Falling Through the Cracks in a Medicaid Non-Expansion State


I have spent my entire adult life working for hospital systems. I did the very best I could to assist anyone and everyone through their medical crises. These were often financial ones rather than medical ones. I have seen both the professional and personal sides of our medical and insurance industries in the United States. Yet I am still absolutely shocked that our government is casting a large demographic of people aside while we are literally fighting for our lives.

I worked for almost 14 years for one employer. I always received “outstanding” performance appraisals, and was seen as a stand out employee. My employer was healthcare based, yet I was terminated in a very underhanded way using legal loopholes because I received a cancer diagnosis. I fought my cancer for almost five years, but still worked through my appointments, my treatments etc. But I was an expensive employee to keep on the books due to the cost to the companies medical claims payouts. I was absolutely shocked and blindsided when I received a letter in the mail informing me that I was terminated.

While the company spun the line that I was too ill and missing too much time to stay employed, they also terminated my disability claim stating I did not fit their criteria for being unable to perform my job duties. Again, I was astounded by this statement as I can no longer live independently and require assistance to complete daily living activities. I won’t go into massive detail, but the medical evidence is overwhelming that I do qualify as a disabled individual. It amazes me that it is legal for the same company to fire me for being too sick to be a valuable employee, yet they can also claim I am healthy enough to work.

I am a single woman with no dependents. This means I went from one income to zero income immediately and without warning. Since I have three independent cancers, a multitude of physicians, medications and treatments that are ongoing to continue living, this was a terrifying situation for me to find myself in.

Since I no longer had health insurance and zero income, I immediately applied for Medicaid so I could continue my therapies. After much discussion, many forms and an unreasonable amount of time, it was explained to me that I am denied Medicaid coverage due to my state being a non-expansion state. I qualify from a financial standpoint, however, until the department of disability services qualifies me as officially “disabled” they will not offer me coverage since the state has a work requirement. However, I am too sick to work. If I even tried (which would be unsuccessful) it would tank my disability case.

The case worker at Medicaid explained to me that they usually have a decision very quickly, yet I have now been waiting for 10 months. Ten months without treatment, 10 months allowing my cancers to spread and my body receiving no medical treatment that it desperately needs. They use the same entity that SSI/SSDI uses which can take one to three years to get a true determination. I could very easily be dead before they reach a decision. I have also been unable to secure any help with my prescriptions, which are many.

Many hospitals provide charity care. However, you need to see a doctor to get the orders to receive treatment from the hospitals. It’s an absolutely vicious cycle.

Unfortunately, many of the roadblocks are because I was diagnosed with cancer in my 20’s. There are very few programs for people in my demographic, yet we do exist. There is a mentality that young people shouldn’t need help. I truly wish I didn’t.

I have tried writing government representatives with no success, either.

I am left simply amazed that in the land of wealth, our government is perfectly fine with allowing its citizens to suffer and die.

I hope every day that a solution is fast approaching, but am disheartened by how many people are touched by these “gaps” or “loopholes.” People should not suffer medically because circumstances beyond their control have touched their lives and made them indigent. The very thought is inhumane.

Not everyone has a support system. Not everyone knows someone who can pay for a roof, clothes, food, let alone the high cost of healthcare. When will enough be enough and people realize how very wrong this is?

I never imagined that after losing everything I have ever worked for, it still would not be enough to satisfy their unrealistic, evil and greedy requirements just for a shot at existing in this life.

What is enough; when is it enough? The mountains of medical records aren’t. The empty bank statements aren’t. The disconnect, repossession and foreclosure notices aren’t.

I am left with overwhelming disgust that we are not doing what we should on the very basic level of helping our own citizens. If you live long enough to be declared disabled by the government, it’s not unusual to still be denied as “over income” due to just disability income.

Maybe it’s never enough.

Change is definitely needed. I still hope some solution comes soon, but I will still be very ashamed and disappointed in the process.

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Getty image by GolfX.

 

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