On MedicaidOctober 12, 2012
When Clark and I divvied up cancer-related responsibilities, the task of getting Medicaid for him was assigned to me. He didn’t have health insurance when he was diagnosed, and because of his advanced pre-existing condition, no company would give it to him. Luckily(?) for us, his cancer and broke status qualified him for the government’s plan for the lowest-income Americans. (Here’s a great Medicaid explainer from the AARP.)
Let’s say, in a fit of tolerance for bureaucratic bullshit, you get your car inspected and wait at the DMV to process your registration, all in one day. Hanging out at the D.C. Medicaid office is 10 times worse. And I imagine I had more resources at my disposal than most applicants – printers to ready my forms in advance and easy access to the Internet. There’s a Web portal now, I see (though it says “Web Registration” instead of “Apply for D.C. Medicaid”), but there wasn’t then — I had to take off work and apply in person. It took two days because the first time, I was turned away from the “wrong” IMA Service Center, even though it doesn’t instruct applicants to go to a specific one on the website. Clark received his approval almost immediately, eight days after I applied.
Medicaid then reimbursed me for a portion of the $15,000 I’d paid out of pocket for his initial scans (I had some savings from a settlement I received after a car accident). It paid for his doctor visits at Georgetown. We had first visited some doctors and had tests performed in Virginia, and bills for those medical treatments, I think, are still unpaid. He’s dead, and we weren’t married, and it was easy to ignore phone calls and mail in the aftermath of losing him. But the D.C. treatments and doctor visits – all of those were covered.
Clark didn’t need the Medicaid for medical treatment once he enrolled in clinical trials – those services were paid for since he was a guinea pig in the hospitals’ experiments. During his first trial, Medicaid paid for all but $1 of each prescription we filled, and there were times when he was taking five different drugs per day. When he was at NIH, they took care of the cost of his drugs with an internal pharmacy.
Everything was so terrible all of the time, I can’t imagine how much worse things would have been without Medicaid. When his cancer progressed too far and he was kicked off the last NIH trial, his Medicaid paid for last-ditch-effort chemo. In those early days, the reimbursements for the money I shelled out paid for food and rent. I was making $40,000 at the time, and I had to cut down shifts at my second, part-time job to accommodate his needs. We lived in pricey D.C., and we certainly struggled, but it would’ve been worse without that money.
With the upcoming election, it’s come time, though, to imagine how much worse it could have been. It could be as bad as if you’re a family of three making, say, $10,000 per year and fail to qualify for Medicaid because of the change in eligibility the system will suffer if Mitt Romney is elected to the presidency. And if you live in one of those places, you might not have access to a free, viable alternative like a clinical trial to help fight your serious disease. You’re poor and sick and fucked.
This is not a minor point of technocratic disagreement. It represents a massive change in our commitment to providing decent medical care for those who can least afford it. Medicaid, much more than Medicare, demonstrates what’s really at stake in November’s election.
I am so grateful Medicaid was there for us when we needed it. I am so grateful I’m not in a position to need it now. I am disgusted that taking it away as an option for one of the most vulnerable populations in the country is actually on the table.