Lee Hepler, 11, was crossing the street just as he had a thousand times before. But this time a car slammed into him, inflicting major internal injuries and severe trauma to his head and chest.
After eight weeks in intensive care, Lee was brought to The Hospital at The Children's Institute of Pittsburgh -- paralyzed, limbs contracted, on a ventilator, essentially non-responsive and suffering "thalamic storms" -- life-threatening instability in the part of the nervous system that controls functions including blood pressure and heart rate.
The story has a happy ending: Lee has returned to school, and is enjoying his family and friends. He has his life back because of two factors.
The first is his own extraordinary determination and strength. The rehabilitation process tests body, mind and spirit -- and, with strong support from his family, Lee met every challenge.
The second is access. Medicaid made it possible for Lee to benefit from the region's most comprehensive and intensive pediatric medical rehabilitation program. For nine months, he was treated by physicians and nurses; physical, occupational and speech/language therapists with whom he had multiple sessions every day; a nutritionist; a psychologist; and a rehabilitation engineer who tailored a series of assistive devices to Lee's evolving needs.
Lee was among the 50 percent of our inpatients and 43 percent of our outpatients who rely on Medicaid for their health care coverage. Families often have health insurance, but a devastating injury or illness can easily push coverage beyond its limit.
That is why we -- along with other health care institutions -- are deeply concerned by the possibility that Pennsylvania's leadership will not accept the federal Affordable Care Act monies allocated for an expansion of Medicaid. Federal funds will cover 100 percent of any expansion for three years and 90 percent after that.
Some Pennsylvania leaders believe that an expansion will be costly for the state, but a new study says otherwise, asserting that a Medicaid expansion will actually produce billions of dollars in economic activity and create thousands of jobs while providing health care coverage for approximately 700,000 Pennsylvania adults and children.
Across the country, it looks as if the majority of states will accept the ACA monies and expand Medicaid. Fewer than 20 states are likely to refuse. Sadly, the split is primarily along party lines, although some Republican governors -- for example, Rick Scott of Florida and John Kasich of Ohio -- are accepting the ACA funds, expanding Medicaid and putting the health of their citizens before party ideology.
Time and again, The Children's Institute receives calls from hospitals in the quad-state area: Another young person like Lee is ready to be released from acute care, but still needs a great deal of both medical and rehabilitative care in a hospital setting.
Many of these children and young adults are medically complex, with serious, even life-threatening, health conditions in addition to the injury or illness that necessitated the acute-care hospitalization.
We are the right place for these young patients. We have capabilities unparalleled in the region. We are the only freestanding pediatric rehabilitation specialty hospital in Pennsylvania, and one of only 20 in the country. We hold accreditations no other institution in the state has earned.
Because we know we can make an enormous difference in the quality of life of these young people, we never turn a patient away because a family is unable to pay. That has been our philosophy and our practice for more than a century.
But we are an independent nonprofit organization, and our financial resources are limited. What will happen when they are depleted? Without quality rehabilitation, the children who need us will be far less independent and far less productive than they could be. That's a sad loss -- for them, for their families and ultimately for society.
With an expansion of Medicaid, more families who turn to us will have insurance coverage. Our resources will therefore stretch further, and many more ill and injured young people will get their lives back.
That is why we strongly urge Pennsylvania's leaders to rethink their position on expanding Medicaid. To aid in their deliberations, we extend this invitation:
Gov. Corbett and Pennsylvania legislators, please come visit our hospital and meet our amazing kids and families. See what Medicaid does every day. Then make the decision that will help guarantee that future children and young adults will be able to receive the medical rehabilitation services they need and deserve.
David K. Miles is president and CEO of The Children's Institute of Pittsburgh (www.amazingkids.org).