Valor House caseworker: 7,000 Montana veterans desperately need Medicaid expansion

Ezra Davis

I served our country from 2001 to 2005 as a member of the United States Army. During this time, I spent a year in Iraq serving in the Headquarters unit of 1-8th Infantry out of Fort Carson, Colo. Following my service, I became involved with veterans advocacy, but was unfulfilled with the results I was seeing.  

Seeking something with more tangible measures of success, I became employed as the case manager at the Poverello Center’s Valor House transitional housing program for veterans who are experiencing homelessness.

Sam is one of 17 veterans currently staying with us at the Valor House. He arrived at the Poverello Center last spring after being unsheltered for over a year in a rural community in western Montana.  Due to his veteran status, we were able to get him into an apartment at the Valor House.

Sam is a combat veteran who served during Operation Iraqi Freedom, but unlike myself, he does not qualify for VA benefits due to a negative discharge he received as a result of persistent mental health symptomatology.  While serving, instead of facing the stigma of seeking out a mental health care professional, Sam chose to remain quiet and not disclose the difficulties he was having.

Although Sam’s mental health condition predates his military service, combat-related trauma clearly exacerbated his condition. Receiving a discharge upgrade would allow Sam to receive benefits. This seemingly practical solution may take years and is not as accessible as it may seem at first glance. Mental health diagnoses made in childhood, along with scant mental health records regarding his combat experience make for major hurdles to Sam’s discharge upgrade.  

Sam is not the only veteran we serve who does not receive VA health care benefits. About 30 percent of the veterans served through the Poverello Center’s programs are not eligible for VA health care benefits. To receive care through the VA, veterans must meet certain criteria in terms of time served, disability and income. For example, many service members after 1980 served less than two full years, and therefore are ineligible for VA care. Other examples include Reserve or National Guard veterans who do not qualify for VA benefits because they do not meet deployment requirements as an active duty service member, despite serving loyally for years.

Medicaid expansion has given Sam the opportunity to be one of the 7,000 veterans in Montana who has been able to get health care services. Through Medicaid, Sam receives dental care, which is generally not available to most veterans, even for those who receive VA health care.  Sam’s holistic care offered through Medicaid has stabilized him enough to begin to look for permanent housing.

If Medicaid expansion is rolled back, or if onerous work requirements are added to the program, it could have devastating consequences for Sam and the 7,000 veterans who now receive health care through Medicaid. In the future, Sam may be able to work again, but right now his mental health stability requires his full-time focus. If he loses Medicaid, either because of a rollback or because of a work requirement, his progress will be stalled and he will likely continue his cycle of homelessness.

I work daily to make sure that every person who served our country, whether voluntarily or as a draftee, has a stable, safe and warm place to live. No one should be without secure housing, especially our veterans. I am asking our elected officials in Helena to help make this fight a little easier.  Help me move Sam out of homelessness by doing the right thing: renew Medicaid expansion and refuse to make changes to the program that would hurt our veterans in Montana.

Ezra Davis, MSW, is a case manager at the Valor House in Missoula and is a Specialist US Army E-4 veteran.