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The hidden truth about Medicaid: 64% of recipients are employed workers [1]

['Maureen Herman']

Date: 2025-04-13

There's a lot in the news about the looming cuts to Medicaid and fears about potential cuts to Medicare. A lot of people don't know the difference between the two and what they do. The key lies in what comes after "Medi." MediCARE is a caring program. It's federal medical coverage you pay into with every paycheck of your life. It's there when you retire or if you become disabled before retirement age. MedicAID is aid. It's a financial aid program run by each state that provides medical and dental coverage to low income Americans. It is paid for with tax dollars from both state and federal taxes. 72 million Americans are on Medicaid, that's 1 in 5 people, 40% of which are children. 64% of Medicaid recipients are employed. That means their jobs do not offer health insurance and they cannot afford to buy it.

Most disabled Americans have both Medicare and Medicaid due to their dependence on Social Security cash benefits for the entirety of their income. The average Social Security cash benefit for retirees and the disabled is $1538.00 per month. Like Medicare, Social Security income is self-funded via one's lifelong earnings.. For the disabled, it's the same amount they would have gotten and will get when they reach retirement age. Essentially, Social Security Disability is early retirement and Medicare is its accompanying medical coverage. The elderly and disabled have exactly the same benefits. Any "cuts" to Social Security or Medicare coverage would be literal wage theft. Any cuts to Medicaid, especially the basic defunding of the entire program that is being legislated now, would be literal death sentences for some — if not immediate, then cumulatively. Over Nine million people on Medicaid are disabled.

The disabled in this country do not automatically qualify for Social Security Disability and Medicare. It is a complicated and lengthy process which requires enormous documentation and often legal assistance. Sixty-seven percent of disability applications are denied, so 4 out of 5 applicants. About 30,000 Americans die each year while waiting for a decision on their Social Security Disability applications.

On the other hand, those applying for MedicAID can qualify based on income, which makes it a far more immediate and accessible program and a true safety net for individuals, families and the disabled. It will be a catastrophic loss for this country when these cuts are implemented: no screenings for cancer or disease, people will no longer be able to get the medications they need and depend on, adults and children no longer getting regular dental check-ups, people with mental illness no longer able to get diagnosis, treatment or stay on prescribed medications, people with alcoholism and addiction no longer able to access treatment programs, pregnant women no longer able to get care or even afford childbirth, let alone access health care for their infants including the basic vaccinations we all grew up with that keep this country free of so many diseases.

Remember, 64% of these people are employed. If wages in this country are so low that so many people rely on Medicaid for their health insurance, then that is not the employee's shortcoming, it is our country's structure and lopsided wealth distribution. Companies earning record profits give bonuses not to the workers who make that possible but to the CEO's, who are given all the credit — and cash — via their assumed business acumen. Corporate profit-sharing with employees is happening less and less while corporate profits on the whole continue to rise.

Walmart is a top employer of Medicaid beneficiaries in many states. A study by the Government Accountability Office found that a large portion of Walmart employees were on Medicaid and SNAP. So the benefits grifter here is not the recipients, but the corporations who depend on Medicaid to provide the health insurance they don't want to pay for. In many cases, employees' hours are based on keeping them just below the amount the law would require the employer to offer health insurance. If anything is a scam it is that, and Walmart, which ranks as the world's largest company by revenue, is one of the biggest offenders. They have held the top spot in the Fortune Global 500 for the past 12 years, with $670 billion in revenue — more than Amazon.

I have been on Medicare since 2005 and Medicaid since 2002. When I had my daughter, I was an alcoholic and addict living with untreated mental health disorders, had no job and no home. The pregnancy was a result of a sexual assault. It was the worst time of my life. I was what most Republicans would deem a "lost cause" or in the words of Elon Musk, a "parasite." But the safety net of Medicaid was there for me. That meant I had pre-natal care, had my daughter at a hospital, got into a treatment program and stayed sober, my daughter had infant care and vaccinations, I could go to the dentist, and I finally receive diagnosis, treatment and consistent medication for my Major Depressive Disorder and PTSD from both a psychiatrist and a therapist.

