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New program lowers health care costs for needy

This article first appeared in the St. Louis Beacon, April 17, 2012 - Like many other independent contractors, Doug Mitchell and Susan Gottschall say they earn enough to pay their bills but not enough to afford health insurance. But their access to affordable medical care may be about to change.

Over the weekend they heard about a new program through which some local health centers will allow certain uninsured St. Louis and St. Louis County residents to get access to health services at unbelievably inexpensive rates — ranging from 50 cents to $3 for doctor visits, dental visits and generic prescription drugs.

That explains why the two St. Louis County residents — she's a music teacher and he's an assistant surveyor — wasted no time getting to a Grace Hill health site on the south side on Monday to apply for the program.

Residents also can sign up at St. Louis ConnectCare, Myrtle Hilliard Davis Health Centers, Peoples Health Centers, Family Care Health Centers and St. Louis County Health Department.

The project is coordinated by the St. Louis Regional Health Commission. About 17,000 patients are expected to be served by the new program, which starts this summer. Uninsured patients with ties to the health centers have been eligible to sign up since last November. The program was opened Monday to uninsured patients who are not now patients at any of the participating clinics.

Called Gateway to Better Health, the program is part of a federal demonstration grant intended to help the federal government and local providers figure out the best and most effective way to spend what used to be a health-care block grant. In other words, the funding isn't new but is part of federal block grant dollars already coming to the Regional Health Commission for clinic services.  

The demonstration program is expected to run for 18 months, ending at about the time that all benefits of the Affordable Care Act are to take effect. The act itself is being contested. At some point in June, the Supreme Court is expected to hand down a ruling on the validity of parts or all of the health-care law.

Eligibility for the low-cost Better Health program is limited to uninsured city and county residents who are between the ages of 19-65, are ineligible for Medicaid or Medicare, and have income at or below 133 percent of the federal poverty level. That means an income no higher than $14,484 for an adult living alone.

Assuming Gottschall, the music teacher, meets the eligibility guidelines, she says it will be easier to afford a co-pay of $3 tops for a medical, dental or prescription service she might get at a participating clinic.

"I haven't had health insurance for about five years, haven't had a mammogram or pap smear because I can't afford them," says Gottschall, 44. "I'm not at child-bearing age, but I want to keep myself away from as much risk as possible."

She also praises the low-cost medical services because "it will give me access if there is an emergency and it provides prevention. I've had friends in the past who didn't have health insurance and passed away way too young."

Mitchell, 53, agreed, saying his lack of health insurance is a constant worry.

"If there is an accident, there is no way I'd be able to pay for the care," he says. "This program sounds good because there is no other way I can afford health care."

At the entrance to the Grace Hill Soulard-Benton Health Center, 2220 Lemp Avenue, workers were distributing small gifts, such as scarves and ink pens, to people who dropped by to enroll. Yvonne Buhlinger, Grace Hill's vice president of community health services, says the token gifts are helpful to get people in the door. Some wouldn't show up even though they lack access to inexpensive health insurance.

"Some people are making little money and their budgets are already stretched," Buhlinger says. "They have challenges in life that many others among us may not have. They may have to use more than one bus just to get here. So the gifts are to recognize their diligence and say thanks for coming."

She says eligible residents have until June 30 to sign up for the program. Eligible people who miss the deadline can still get medical services at health centers for as little as $15, she says, adding that even that low rate can be unbearable for some. She says that is one reason the new program is so important.

"Some will be disappointed if they didn't enroll and have to pay $15 for a visit," she says. "Grace Hill is here to provide high quality of care. Where else can you get that for $3?"

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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