The Tennessee Justice Center is a nonprofit public interest law and advocacy firm that serves Tennessee families. The award is in recognition of Samborski’s love and dedication to gaining desperately needed support and health care for her husband.
Samborski is her husband’s translator. She speaks for him when he canTt find the words. She helps him understand when people are talking too fast. In church, she takes notes on the sermon so her husband, Mike Samborski, can read and understand.
“He calls me his interpreter,” she said.
Itts not that Mike Samborski doesn’t speak English. He can read, write and speak just fine. But he has receptive aphasia, a brain condition resulting from a stroke in the fall 2013. The aphasia means his brain has trouble interpreting others’ speech. “A lot of times, it goes to writing things down,” Karen Samborski said.
Mike Samborski was a landscape designer and stone mason and owned his own business, but after the stroke he couldn’t go back to work, and his wife had to leave her work in retail management to help care for him. In the fall 2014, the couple moved from Massachusetts to Lebanon, to live with Karen Samborski’s twin sister and her husband until they could get back on their feet.
In Massachusetts, Mike Samborski received speech therapy through the state’s Medicaid program. The couple thought he’d be able to get help in Tennessee, too. Karen Samborski tried to research coverage options for her husband before they moved, but information was scarce.
“It was unsettling to move down here and hope it all falls into place,” she said.
After they arrived, Mike Samborski applied for TennCare. They waited months for a decision, but no one they talked to could tell them whether he would be eligible. Finally, he was turned down.
Confused, Karen Samborski called the Tennessee Justice Center for help. Even though her husband was declared disabled by the Social Security Administration, he was still in the two-year waiting period for Medicare and was not eligible for any health insurance in Tennessee. Tennessee’s Medicaid program (TennCare) is much more restrictive than in Massachusetts.
To make matters worse, they were not eligible for assistance to buy coverage at healthcare.gov. They were in the coverage gap.
“It was shocking to come down here and find it was totally different,” Karen Samborski said. “I was just so disappointed. I saw how well he responded to speech therapy back home. I saw what an improvement it made.”
She was even more devastated to learn that Insure Tennessee, a plan that would have provided coverage to people in her and her husband’s situation, had failed in the state legislature.
“It’s a loved one’s health.” Karen Samborski said. “Why do we have to put a price on that?”
Staff at the Tennessee Justice Center explained the complex policy and political situation that had left her and her husband behind. TJC also found a way to get them coverage. If Karen Samborski took a part-time job, she and her husband would have enough income for assistance on the marketplace, and she could still be home part time to care for her husband. TJC connected her with a health insurance navigator, who helped her select a plan.
When Mike Samborski’s Medicare finally started, TJC connected them with a Medicare advocate to find a plan covering speech therapy. And when tax issues about their home in Massachusetts threatened to complicate their coverage, TJC worked with the Legal Aid Society to answer her questions. Because of TJC’s efforts, the couple is now out of the coverage gap. While they still have health care challenges, they have both been able to see a primary physician.
“I’ve been very lucky to have had my wife with me through this whole time and still helping,” Mike Samborski said. “This stroke has been rough for both of us. In some ways we are closer now than before even though we’ve always been there for each other. Having insurance has lifted a heavy burden off of our shoulders.”
For her part, Karen Samborski is glad she can help her husband navigate the world.
“This was part of our wedding vows,” she said. “We took a vow, ‘in sickness and in health.’s