Close The Medicaid Coverage Gap

By Anthony Cook, Otherwords

I have terrible chronic pain that’s left me unable to work for the last few years. I can’t sleep well, and every day is a battle just to take care of myself.

It would be life-changing if I could be seen by a doctor. But I’m one of the 2 million Americans caught in what’s called the Medicaid coverage gap: we’re people in a no man’s land who can’t afford health insurance on their own, but aren’t eligible for their state or federal health insurance programs.

I’ve worked hard for decades and saved for my retirement, but I currently don’t have enough income to get covered through an Affordable Care Act marketplace plan. I also don’t qualify for the Medicaid program in my state of Texas, since it doesn’t offer any health insurance options to adults like me who aren’t yet 65 years old, aren’t pregnant or caretakers of young children, and don’t meet the state’s very narrow definition of disability.

I try my best not to be a burden to those around me, but even something as simple as getting up to answer the phone is difficult. I struggle to use my hands since my fingers have become crooked in the past year due to arthritis that I can’t afford to see a doctor about. I also need care for my bad hip, knee, and shoulder.

But I have no way to get health care that I can afford. Texas is my home, and home to over three-quarters of a million others stuck in the Medicaid coverage gap like me. Year after year, Texas has refused to expand Medicaid, leaving us with no options for affordable health coverage and care.

Instead, I’ve been trying my best to manage my pain with over-the-counter medicine like Tylenol and at-home remedies because those are all I can afford. Even for these, I’m quickly draining the money I’d saved for retirement.

I worry every day about what I’ll do when that money runs out — especially when the pain becomes unbearable and I have to make the difficult decision to go to the emergency room. Each time I go, I have to pay out-of-pocket. Those visits cost me at least $300, sometimes much more. With my savings running low, I know there will come a time when I won’t be able to afford this kind of last-resort option either.

When I’m discharged from the emergency room, the doctors send me home with referrals, urging me to see specialists so I can get the care and treatment my body needs. But I can’t —  those offices won’t even book an appointment with me until I have insurance.

If Texas expanded Medicaid, I’d be able to actually see those doctors who could help me get my body fixed — rather than just patching it up at the ER while I suffer through painful, fixable problems.

I want to be able to see a doctor. I want to feel relief from the pain that is getting worse every day. I want to be able to work. I want to be able to take care of myself and improve my quality of life.

Close the Medicaid coverage gap, in Texas and everywhere else.