Nonprofits come to veterans' aid to bolster health care in Pennsylvania

Sept. 30--Irwin Scott wants to flash a great smile -- a big, toothy grin that shreds his self-consciousness.

Yet that's not so simple after two years without a dental appointment, said Mr. Scott, 64, of the Carrick area. A Marine Corps veteran who served in the Vietnam War era, he ranks among thousands of Pennsylvanians whose federal veteran benefits fall short of complete health insurance.

Now nonprofits are using the state Medicaid expansion to help plug that and similar gaps, pushing to enroll around 20,000 uninsured Pennsylvania veterans and many others who lack comprehensive federal coverage. Gov. Tom Wolf expanded the assistance program in April, when he granted eligibility to as many as 600,000 additional residents under the federal Affordable Care Act.

"The VA is good. But they don't serve all of my needs for me," Mr. Scott said about the Department of Veterans Affairs, which cares for more than 8.7 million veterans a year nationwide. "I have a pet peeve about teeth. I like to keep my appearance up."

He braved a rainstorm Tuesday morning to explore what Medicaid might hold for him, arriving early at an enrollment session at Veterans Place of Washington Boulevard. The national Enroll America group has co-hosted at least five gatherings since June at the Larimer center, an assistance hub for homeless and troubled veterans.

Between there and the Consumer Health Coalition on the North Side, Enroll America has helped sign up more than 50 veterans and relatives for medical assistance in the last three months, organizer Robin Schmidt said. She estimated most were newly eligible under the Medicaid expansion and counted as homeless, although some had transitional or other temporary housing.

"It gives the homeless population access to mental health facilities. It gives them access to instant health care," Ms. Schmidt said.

She said federal grants should help nonprofits encourage sign-ups for at least three more years.

Expanded Medicaid under the Affordable Care Act allows medical assistance for people ages 19 to 64 with incomes up to 138 percent of the poverty level, an offering that could approach $1 trillion nationwide by 2022, according to the Center on Budget and Policy Priorities in Washington, D.C. Of the 8,126 veterans statewide in the Medicaid program, 2,453 have gained access because of the expansion, the state Department of Human Services said.

Earlier guidelines in Pennsylvania had limited the help largely to those with disabilities, chronic illnesses or incomes around 40 percent of the poverty level. About 2.2 million children and adults in the state had been enrolled before the expansion.

"Health care should be basic. Everyone should have health care," said Marlon Ferguson, executive director at Veterans Place.

He said the broadened policy should help alleviate poverty, mental illness, medical debts and related burdens on veterans. Homeless veterans in the Pittsburgh area topped 800 last summer, according to estimates shared by his organization.

Most veterans who enlisted or entered active military duty since the early 1980s need to log at least 24 continuous months of service or complete an active-duty period in order to qualify for VA health benefits. A variety of exceptions applies, according to the federal government.

Many retired service members may receive covered VA care for a portion, though not all, of their medical needs.

"I think there's a common misperception that just because you've served, you're eligible" for thorough VA benefits, Mr. Ferguson said.

Without federal coverage, about 1.3 million veterans had no health insurance in 2010, the Washington, D.C.-based Urban Institute found. It estimated around 45,500 of those lived in Pennsylvania, about 19,100 of whom would qualify for help under expanded Medicaid.

The figures do not include about 4,800 uninsured spouses of Pennsylvania veterans who would now be Medicaid-eligible, according to the 2010 analysis.

Back at Veterans Place, Mr. Ferguson said clients are thankful to know there's help.

"How can you better your lot in life if your basic needs aren't being met?" he said.

Adam Smeltz: asmeltz@post-gazette.com, 412-263-2625 or on Twitter @asmeltz.

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