The Doctor is In…

By Irwin Becker

One of the unheralded doctors working on health reform in Rhode Island is the diminutive Nick Tsiongas, or Doctor Nick, as he was known to the advocates who worked with him when the battles started to adopt lead poisoning prevention laws in Rhode Island. He happened onto that issue in the late 1980′s because he was then the only doctor in the Legislature.

So naturally, he was the one I called to decode the historic federal health reform bill’s impact on the homeless.  Nick is still accessible even though he is chairman of Health Right, an amalgam of unions, small business, consumers, medical professionals and other health care reformers who work to make health available and affordable for everyone in the state. And he still pinches pennies–he even answers his own office phone.

So, in a nutshell, how does the historic health law help those obviously most in need?  Here are some of Nick’s conclusions.

* For the first time, childless adults can join Medicaid with incomes up to 133% of the poverty level, which for single adults exceeds the low $20,000 range. States will be funded 100 % by the federal government for this expanded coverage. This goes into effect in 2014. What this does accomplish is that all eligible applicants under 65 will be part of Medicaid.

* During the next five years, an additional $1 billion will go to community health clinics and the National Health Services Corps, which provides the medical workforce for the centers that will increase service to the low-income and currently uninsured populations.

* Children up to the age of 26 can be covered by their families’ plans. Dr. Nick said this would help the young homeless who might be estranged from their families to seek assistance.

* With a growing number of children becoming homeless–323 in this state at the end of March–insurers can no longer deny coverage to children with preexisting conditions, or exclude those conditions from coverage.

* By 2011, Medicare will provide free preventive services, as will group and individual health plans.

When asked about the more than 20 states that filed law suits challenging the constitutionality of the new law, Tsiongas noted the legislation’s  increased funding and expanded programs, adding:  “The states should not be crying, although that doesn’t prevent some people from crying anyway.”