Within days, the cough quickly escalated into a burning chest pain that dropped 30-year-old Brittany Marie Wells to her kitchen floor.
“I started crying,” Wells said. “My mom ended up calling my dad, telling him that we needed to go to the hospital.”
But she refused to go.
Having just returned to Columbus from a cruise trip to Progreso and Cozumel, Wells suspected she had contracted COVID-19, the disease caused by the novel coronavirus that has claimed more than 50,000 lives worldwide.
But without health insurance coverage, she feared a doctor’s visit would just be one more bill to pay.
Wells is hardly alone. For many uninsured Mississippians who are saddled with medical debt, hospital visits or stays are a chance they feel they can’t afford to take. Even getting a coronavirus test, which can cost hundreds of dollars for the uninsured, can be a hard choice.
But in Mississippi, the pandemic may hit particularly hard when the state’s high rate of uninsured population is paired with the nation’s highest COVID-19 hospitalization rate, recent data shows.
Roughly 12 percent of Mississippians were not insured as of 2018, the latest year data is available from the American Community Survey, which is conducted by the U.S. Census Bureau every year. That ranks the state fifth in the nation for rate of uninsured residents.
As of Thursday, Mississippi also had a COVID-19 hospitalization rate of 31 percent, the highest among all 40 states that report hospitalization data, according to The COVID-19 Tracking Project.
For the uninsured, help to lower the cost of care may be on the horizon. Free testing is available at the Mississippi Public Health Laboratory and state-affiliated drive-up sites across the state. On Friday, President Donald Trump pledged federal funds to reimbursing hospitals that treat uninsured COVID-19 patients.
But for now, comprehensive help has not arrived. Affordable services and resources, although available, remain scarce in the Golden Triangle.
Another debt
For every day Wells waited, the symptoms remained, or even worsened. Her fever lasted five days. Her temperature shot up to a high of 102.1 Fahrenheit.
“It would go from 102.1 to 101 to 100.9,” she said. “It never got under 100.5 within those five days.”
Wells eventually decided to get tested for the coronavirus at a Columbus urgent care clinic. She was first tested for flu and strep, both of which came back negative, before being swabbed for COVID-19. The result came back after 11 days, she said, and it was negative.
The clinic gave her a discount for paying out of pocket. Still, the entire visit cost her $269.
That cost, Wells said, adds to the more than $10,000 worth of medical debt she racked up over the past year for underlying health issues. Being a student at the Mississippi University for Women, she said, $30,000 worth of student loans await.
Sometimes when her medical bills were sent to debt collection agencies, she would get harassed.
“It’s hard when you are having to pay other bills,” Wells said. “It’s hard whenever you have to sit there and calculate how much this visit is going to be.”
Another area resident, an assistant manager in real estate who asked to remain anonymous for job security reasons, told The Dispatch she had to receive multiple tests for flu, strep and the coronavirus. The symptoms would not go away, she said, and her fever lasted at least 10 days.
“When I would walk up the stairs to my apartment,” she said, “it was like I had played an entire basketball game.”
Her insured girlfriend, who also received a coronavirus test, paid a $35 copayment. But for the uninsured partner, the cost was almost 10 times higher for the same test. In all, she spent almost $700 for her various tests, she said.
“I think it’s ludicrous,” she said. “I can’t imagine how many people just wouldn’t be able to afford to do that. I know people who couldn’t afford to do that.”
Her job does not offer paid sick leave, she said, so she kept working from home for several days while waiting on her coronavirus test result, which was negative.
“It’s incredibly frustrating when you are trying to work at the same level of effectiveness,” she said, “and your brain is not working right because you’ve been running a fever for 10 days.
“In the back of your mind you are always thinking, ‘if I had paid time off or if I had insurance,'” she added. “Somebody out there can make this much easier for me and they are choosing not to.”
Deterred from care
Many others, while not showing symptoms, worry they may fall ill soon.
But instead of their own health, money is the concern. A lot of them are already delaying the care they need to relieve the financial burden.
In 2016, 19.2 percent of the state’s adult population — the highest rate among all states — hadn’t sought medical treatment in 12 months because of the cost, data from the Kaiser Family Foundation shows.
Carol Plunkett, 52, who lives near Starkville, said she will not go to the doctor unless absolutely necessary. Even with a family history of cancer, she stopped receiving regular screenings after quitting her job and losing health insurance in 2018.
