Navigating the Gap: Tim Messenger

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 ***UPDATED Nov. 30, 2016***

When we first met Tim last spring, he was struggling in the Medicaid gap like 300,000 other N.C. residents. He had no income, and he couldn’t qualify for health care through Medicaid because he had no children or qualifying disabilities.

Because he spent years without access to preventative care that could have managed his Type 2 Diabetes, Tim’s eyesight has deteriorated enough for him to demonstrate that he has a disability, and he qualified for Social Security disability benefits this fall.

Thanks to the Affordable Care Act (ACA), he was able to use his Social Security income to apply for health insurance through the Health Insurance Marketplace and receive a tim-messenger-acasubsidy. Before the ACA, people like Tim found themselves in a different gap — living month-to-month on a tiny Social Security check with few other options for support.

Yesterday, a LSSP health insurance navigator helped Tim enroll in a plan with a premium that costs $30.42 a month and includes coverage for his ophthalmologist to perform a necessary surgery on his eyes. He also signed up for a dental plan.

Your support of the work LSSP does makes these tangible impacts on people’s lives possible.

During a time when the future of our country’s healthcare system is uncertain, people like Tim, who have already spent years struggling to access health care, are more vulnerable now than ever. Access to coverage matters. LSSP is committed to helping people like Tim and will continue to advocate for policies that enable them to receive the care they need.

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For most of his adult life, Tim Messenger worked in operations management and hademployer-provided health insurance, but in January 2014, Tim was laid off from his position as inventory manager.

The same week he was laid off, Tim’s mortgage company notified him that they were not going to continue working with him and his now ex-wife as they were trying to sell their house as part of a divorce. His neighborhood property values had been hit hard by the recession and, after 20 years of house payments, his property value was half the initial purchase price.

Tim also began to lose weight, but given the stress of losing his job, going through a divorce and trying to sell his home, he didn’t think much of it. He also began to notice trouble with his vision, but he couldn’t afford to see a doctor.

“I knew it was more serious than needing new glasses,” Tim says.

Promising job prospects with benefits did not materialize; Tim’s unemployment benefits ran out, and he found himself relying on the goodwill of friends and family for a place to stay, but by February 2015, Tim was living out of his van, looking for work by day and trying to find a safe place to park at night and sleep a few hours at a time.

“I was pursuing jobs and thought health insurance was right around the corner, and it never panned out,” Tim says.

“You fall into a survival mode,” he says of that period.

His eyesight continued to get worse until it ultimately caused him to have two car accidents in 2015, one in May, the other in July, which totaled his van.

Those accidents were a turning point for Tim.

A visit to the Bethesda Health Center, a free clinic in Mecklenburg County operating in part with the Camino Community Center, led to an appointment with a retina specialist along with the unexpected diagnosis that Tim had Type 2 Diabetes.  The clinic connected him with the N.C. Division of Services for the Blind, who covered laser surgery on his retina.  His recovery has been hampered by complications requiring repeated injections in his eyes, while his eye condition and inability to heal has been exacerbated by poor circulation resulting from diabetes.

“I just figured that after four to five months, things would be relatively back to normal,” he says. “Now it’s been almost a year.”

Tim had fallen prey to a situation that is far too common for middle-aged, single men, with low or no income.  Victims of an economic downturn and unemployment beyond their control, financial stability slips away and untreated health problems can quickly turn into complex and irreversible illnesses with life-changing ramifications. With preventative care and earlier diagnoses of his ailments, he may have been able to avoid the auto accidents and surgery and managed his diabetes so that he could continue to work and take care of his needs.

Tim has tried to get on with his life by looking for work. His previous jobs required a high degree of physical activity, but nerve damage resulting from diabetes and injuries suffered from the car accidents prevent him from seeking the same type of work.  Also, with his diminished vision, he can’t see a computer screen to search and apply for jobs online.

Tim, a man of faith, believes that everything happens for a reason. Friends from his church, Camino Church, became concerned and offered him a place to stay in May 2015. For the last year, he has relied on the church’s support, and he has been volunteering in the Camino Thrift Store, applying his background in retail to help where he can.

Last spring a health insurance navigator from Legal Services of Southern Piedmont working at Bethesda helped Tim apply for Medicaid, and in July, he applied for Social Security Disability benefits, which he recently learned he was qualified to receive.

Before this news, Tim was one of 300,000 people in North Carolina who fall into the Medicaid coverage gap, ineligible for Medicaid because he had no children or qualifying disabilities and he earned too little to qualify for tax credits that would help him afford insurance through the Health Insurance Marketplace.

Tim’s qualification for disability benefits was a huge hurdle to clear because proof of having a disability is often a difficult, long process. But because Tim has spent the last two years in the Medicaid gap, his health has deteriorated enough for him to demonstrate that he clearly has a disability.

If he had been able to access both the preventative and immediate care he needed in the first place through Medicaid coverage, Tim would have his eyesight and be in better health. He could have been looking for another job instead of trying to piece together care he needed.

Qualifying for disability benefits makes him ineligible to qualify for Medicaid now, but thanks to the Affordable Care Act (ACA), he now has the option to apply for health insurance through the Health Insurance Marketplace. Prior to the ACA, people like Tim found themselves in a different gap — living month-to-month on a tiny social security check with few other options for support.

With what seems like a fresh start ahead of him, Tim is hopeful that he will eventually be able to regain his eyesight with the right treatment. He still wants to find a job and get his own place where he can live independently again. He also hopes to use his experience to help others keep going when life takes an unfortunate turn.

“God allows you to go through things for a reason,” he says. “So you can help others go through it.”

Read more about Tim’s story in this Charlotte Observer article to see how his situation fits into the greater context of Medicaid expansion, as well as the upcoming election Nov. 8.

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