Ohioans without insurance seek help - State may shift money to pay for cystic fibrosis treatment in hospitals

Patrick McGuinness works two jobs to dig out from a growing pile of medical bills totaling at least $24,000.

The 25-year-old Akron man has cystic fibrosis, an incurable, inherited disease of the lungs and digestive system that ultimately is fatal.

But for now, at least, McGuinness' biggest challenge is his lack of health insurance, not his health problems.

Hospital creditors routinely call him at home and work, demanding that he pay hundreds of dollars of his bills.

"I deposited basically everything and anything I had saved," McGuinness said recently after getting off work from his job as a manager at Best Buy in the Montrose area.

Some extra help -- albeit limited -- could be on the way for McGuinness and several dozen other adult cystic fibrosis patients who lack health insurance.

The Ohio Department of Health is proposing that at least part of $1.3 million in unused state money originally earmarked to buy prescriptions for adults with cystic fibrosis be used to pay for up to seven hospital days for those patients through June 30.

The number of covered days could be increased slightly by state legislators.

The $1.3 million is going unused because only about 150 adults with cystic fibrosis have applied for coverage, not the expected 175, said Anne Harnish, assistant director of the Ohio Department of Health.

The proposal also calls for part of the unused money to pay health insurance premiums for adult cystic fibrosis patients with access to coverage.

However, the majority of the untapped money would be transferred to help people with other serious medical conditions, including the blood-clotting disorder hemophilia.

The proposal would temporarily restore some lost services to many of the 28,000 children covered by a state program known as the Bureau for Children with Medical Handicaps, or BCMH, Harnish said.

In recent years, BCMH slashed coverage because of cuts in state funding. Some -- but not all -- services were reinstated when legislators approved additional funding for the current two-year state budget, which covers July 1, 2005, through June 30.

Along with adding new help for adults with cystic fibrosis, the proposal would reinstate coverage for disposable undergarments for handicapped children and help hemophilia centers buy expensive blood-clotting factor, Harnish said.

Some of the money also would be used to increase funding for case managers and nurses at health departments.

"I think the state health department has a responsibility to think about everyone's needs and concerns in this program, and I think we tried to do that," Harnish said.

State drug coverage lost

McGuinness' mother, Barb McGuinness, said she supports the proposal as long as the money is indeed available.

But her son and possibly others still are waiting to get promised state help, said the Jackson Township mother, who serves on the state's Cystic Fibrosis Legislative Task Force.

Because of glitches with his application, McGuinness lost his state drug coverage at the end of June. He stopped taking most of his medicines, which cost thousands of dollars each.

"Let's make sure the patients who were promised the care get the care," she said.

In the meantime, McGuinness tries to eat a healthy diet and get as much rest as possible to avoid a flare-up.

"He's just flirting with disaster, he really is, because he knows he can't afford to do anything else," his mother said.

Refuses to quit working

Along with his job at Best Buy, McGuinness also works part time as a server as Ken Stewart's Lodge in Bath Township. A payment plan proposed by hospital creditors leaves him with only $200 per month from his take-home pay.

Although McGuinness plans to sign up for health insurance coverage through one of his jobs next year, any bills associated with his cystic fibrosis won't be covered because it's a pre-existing condition.

He refuses to quit working, even though he'd probably qualify for more government assistance.

"I have too many ethics to do that," he said. "I know I'm healthy enough to work. I know I'm healthy enough to contribute to society."

Back when the BCMH program was created decades ago, most children with cystic fibrosis didn't survive into adulthood, Harnish said.

For most patients, she said, the BCMH program is a "payer of last resort" that picks up some co-payments and services that aren't covered by other insurance programs.

Ohio has the fourth largest cystic fibrosis population in the country: More than 1,300 Ohioans -- including more than 530 adults -- live with the genetic disorder, according to the Cystic Fibrosis Foundation.

"BCMH is not going to be the definitive answer for people with cystic fibrosis," McGuinness' mother said. "There has to be something else."