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Medicaid Expansion: A difficult choice for skeptical legislators

By Ron Feemster
January 8, 2013

Jane Fonfara is the only person in her family with a job — and the only one without health insurance. Her husband, Dennis, 69, has battled a series of heart attacks and undergone multiple heart surgeries since he was 36. He is covered by Medicare. Their 17-year-old daughter was diagnosed with Asperger’s Syndrome, which has so far prevented her from completing a full year of high school without taking time off. She receives health insurance until her 19thbirthday through KidCare CHIP, a state insurance program for low-income children that is funded in part by the federal government.

But Fonfara, 56, a permanent part-time employee at the University of Wyoming bookstore in Laramie, manages her insulin-dependent diabetes with no health coverage. She receives no insurance through her job and can find no affordable plans on the private market. And even if she enrolled in an inexpensive health plan tomorrow, she would almost surely get no immediate coverage for diabetes, which insurers could classify as a pre-existing medical condition.With no other alternatives, Fonfara does what many other chronically ill low-income adults in Wyoming do; she relies on charity. When she needs to see a doctor, she goes to the Downtown Clinic in Laramie, where a rotating staff of volunteer doctors and nurses donate their time. She pays nominal fees to see a provider and gets her medication for free. She takes two types of insulin and two other drugs every day, drugs that retail for hundreds of dollars a month. The clinic helps her apply to the patient-assistance programs of pharmaceutical companies, which donate drugs for low-income people.

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