States’ Refusal To Expand Medicaid Is A Great Way To Keep Poor Families Down

begging-hands-poorSeveral states are refusing to expand Medicaid next month, meaning the poorest of poor families may be completely unable to obtain any kind of health insurance. I understand money doesn’t grow on trees and states’ budgets are super tight, but come on, health insurance isn’t like food stamps or subsidized housing. Don’t get me wrong, these programs are important, too. But there are other solutions to food insecurity and homelessness. Move in with a friend. Work at a restaurant. But if you need health insurance and can’t get it, it’s not like your neighbor or mother is going to be able to pay your medical bills.

From the New York Times:

Sandy Praeger, the insurance commissioner of Kansas, said she would help consumers understand their options.

In most cases, she said, adults with incomes from 32 percent to 100 percent of the poverty level ($6,250 to $19,530 for a family of three) “will have no assistance.” They will see advertisements promoting new insurance options, but in most cases will not learn that they are ineligible until they apply.

Administration officials said they worried that frustrated consumers might blame President Obama rather than Republicans like Gov. Rick Perry of Texas and Gov. Bobby Jindal of Louisiana, who have resisted the expansion of Medicaid.

And to put it in practical terms, here’s a quote from Jonathan E. Chapman, executive director of the Louisiana Primary Care Association: “If the breadwinner in a family of four works full time at a job that pays $14 an hour and the family has no other income, he or she will be eligible for insurance subsidies. But if they make $10 an hour, they will not be eligible for anything.”

I used to get all bent out of shape when my husband and I were making just enough to land us right at the cutoff for government aid, specifically Medicaid. Yeah, they have to draw the line somewhere, but why did it have to be there? We were still poor, and it didn’t seem fair that we weren’t quite poor enough to qualify.

Well, this new situation makes me feel like a royal asshat. When I was complaining about our ineligibility for Medicaid, we were having no problem with our basic necessities, and my husband and I were both on career tracks that had the potential for us to earn more down the line. In short, we weren’t thriving, but we were okay.

That’s not the case for families living in poverty. These are the kind of people who will probably earn basically the same hourly wage their entire lives, who may be disabled and cannot work, or who may be responsible for dependent children or disabled family members. What happens when these workers’ children or parents become hurt or ill? It sounds like, without Medicaid, they’re facing bankruptcy, which is just another lock on the door keeping them from overcoming their situation.

This decision enrages me, and it looks like it’s just another ploy to keep the wealth gap exactly as it is.

(photo: Antonov Roman / Shutterstock)

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  • Shelly Lloyd

    Move in with a friend? Work in a restaurant? That is your cure all for the hungry and homeless. WTF? Years ago when my husband and I were just starting out and we were young and very, very poor I did work in a restaurant. And let me tell you they did not give me free food because I worked there. All employees got was a 10% discount. That was not enough to feed us. There was many time there was no food at home, and I could not spend my tips on food because everything had to go to rent. I remember working 2 days with the only food at home was saltine crackers and having to go to work and serve food all day while I was starving.
    You seem to be very out of touch with what the working poor has to go through.

    • Amanda Low

      Whoa, whoa, whoa. Not attempting to present a cure-all here, that was just an isolated example. I worked as a server for three years and my husband has been in the restaurant industry his whole life. Discounts vary depending on where you work, but there were times I’d come in and be completely broke and my manager would buy me a meal because I was starving. So I’m certainly not out of touch, and I’m sorry for what you went through! That sounds really horrible.

  • Valeri Jones

    This is a little scary. We have a family of 5 and we are barely within the cutoff to receive Medicaid. We are actually eligible for food stamps as well, but it’s only like $200 a month. Even though it would help, we recently chose not to take those because we make enough to be able to buy our own groceries and there are too many needy families out there. If my husband or I were to get a $1 an hour raise (which will be happening within the next year), we will no longer be eligible for Medicaid. I work at a restaurant, and my employers don’t offer health insurance. Just life insurance policies and accidental injury things. Therefore, my husband will have to pick up insurance through his work on all 5 of us, and it will cost him so much out of his paychecks that we won’t be able to live. We would be better off if I quit my job, taking our household income down enough so that we would still be able to get the health insurance. Of course, then we would have to sign up for food stamps again because we’d never be able to buy groceries on just what he makes. It’s a vicious cycle, and I wish they would find a way to fix the system so that people didn’t fall through the cracks.


    As a Canadian with access to excellent affordable health care, I find the American experience mind boggling! Not once in my life have I ever had to worry if I could afford health care for my children or parents. If we need it, it is there – emergency surgery, chemotherapy, knee replacements, etc. Sure we may have to wait a bit for non-emergency treatment but we get it despite our income level. To us, this seems like a basic human right. How can Americans accept this inequity in their society?

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