“I told my husband one day … ‘I guess if I get cancer I won’t ever know it,'” she said. “‘ I’ll just die from it.'”
Plunkett also has been having a sharp pain in her stomach for six months, she said, but she refused to seek care for it.
“It’s not unbearable,” she said. “I have a sharp pain and I just have to stop for a second and then go on.”
Plunkett said she still owes medical debts from when she quit her job. The company cut off her insurance coverage early, she said, leaving her a $6,000 bill from a medical exam that assessed her risk of getting cancer. The results required further testing, but without insurance, she didn’t pursue it.
Sometimes, Plunkett dreads what would follow if she contracted the coronavirus and the symptoms became serious.
“(I don’t know) if I would even have the money to have the test done,” she said. “If I did have it, I don’t know what I would do. I guess I would have to live at the hospital, cleaning beds to pay it back.”
Plunkett also is the primary caregiver for her 82-year-old wheelchair-bound mother, who is vulnerable to the virus because of her age and underlying health conditions, she said.
“It would drive me crazy if I brought (the virus) home to her,” Plunkett said. “(But) other than sending her to a nursing home, there’s nowhere for her to go.”
Hailey Elkins, who works as an independently contracted nail technician at the Belles Nail Bar in Starkville, said she is putting off tests she needs due to the cost. She’s already $10,000 in debt for medical care, she said.
“If we get the flu, we don’t go to the doctor’s (office),” Elkins said. “We can’t afford to.”
And if the coronavirus hits, she said, she will stay home.
“We can’t really jump in the vehicle and go to the doctor’s office, and then give them $145 just for the test,” she said.
A pet care worker in Lowndes County, who asked not to be named due to privacy concerns, told The Dispatch she hasn’t had a female exam in at least 10 years. She takes over-the-counter medication to treat her body aches to “keep going.”
Like Plunkett, she decided to refrain from doctor’s visits unless she is seriously hurt.
“I smashed (my leg) between my riding mower and the bumper of a camper (a few summers ago),” she said. “I had no choice but to go to the emergency room. The bill was $2,000.”
Faced with the coronavirus pandemic, she hopes the government could help cover the uninsured.
“I don’t believe in freebies,” she said. “But I think this is the one time that the government needs to step up and not charge people if they have to get tested … (or) go into the hospital.
“Just take care of them,” she added.
Resources are available, but scarce
The care may be on its way.
Trump announced Friday afternoon his administration will use funds from the $2 trillion economic relief package Congress passed last month to reimburse hospitals that treat uninsured COVID-19 patients.
Meanwhile, the Mississippi Department of Health (MSDH) is offering free testing through the state public health lab — which runs roughly 380 tests a day — and its affiliated drive-up testing sites across the state, said spokeswoman Liz Sharlot.
The sites, set up as a partnership between the MSDH and the University of Mississippi Medical Center (UMMC), started offering free testing on March 27, said department spokeswoman Elizabeth Grey. The site at the Mississippi State Fairgrounds in Jackson runs every day from 9 a.m. to 4 p.m., she said. Other one-day, drive-up testing sites are also set up across the state with varying locations each week.
Using telemedicine, patients with symptoms can receive a free screening over the phone or via an app, according to the UMMC’s website. Those deemed eligible for a test can make an appointment within 24 hours and get tested at the designated location free of charge, the website said.
However, the service has yet to arrive in the Golden Triangle area.
Community Health Centers, where patients can pay for services based on their family size and income level, are scarce in the area. There are only two of such clinics in the surrounding four counties — the Greater Meridian Health Clinics in Starkville and Shuqualak.
Local clinics and hospitals, which have varying processes for coronavirus testing and partner with commercial labs, may still charge for their services, Sharlot said.
For now, help comes from within the community.
Self-pay patients in the Golden Triangle can receive discounted rates at certain clinics, such as the Allegro Family Clinic and the Weekends Plus Urgent Care.
The Good Samaritan Medical Clinic, a nonprofit that triages uninsured patients for free every other Thursday, is also contemplating the idea of getting supplies it needs to test patients, said clinic board member Dr. James Woodard.
Baptist Memorial Hospital locations, including Columbus, are deferring bills on all uninsured patients, said Memphis-based Baptist spokeswoman Ayoka Pond. The federal stimulus package could allow the hospital to waive the cost, she said.
“Our intent is for no one to have to pay out-of-pocket costs for testing,” Pond said.
Yue Stella Yu was previously a reporter for The Dispatch.
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