Faces of Medicaid
Medicaid provides health and long-term care coverage to nearly 70 million low-income Americans across the U.S. and is an integral part of the nation’s health care system. Since its enactment in 1965, Medicaid has evolved considerably at the national and state level as policymakers have turned to the program to respond to America’s diverse and changing societal needs. Today, the program provides access to affordable health insurance for low-income Americans, a healthy start for millions of children, access to essential services and supports for children with special needs and broader coverage to many individuals with severe physical and mental health conditions, facilitating independent living and community integration. Medicaid also supports poor Medicare beneficiaries and shoulders the high costs of long-term care for those who could not otherwise afford it.
The stories here reveal the range of experience and diverse roles that Medicaid plays in the lives of Americans across the U.S. These stories are not intended to be an evaluation of the program, but to get underneath Medicaid’s statistics and provide insight into individual experiences with the program. We have provided links to Foundation resources that complement these personal stories.
We gratefully acknowledge Mad Squid Media for their video production services and to the families who were kind enough to share their stories with us.
“Now I have an understanding of why these programs exist and how they can benefit people who are hard-working Americans who just aren’t at the place yet where they can afford private health insurance.”
Todd is a full-time student and works two part time jobs. His wife Erin stays at home with their 8 month old baby, Jane. Erin had Medicaid coverage during her pregnancy and the two months that followed but she and husband Todd are now uninsured. They earn too little to qualify for subsidies in the Marketplace but too much to qualify for Medicaid in Utah.
- Children’s Health Coverage: Medicaid, CHIP and the ACA
- The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid–An Update
- The Uninsured: An Interactive Tool
“[When I was uninsured] I would get a bill for $3,000, $1,500 dollars, it got astronomical…Medicaid has just been a big help to me…I don’t have to worry about that along with everything else.”
When Wendy lost her job in 2009, she lost her health insurance with it. While unemployed and uninsured, Wendy began noticing symptoms of what turned out to be pernicious anemia, a treatable but incurable condition affecting the body’s red blood cells. Hospital visits and treatment led to serious medical debt, which Wendy was unable to pay off. She now has a temporary job but no offer of employer health coverage. When Ohio expanded Medicaid under the Affordable Care Act in January 2014, Wendy became eligible. With this coverage, Wendy is able to receive treatment for her chronic condition.
- The Effects of the Medicaid Expansion on State Budgets: An Early Look in Select States
- How will the Uninsured in Ohio Fare Under the Affordable Care Act?
“Our private insurance doesn’t cover all the specialists that he needs to see and Medicaid really helps supplement…it changes our life—for the better.”
Sam is six years old and has fragile X syndrome and mild autism, resulting in various developmental disabilities. He has private insurance but it doesn’t cover all the specialists, services and therapies that someone with his condition requires. Through a Medicaid option, Sam is able to receive Medicaid as supplemental insurance to “wrap around” the services that are not covered by his private insurance, including occupational therapy, physical therapy and speech therapy.
“[Through] a Medicaid waiver program, tailored for people with disabilities, Abdul got an internship and a job coach, who helps him to navigate his work environment and feel more confident…”
Abdul was born with several developmental disabilities which affect his ability to learn and communicate. Through a Medicaid waiver in his state, Abdul received an internship placement, as well as a job and transportation coach. He was eventually offered full-time employment at his internship site, which is where he works today. His job and transportation coach give him the skills he needs to navigate his environment, be effective at work and become more independent.
- Olmstead’s Role in Community Integration for People with Disabilities Under Medicaid: 15 Years After the Supreme Court’s Olmstead Decision
“Medicaid allowed me to have the same care as everybody else, in the same respiratory hospital and in this nursing home…there’s no discrimination.”
Penny is a senior with Guillain-Barré Syndrome and resides in a nursing home. As a result of her illness, she is unable to walk and needs 24-hour access to care. Although she is eligible for and enrolled in Medicare, Medicaid pays for her long-term care needs.
- Medicaid and Long-Term Services and Supports: A Primer
- Medicaid’s Role for Dual Eligible Beneficiaries
“My children currently have Medicaid…it’s a blessing. I myself do not…which frightens me because I am their caregiver.”
Maria is a registered nurse at a community health center in Texas. She doesn’t earn enough to purchase private health insurance for herself or her children and doesn’t have employer coverage. Because of her income, the children qualify for and are enrolled in Medicaid but as an adult, Maria remains ineligible and uninsured.
- The Impact of the Coverage Gap in States not Expanding Medicaid by Race and Ethnicity
- Are Uninsured Adults Who Could Gain Medicaid Coverage Working?
“I’d really like to be able to help somebody, the way they’ve helped me…To me, Medicaid means I’ve been given a second chance.”
Bill was 27 years old and working as a nurse when he had his first mental break. He was admitted to the hospital and diagnosed with bipolar disorder. Because of the severity of his condition, Bill had to stop working and spends 30 hours a week in a day program while taking medication to manage his condition, both of which are covered by Medicaid.
“Medicaid coverage in Arkansas was expanded [in 2014] and I was then covered…It was such a relief…Now, I’m just like anyone else who works and has insurance.”
Kim works as an assistant to a general contractor. Before gaining coverage through Arkansas’ Medicaid expansion, she was uninsured for a period of 12 years. During that time, she was unable to get preventive care and avoided seeking medical attention, due to cost, until she was extremely ill and required hospitalization. Her son Steven has had Medicaid since he was 3 years old, receiving preventive care, as well as treatment for his asthma and allergies.
“My mom had Medicare at the time of her stroke but it did not cover long-term care. To us, Medicaid means being able to live with dignity, in the community, with friends and family.”
After Mary Francis suffered a stroke in 1999, she relocated from Oklahoma City to Richmond, Virginia, to live with her daughter, Mary. Her stroke left her with no muscle control on the left side of her body, and she has since required the help of a caregiver for everyday activities, including walking and meal preparation. She sold her home and spent down all her assets in order to become eligible for Medicaid, and Medicaid now provides her access to an adult day center during the week, as well as self-directed home and community-based services (HCBS). She has chosen her daughter, Mary, as her full-time caregiver.
- Serving Low-Income Seniors Where They Live: Medicaid’s role in Providing Community-Based Long-Term Services and Supports
- Medicaid Home and Community-Based Services Programs: 2011 Data Update
“Because she [Maxine] is able to stay in her own home, she feels a certain amount of independence.”
Maxine is a 90 year old woman who has diabetes, spinal stenosis, and short-term memory loss. These conditions require her to have a full-time caregiver to assist with cooking, cleaning and other daily activities. It was important to Maxine to remain in the home she has lived in for the last 65 years rather than moving to an assisted living facility. Through Medicaid, Maxine is able to receive home and community-based services (HCBS) and to self-direct her care. She has chosen her daughter, Susan, as her caregiver.
- Medicaid and Long-Term Services and Supports: A Primer
- Long-Term Care in the United States: A Timeline