Health reform seen benefiting homeless

ATLANTIC CITY, N.J. | Victor Rozanski’s wife gave him an ultimatum: It’s either me or the bottle. He chose the bottle.

The drinking wrecked his marriage. The 47-year-old lost his job as a printer and hopped on a bus to Atlantic City, where his life’s savings of $1,500 vanished in two days of drinking and gambling.

While sleeping in an alley one night, he nearly lost a leg to a cut that became infected and infested with maggots. His hernia and psychiatric disorders went untreated for years as he bounced from one casino bus lounge to the next, getting rousted every hour or so.

People like Mr. Rozanski, who is trying get off the street with the help of a homeless shelter detox program, have gotten scant attention in the contentious national debate over whether and how to reform the nation’s health care system. Among the nearly 50 million Americans who don’t have health coverage are an unknown number of homeless adults, who would become eligible for Medicaid under proposals being considered in Congress.

“They deserve the same benefits as everybody else, regardless of your status in life,” said Katherine Grant-Davis, president of the New Jersey Primary Care Association.

Many homeless people do not seek or receive primary care, and instead turn up in hospital emergency rooms when illnesses such as high blood pressure, diabetes or respiratory ailments flare up.

Linda Douglass, spokeswoman for the White House’s Office of Health Reform, said one of the main goals of the effort is to extend coverage to low-income Americans. She said homeless people would be able to enroll at hospitals or clinics.

A House bill would allow people earning up to $14,400 a year to qualify, while a Senate bill would set the limit at $16,200.

Nationwide estimates of the homeless population vary greatly, and it is a community in constant flux. The federal government considers people to be homeless when they lack a permanent shelter, but does not include those who double-up with friends or relatives.

On any given night, 750,000 people may be homeless in the United States, and as many as 3.5 million can experience homelessness in a particular year, according to the National Law Center on Homelessness and Poverty.

Homeless adults without children generally do not qualify for Medicaid unless they have a serious documented disability, said Barbara DiPietro, policy director for the National Health Care for the Homeless Council.

“What is currently on the table is an absolutely solid step forward for homeless folks,” she said. “The singular piece that is most helpful is the expansion of Medicaid to all low-income people.”

Johnnie Bond, who spent eight years sleeping on park benches in Atlantic City, said he hadn’t seen a doctor for 20 years. The 61-year-old lost his apartment after losing his job as a restaurant dishwasher. Left untreated were his heart disease and other ailments.

“I had these sharp pains in the middle of my chest that would almost double me over,” he said. “I couldn’t walk more than a block. It turned out I had had a heart attack and didn’t know it.”

He also had high blood pressure and diabetes, all of which went untreated until he showed up at a community health center that helped him find subsidized housing.

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