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'It should not matter how much you make' | Local family continually denied Medicaid coverage

HB 290 would make it easier for Texas children eligible for Medicaid to keep their coverage, and is on the governor's desk waiting for his signature.

SAN ANTONIO — Bobbie Sheldon holds her daughter, Jessie Jane, in her lap as her other daughter, Ember, dances with her sister. The trio laughs and bounces around to the song 'Boot Scootin' Boogie' by musical group Brooks and Dunn.

 "She's a free spirit, very loving and caring, she’ll give you tons of attention," Sheldon said about her daughter Ember. 

Jessie Jane giggles as her sister gives her a kiss on her head.

"She's very sweet and she's very active," Sheldon said about her daughter, Jessie.

Watching the girls, it's difficult to know both were born with disabilities. Ember will be two in July. She has microtia, or an under-developed ear, breathing and heart problems, along with Bell's Palsy.

"She struggles with drinking, eating, smiling, forming words," Sheldon said.

Jessie Jane is five months old, but has spent three of them in the hospital. 

"She has multiple disabilities to seizure disorders, lack of oxygen to the brain," Sheldon said. "She had a stroke. She has four heart conditions and one main heart condition--which is coarctation of the aorta where she had to have triple bypass, open heart surgery at day three of life."

Sheldon said she does all she can to make sure the girls get the care they need. However, with so much treatment the girls have to undergo, the costs add up and fast. Sheldon said Jessie Jane's medical bills near one million dollars. 

"It was $853,000," Sheldon said.

Sheldon said she has applied for Medicaid multiple times, but has been denied because she makes too much money. 

"It should not matter how much you make," Sheldon said.

When the pandemic happened, Sheldon's husband was laid off, and the family was able to get Medicaid for Ember. The couple claimed they were separated and Sheldon even left the home. 

"So he was able to get Medicaid at least 'til September," Sheldon said.

A bill is awaiting Gov. Greg Abbott's signature that would make it easier for Texas children eligible for Medicaid to keep their coverage. SB 290 ensures that children aren't removed from their Medicaid for as long as they qualify. Currently, the state requires multiple income checks throughout a calendar year. 

"What this bill does is it ensures that a child only has to be verified once a year to ensure that they have 12 months of continuous coverage," Texas Rep. for House District 117, Philip Cortez said. 

Cortez said he worked on the bill for the past two legislative sessions and is excited to see it pass. 

"Over 60,000 Texas kids will benefit from this change of law," Cortez said. 

While this will help with Ember's treatment, Sheldon said she will continue to try and get assistance for both of her children.

"If I were to be able to get medicate without having to keep applying for both girls, it would be a blessing because I won't have to worry about whether or not they're being taken care of medically," Sheldon said. 

   

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