Heidi Riley: How Medicaid Rescued My Brother

Heidi Riley, a retired financial services professional from Point Pleasant, New Jersey, has watched her brother’s life change dramatically due to serious illness, and she has seen firsthand how Medicaid has played a critical role in keeping him alive. Her brother, a retired self-employed business owner, lives alone in Jackson and has multiple chronic conditions, including end stage renal disease, congestive heart failure and diabetes. In the last six months, he began dialysis three times a week. He also has a blood clotting disorder and requires multiple medications.

He has some mobility with a wheelchair but no car, which makes getting around difficult. On this front, Medicaid and Medicare provide vital support. “Medicare, Medicaid pays for him to have a wheelchair for transport. And they also pay for him to get to and from dialysis and his medical appointments,” she said. He uses medical transportation frequently, including for a multi-step procedure to implant a fistula for dialysis access. “He’s going fairly regularly for either check on it or adjust it or make sure that it’s forming properly.”

Heidi manages most of his grocery shopping and meal prep because he cannot shop for himself, and “to make sure that he’s getting proper nutrition, which is extremely important when you’re on dialysis.”

Heidi explained how her brother ended up relying on Medicaid after years of paying thousands of dollars monthly for private health insurance. “He was paying $2,000 to $2,500 a month for his health insurance,” she said. When he became too ill to work and couldn’t keep up with premiums, he lost his insurance without telling anyone. She described how his period of being uninsured impacted his health and finances. “He was diabetic. It started with he couldn’t pay for, or he didn’t have coverage for his insulin. He borrowed money from me. And I gladly gave it to him for that purpose.” Over time, more medications became unaffordable, and he stopped seeking care.

After he collapsed and was taken to the hospital, the bills began to arrive. Heidi immediately began applying for Medicaid. “I got him, I started an application for Medicaid and at that point they were telling us that he had blood cancer and that really would have been catastrophic. Not that his kidney failure isn’t.”

Fortunately, Medicaid covered everything. “He did not end up paying for anything, including the ambulance rides, which there were two or three. They picked up pretty much everything.”

Now that he is receiving consistent care, Heidi says, “The doctors that he’s been able to access have been phenomenal and have treated him like any other patient. There hasn’t been any discrimination that he was on Medicaid or what have you.” She added, “He was embarrassed. He was convinced that if you were on AHA, you were not going to get treated the same way that you get treated if you had your own private insurance… Thankfully, he did not lose his dignity on top of everything else going through this ordeal.”

Reflecting on what would have happened without Medicaid, Heidi didn’t hesitate. “Frankly, he would be dead today.”

Asked what she would tell Congress about Medicaid and Medicare, she said, “There are so many people like my brother, so many people with children, so many people with parents who for whatever reason, they’re all good. Many of them are hardworking. And a lot of times it’s a disability or a diagnosis of a catastrophic nature financially.”

She warned about the broader consequences of cutting these programs. “They affect everyone’s ability to access locally the services they need… So like it or not, the reality is that we need to have these types of safety nets in place because they affect everyone in the community, not just the person that is receiving the services and the care.”

Heidi ended with a message for policymakers. “It is unfair that politicians use this as their political football and put a lot of individuals into mental anxiety, psychological anxiety over whether or not they’re going to be able to pay their bills or get the medication they need or get the help they need. And it’s time that they agree to the contract and stop messing around with all of us who have family.”

She added, “Health care and the health of the people in a community determines the health of the community overall.”