverage have shown improvements in mental health, because they don't have to worry about paying unmanageable medical bills or finding a doctor's office that will accept the uninsured, she writes: "You see it in their faces," said Janie Hovatter, a patient advocate at Cabin Creek Health Systems, a southern West Virginia health clinic. "They just kind of relax."

Some in rural areas resist signing up because they don't like President Obama; in Eastern Kentucky and West Virginia, he is blamed for decimation of the coal industry. "Recruiters trying to persuade people to enroll say they sometimes feel like drug peddlers," Tavernise writes. However, many people are putting their need for healthcare over their dislike of the president. Rachel Williams, a McDonald's worker from Mingo County who didn't have insurance, would not fill out insurance forms when she went to the emergency room because of kidney stones. But later, when she found out she qualified for Medicaid, she signed up right away.

Studies show that 10 percent of premature deaths in the U.S. are caused by lack of access to medical care, while 40 percent are caused by behaviors like smoking and eating unhealthy food. "The rest is linked to genetics and social and environmental factors," Tavernise reports. Lavetta Hutchinson, a nurse in McDowell County, told her the law won't do much to improve health, especially that of the many people who have turned to drugs because of a lack of education and economic opportunity. "People don't see the value of prevention," Hutchinson said. Living better is more expensive, Tavernise notes: "Poverty is short-term thinking?what can I do today to survive," said Sister Janet Peterworth, a charity worker in Mingo County who is enrolling people.

Others see the new accessibility of health coverage as a stepping stone for increased health among the poor. Many Mingo County Diabetes Coalition patients could previously afford only food or medicine, social worker Gina Justice told Tavernise. "If you can take away that stress because now you've got a medical card, then you can focus on healthier eating that will help with these medical issues," Justice said. (Read more)

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