Clusterfuck

Throughout the industrialized world, only in America could Michael Veasey have experienced this.

Veasey enrolled in AHCCCS, Arizona’s health-insurance program for the poor, on July 16, 2010. He says he was told to reapply annually, so he dutifully returned on July 8 of this year—but that was too late, according to the budget-strapped state of Arizona, and Veasey lost his coverage (See “Living on the Edge,” Currents, July 28).

It is health insurance that Veasey, 56, desperately needs. He is homeless and almost penniless, and his severe breathing problems left him hospitalized in February at the Tucson Medical Center.

Veasey decided to appeal his expulsion from AHCCCS. He contends that he compiled with what he was told about reapplying. Veasey also believes the AHCCCS program didn’t follow its own guidelines for terminating people.

On May 12, AHCCCS sent Veasey a letter telling him that he had until the end of the month to reapply. “This will help us to complete the application process before your benefits end,” the form letter states.

Since he receives his mail via general delivery at the main post office—which is quite a distance from where he camps—Veasey didn’t pick up this letter. Nor did he see a second letter from AHCCCS, dated June 13, until after he had reapplied and been turned down. This letter said he needed to reapply by June 24.

But on an AHCCCS “Fact Sheet,” the state agency straightforwardly declared at the time: “All AHCCCS Care members will be notified 60 days before the due date of their renewal.”

Because 60 days after May 12 was July 11, Veasey claims that he met the state’s criteria by three days.

Prior to Veasey’s scheduled appeal hearing, Monica Coury, a spokeswoman for AHCCCS, responded in an e-mail: “The 60 days advance is not a federal or state requirement nor is it a formal AHCCCS policy. It is the goal to send out the initial renewal notice 60 days in advance. Based on (the Tucson Weekly‘s) feedback, we will amend our fact sheet and other materials to state that renewal notices are typically sent 45 to 60 days in advance.”

In other words, Veasey’s oversight in not picking up his mail cost him his health-insurance coverage. Meanwhile, the AHCCCS oversight was just a minor problem that officials can easily correct by simply amending their “Fact Sheet.”

But Veasey believed the AHCCCS error should entitle him to retain his coverage. That is what he intended to tell a Phoenix administrative law judge during a telephone appeal hearing last Friday, Aug. 26.

The hearing was scheduled for 2:30 p.m., and Veasey was already at the Department of Economic Security (DES) office on Fort Lowell Road when I arrived at 2:15.

In the crowded waiting area, we sat and chatted as people’s names were occasionally called for interviews. But after more than two hours passed, Veasey’s name still hadn’t been heard.

During the long wait, one woman astutely observed: “There’s got to be a better way than this.”

That certainly proved to be the case with Veasey: Late in the day, he learned the judge in Phoenix had dismissed his case for nonappearance—even though his name was never called to appear.

While Veasey attempts to get the bureaucracy to correct its mistake, he will need to try again to get his medical insurance reinstated.

Veasey is just one of many people being dropped from AHCCCS for budgetary reasons. When they’re booted, they’re given options about other health-care organizations that may offer help.

One of those is the Pima Community Access Program (PCAP). It provides deeply discounted medical services to subscribers, but not to people like Veasey.

Michal Goforth, executive director of PCAP, explains that only those earning between 100 and 250 percent of the federal poverty level qualify for her agency’s program. Those who make less, she says, don’t have the ability to pay even the small amounts required for the services rendered by participating physicians and hospitals.

“It’s so heartbreaking to be on this end,” Goforth says about meeting people who have either lost their AHCCCS coverage or aren’t able to sign up because of the current freeze on new enrollments.

Even given PCAP’s income restriction, Goforth says: “We’re seeing a steady enrollment increase.”

On the other hand, AHCCCS officials have no idea how many people in Pima County, like Veasey, have lost their AHCCCS coverage. Nor do they know how many people have filed appeals.

Even without AHCCCS, because of federal laws, Veasey can still obtain some medical attention at TMC or other local hospitals—it’s just that AHCCCS won’t pay for the care.

Based on that reality, Michael Letson, a spokesman for TMC, urges people: “Stay on AHCCCS!”

If people get dropped from the program, Letson says: “It’s a real challenge. Their options start getting fewer and farther between.

“This is a statewide issue … and is more than TMC can resolve,” Letson says. “But we’ll keep working to find some solution on a large-scale basis.”

However, that dilemma leads to a disturbing question: Do the policymakers who approved kicking poor, sick people like Michael Veasey off AHCCCS actually want to find a solution?

Those seeking to retain their AHCCCS coverage should visit dontgetdroppedaz.org for more information.

This article appears in Sep 1-7, 2011.