Louisville Magazine

AUG 2016

Louisville Magazine is Louisville's city magazine, covering Louisville people, lifestyles, politics, sports, restaurants, entertainment and homes. Includes a monthly calendar of events.

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66 LOUISVILLE MAGAZINE 8.16 Hurdle to Healthcare By Amy Talbott Photo by Mickie Winters Casualties in the governor's plan to "fix" Medicaid. Bob Crawford was between jobs last year when he received a letter from the state saying he needed to sign up for health insurance or pay a penalty. As a stopgap measure, he success- fully applied for Medicaid. Crawford was getting ready to start work with a tree-care company in Louisville, so the Medicaid would keep him covered until the insur- ance kicked in at his job. en, on Sept. 19, he was helping a friend remove a limb from a tree. ey were up in the tree doing what he calls a "controlled drop." "Me and another guy were holding the rope and (the limb) basically broke loose before it was supposed to. en it fell," he says. "It swung the other guy off the rope, and as soon as it swung him out of the way, the branch hit me from above in the head and I dropped probably 15 feet to the ground, and immediately I knew something was seriously wrong. I couldn't really move my feet or my arms." e spinal-cord injury put him in an intensive care unit at University Hospital for four weeks, followed by six weeks as an in- patient at Frazier Rehab Institute. Crawford and his then-fiancée Brandie, both in their late 30s, got married at the hospital on Oct. 8 because they weren't sure if he'd survive a surgery scheduled for the next day. Brandie, who'd been a social worker for about 11 years, said she went into work mode as soon as she got to the ER the day of Crawford's injury. "I don't know if it was a coping skill or what," she says, "but I was like, OK, here's what the deal is, here's what the problem is; now I just need you to tell me how we're going to fix it." She's been in work mode almost nonstop ever since. If Kentucky hadn't expanded Medicaid in 2014 as part of the Affordable Care Act, it's likely that Crawford, being between jobs, wouldn't have had health insurance. Before the expansion, Medicaid was really only open to elderly or disabled people, low-income pregnant women and children. After the expansion, anybody making 138 percent or less of the federal poverty level (about $16,394 annually for an individual or $27,821 for a family of three in 2016) could get coverage. Brandie never thought she'd have Med- icaid either; she'd had employer-sponsored coverage her whole adult life. She tried to continue working her job at a therapeutic foster-care home, but when Bob came home from the hospital in November, it was clear that she couldn't work full-time and take care of Bob, who is now in a power wheel- chair and has very little movement from the neck down. ey didn't have any family members who were comfortable doing all the required care, so Brandie quit her job. Which meant losing her health insurance and signing herself and her three sons up for Medicaid. e Medicaid expansion covers about 67,000 Louisvillians and 440,000 Ken- tuckians. Kentucky's expansion was among the largest of the 32 states that expanded the program after the Affordable Care Act Bob and Brandie Crawford

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