When my husband and I were signing the documents to adopt our three children from foster care, we didn’t realize we were becoming Medicaid parents. As wards of the state of Texas, our children’s health care was provided by the state until our adoption was finalized 6-8 months later. Only after their names had been legally changed and the court gavel dropped, would they be eligible for either of our employer based insurance programs.
I am ashamed to say that my first thought was, “Finally, after all these years of paying into this system, I get to use it.” Despite being relatively progressive in my politics, my experience with entitlements was limited and mostly philosophical. I thought it worked like my insurance plan but with the state of Texas picking up the bill.
That was until my youngest fell on the playground at school and sustained a rather large cut. New mother worry demanded that I pick her up and cart her off to the “doc in the box” around the corner from my office. I entered, with my SMU shirt on, filled out the paperwork, and was immediately told that they didn’t take Medicaid. When I asked how much a visit would be out of pocket, I was informed that if she indeed needed stitches it could be in the hundreds if not thousands of dollars and it was payable at the time of service. I went to my seat with a bleeding 4-year-old and my iPhone trying to find any quick care facility that took our coverage. Each time I was told, “Oh she has Medicaid, she has to go to Parkland’s emergency room.”
The emergency room for a non-emergency? I was outraged and I was vocal. Finally, a doctor in the back of the facility who overheard my conversation came out and sat next to me. “Look,” he said, “this isn’t official, but she doesn’t need stitches just a good Band-Aid. You don’t need to go to Parkland to sit for three hours to be told that.” I thanked him profusely. I began to wonder what fresh hell was I signed up for.
That question was answered when I had to take my son to the Medicaid Clinic about 20 minutes from our home. Because we lived on the ‘good side of town’ people in East Dallas like us had to drive at least 20 minutes to get care. Never mind the fact that there were plenty of average people living in our neighborhood. The facility near the industrial part of Dallas was stark and institutional. No painted balloons, copies of Highlights or toys to keep little ones occupied. Just rows of blue plastic chairs and an overhead tv mounted on the wall that was on mute.
The intake nurse barely looked at me as she asked me about the paternity of my son and the other children in my house. After asking about my drug habit which she assumed I had, she already had checked the highest grade of education as “high school” without asking. “Um, nurse, I am sorry, but you are incorrect I have a graduate degree.” She looked at me and said, “No that’s for people who have been to college not graduated from high school.” I just sat there staring.
The doctor who treated my son was as dismissive. No doubt given the state of the waiting room, we were just one of several dozens of patients who had to be seen. He too asked about paternity and ‘who I lived with.” He asked if I could read the instructions he was handing me. When I asked, when would he like to see my child for a follow-up, he said that it was doubtful that he would be the one to see him because he had gotten a position at a ‘better facility.’
Waiting to check out I saw others—mothers, fathers, grandparents, and aunts being treated like cattle on a long drive. Hispanic? Then expect to be treated even worse. Three times I endured that horror. Each time becoming sadder and madder. While I realized that I only had to endure this for a few months it broke my heart that so many in these waiting rooms this was the best care our society decided that they deserved.
I wish I could tell you that it was easier trying to get them glasses or seen by a specialist or surgeon. The eye doctor’s appointment was a 5-month wait. Behavioral Health Assessment—sorry, we can get you to a social worker but we can’t cover a psychiatrist unless he injures himself or others. Preventative care, I must say was easily scheduled even if I did have to wait for several hours for booster shots or well-baby checkups.
I haven’t shared this experience even with my children’s godparents because I was ashamed. I was ashamed that we really did need the benefits from the state—it was hard going from 0 to 3 children in a matter of weeks. Between $2000/month (roughly the amount of our mortgage) in childcare so we could work and an increased grocery bill, we were still getting our sea legs underneath us. I remain grateful to this day for the way that many of our friends stepped in to help us make ends meet that first year.
But I was also ashamed of all the assumptions I had made about people on Medicaid and my false belief that they were getting some gold standard of care. I was ashamed that my country, had relegated the ‘least of these’—people who got up every morning and worked at McDonald’s, in our stores, cleaning our floors, or cleaning our houses to a level of service that no member of Congress would ever let themselves, let alone their children suffer through. There are facilities we have found that are innovative and take Medicaid—Children’s Healthcare network is wonderful but trust me, it took all of my research skills to find them. Also because every parent wants the best care for their child, the wait for basic services can be incredibly long.
Don’t get me wrong. As an economic system, I must admit I am attached to capitalism especially when it affords me all the stuff I want. But it takes someone naïve or cruel to think that in an economic system designed for survival of the fittest that there is no obligation for the fit who survive (if not thrive) to provide for the human carnage left in our wake.
There are 15 million children in poverty in the United States. Cutting Medicaid is cutting care for THEM. Cutting Medicaid is not cutting a budget line, its cutting care for Samuel, Penny, Edward, Maria, Grace, Sandy, Terry, Bora, Alex….
When you or a friend is ranting and raving about entitlements ask yourself: are these children entitled to care? Are they entitled to hot lunches? Are they entitled to reading programs? Are they entitled to booster shots? Because trust me if we don’t pay for them now, we will pay for them in the cost of lost productivity and mass incarcerations. Trust me, no matter what my most conservative friends argue—people on Medicaid ARE working. No, they don’t get up every morning to scam the system. For what? To live in substandard housing and go to substandard schools. Public Assistance provides the following- vouchers for housing no one will accept; care offered at bare minimal standards; and food provision at sustenance levels. No, you can’t get your nails done on WIC. You can’t your hair done on CHiP. What you can get is judgment without merit and pity without justice. Frankly, our government AND our churches treat the poor in other countries better than we do our own.
The opioid crisis ravaging our rural communities is adding to the foster care rolls every day. Contrary to popular belief foster parents are not living high on the hog—for the most part, they are good people who offer children shelter in the time of a storm. Medicaid is what allows these children already victimized by adults unable or unwilling to care for their basic needs a chance of getting medical attention. It’s how the working poor, the grandparents, the foster parents, and yes, even the adoptive parent with a PhD to pay for surgeries, glasses, braces, and stitches.
My brilliant boy still struggles from the trauma of his early life. Given what he has been though, his scars won’t heal on their own. He needs care, he needs in-depth therapy—he needs a care that with an outrageous premium we now can afford. But I think of all the other little boys who need help. Children who have seen things to unspeakable for little minds to process. Where will they go? How long can they wait? How long will the last until the cognitive ingungruity explodes their lives, hopes, and sanity inot a million pieces.
Please think of them before you start talking about deficits. Call their names as you cut their care. I know I will.