Armonk Woman’s Medicaid Battle Imperils Her Health Care

Geri Mariano has never backed down from a challenge, but fighting a faceless bureaucracy is presenting her with one of her most daunting obstacles.

Mariano, a nearly lifelong Armonk resident, was born with diastrophic dysplasia, a form of dwarfism which also affects her bones and cartilage. Last Aug. 1, she saw her health coverage diminished after she was removed from straight Medicaid, which covered her needs virtually her entire life, to a managed Medicaid company.

As a result of the change, Mariano, 49, who requires multiple health care services, is no longer able to see her longtime primary care physician in Armonk, has had her coverage for her prosthetic legs and physical therapy eliminated and must pay more out of pocket for personal supplies.

Additionally, her two trusted home aides, who combine for two shifts every day, saw their pay cut by 50 cents an hour.

“Being disabled is expensive and it’s all backwards because they have so many limitations on what you can earn that you’re not allowed to make over a certain amount before they start cutting,” Mariano said. “(But) you have to make so much to be able to cover your expenses and while Medicaid has been a safety net – it’s been both a blessing and a curse – managed Medicaid is less of a safety net.”

During the past few weeks, she and a group of friends and community members have launched a letter writing campaign asking Gov. Andrew Cuomo to intervene. On May 18 and 20 in downtown Armonk, she was able to collect 84 signatures of people who signed letters. An online campaign has added another 114 names.

Mariano said the change in coverage can be traced to the governor’s Executive Order 42, which created New York State’s healthcare exchange in April 2012. While that order also bolstered the coverage for those suffering from chronic conditions such as diabetes and mental illness, Mariano said she found herself sent to a managed Medicaid plan shortly after it took effect.

In 2013, she was able to be returned to straight Medicaid, but last year she received a letter that as of Aug. 1, 2016, she would again be switched to a managed plan. This time her efforts to be reinstated have been ignored.

One of her friends, Diane Rowan, who helped Mariano collect signatures during the May 18 Third Thursday celebration in downtown Armonk, said the coverage is taking its toll.

“She’s tried to go through proper channels, through all the government agencies and it’s just totally brick walls all the time, and it’s really a shame,” Rowan said. “She doesn’t want to be constantly relying on other people.”

Last week, the governor’s press office referred The Examiner’s questions regarding Mariano’s situation to the state Department of Health. On May 25, the agency responded with a one-paragraph prepared reply to the inquiry.

“Medicaid managed care plans have member services to assist members in locating providers,” the statement read. “The New York State Department of Health also operates a complaint line for members who may need further assistance. If in-network plan providers can’t provide a specialty service there are ways to see out-of-network providers. There is also an ability for people to change plans.”

Kim Zimmerman, another friend, said she is concerned that despite a life of overcoming obstacles, the complexity of her care will see a largely independent and active person possibly see a diminished quality of life.

Since a spate of medical procedures the past few years, including two spinal surgeries and a second hip replacement, Mariano has required physical therapy from the procedures and to be able to walk again with her prosthetic limbs, Zimmerman said.

Instead, Mariano, whose parents adopted her as a toddler and was the first disabled student to be enrolled in the Byram Hills School District in 1972, is in a wheelchair and needs more help than before. She has been a motivational speaker who talks to school groups and various organizations.

“To get her up again and walking, which is what she used to do, she would get herself up, get herself dressed, she would drive herself, she was living independently for such a long time,” Zimmerman said. “And then she starting having these surgeries and complications and things, this is what her life is now. But if there’s anybody who can get up and walk again, it’s her.”

Mariano said she fears the smaller reimbursement could force her two current aides to look for work elsewhere. That would be another blow, especially since it took a long time to find two trusted aides.

“For them to have taken a 50-cent an hour pay cut, it’s not fair and it’s been hard for them financially and I’m always worried that they’re going to go and get another job,” Mariano said. “I finally have two aides that are good to me.”

Mathuri McCleary, who has been one of Mariano’s aides for the past two and a half years, said she works as much as 54 hours a week so the pay cut adds up. Her colleague has been capped at 40 hours. It’s been difficult but so far she has been managing.

Zimmerman said for all those who know Mariano, they are going to dig in for this fight for the long-term.

“I’m determined. She’s family to me and I’m determined to do whatever is physically and humanly possible,” she said. “She’s a very special woman. She really is.”