The Employed and Willfully Uninsured

A piece from the Herald Tribune describes the plight of what happens when the willfully uninsured, caught off-guard by an unexpected catastrophic illness, confront their options for care:

Their last resort for care is Medicaid, but it is unclear if the O'Learys would qualify -- or what sacrifices they might have to make to do so.

Florida is one of 33 states where Medicaid covers transplant surgery, and the program pays the full cost, a Medicaid spokeswoman official said. But first the O'Learys would have to qualify.

O'Leary would apply under the program's provision for medically disabled people, and that can take 90 days. Even if approved, eligibility documents show an income limit of $1,027 per month, far below Danae's salary.

That leaves the O'Learys with a dilemma -- to pay for Ron's care, they would be better off if she quit her job, giving up their sole stable income. They also might need to sell the restaurant to avoid Medicaid's asset limits.

It is a shame that Medicare rules require another a spouse to become unemployed to qualify their partner for Medicaid, rather than providing a realistic path to repay their debt to our social health programs.

-Wes