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Woman Forced to Flee Idaho After Getting Caught in the Medicaid Gap

Posted on Jan 12, 2014

According to a new report, nearly 55,000 Idaho residents are being tragically impacted by gaps in Medicaid and workers’ compensation benefits within the state. One such woman, Amy Workman, was forced to sell most of her belongings, including her Christmas tree, and move with her 12-year-old son to Oregon. The Workman’s had been living in Coeur d’Alene. The move to Oregon was prompted by the lack of health insurance.

In 2010, the Affordable Care Act was offered to states to expand Medicaid coverage in 2014 for those people who fell between the poverty line and middle class. People who earn less than 1.38 times the federal poverty level were to receive health insurance coverage. The federal government would subsidize the insurance premiums for people who make up to four times the poverty line. Unfortunately, a U.S. Supreme Court ruling in 2012 gave each of the states the ability to opt in or out of the new program. Idaho, along with 24 other states, opted out. 

As a result of the decision to opt out, Ms. Workman, and thousands other like her, fall into this Medicaid gap and are left with three choices: pay full price for a health insurance plan, go without insurance, or move to another state that opted in to the expanded Medicaid program. For Ms. Workman, her last job as a home care aide for a special needs child did not offer health insurance. She was injured on the job approximately one year ago and needed physical therapy. Workers’ compensation benefits to cover the therapy were denied. As a result, she was forced to start paying the costs out of pocket. She estimates that she has incurred $8,000 in medical bills in six months.

Ms. Workman made one last attempt to remain in Idaho. She applied for the state’s Medicaid program. Unfortunately, her application was denied. The State counted the workers’ compensation benefits that she was receiving against her. It also counted her child support checks.

The Morton Law Offices expresses its concern and sympathies to the individuals and families currently facing this financial and health related crisis.

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Alan Morton
Advocate for Justice/Trial Lawyer