The latter, the mental health care I received, completely changed my life for the better and has a great impact still today. I will never forget my psychiatrist at Will County Mental Health in Illinois. He was a very experienced doctor, retired from private practice but still wanting to use his skills for good. The medication regimen he put me on was carefully curated over time and is the basis for my treatment still today. It completely changed my life. He was the one who strongly urged me to apply for Social Security Disability. I balked at the suggestion. I told him I did not think I was disabled, that it didn't make sense. He said, "that's for them to decide." He had not steered me wrong before and I did not want to start declining his advice after all the good he'd done me, so I reluctantly applied.

When I went into the local Social Security office, the lady I had an appointment with took one look at me after I said I was applying for disability, and I could tell by her face and tone that she didn't think I was disabled either. Then she looked up my employment record and earnings and her entire demeanor changed. It took a while for her to scroll through my working life. Then she said, "you should definitely apply" and proceeded to explain to me that in Social Security terms, the definition of disability was not a complete inability to work, but rather, the inability to maintain "substantial gainful employment" for a period of 3 months or more at a time because of a medical condition. The erratic work record of a life lived with progressively worsening untreated mental health disorders was on full display and proved my psychiatrist's point.

So I applied and was accepted and categorized as "permanently disabled," though I thought that eventually I would be able to get better and have a normal work life someday. I came close many times, but ultimately I was never able to create a long-term work situation that accommodated my lack of consistent functionality while also providing the medical security I had with Medicare to stay on the psychiatric medication regimen that made my life possible. And Medicaid, as my secondary insurance, was giving me affordable prescriptions and dental care I did not have with Medicare, as well as being the only health insurance my daughter has ever had. At some point I had to accept a life of poverty dependent on my Social Security income in exchange for the stability of Medicare if I was to function at all and be able to take care of my daughter and myself.

It is not the life I dreamed of growing up in an upper middle class family in the suburbs of Chicago, dreaming of being a journalist and author, assuming all the normalcy that I'd expected in my adult life. If some sort of "Medicare for All" program had existed, I think I would have had a far better chance of creating a flexible work life that I could sustain. But the risk of losing access to my health care and loss of access to my psychiatric medications — which would cost about $50,000 per year out of pocket — forced me to accept an income of $1500/mo with the ability to earn only about $1200 more per month outside of that. It has not been easy, but so many in these programs have it even worse — especially the disabled community.

What worries and angers me now is knowing that if my situation were to arise after the declared cuts to Medicaid and the potential cuts to Social Security and Medicare (which are literally criminal), I would not have been able to survive that dark period of my life, or come through intact in a meaningful way, and certainly not take care of an infant and raise a child. That would be true even if it was Medicaid alone that was absent from the picture. So what happens to those that suffer from these afflictions and conditions now? The suffering, hardship and dire consequences they will experience are very real and will impact generations — and in some cases, extinguish generations. I cannot help but notice that kind of cruelty and the "culling" mentality is intentional — weed out the "parasites" Parasites like me and my daughter.

In my work life in the time I have been on disability I have been a writer, an editor, founded a nonprofit, worked at a tech startup, produced videos for nonprofits, worked as a home organizer, and been a personal assistant to a physically disabled person. I have also raised a wonderful human being who is attending college, working and building her life. There were times in these various ventures I thought I would be able to escape the catch-22 of being on disability and support myself. But my psychiatric realities always interfered with my well-intentioned plans and I had to accept them as a given, rather than a merely possible roadblock.

The new heads of Health and Human Services and Medicare and Medicaid only add to the looming darkness ahead. Talk of the "dangers" of psychiatric medications and "wellness farms" for addiction disorders abound. What's dangerous is these beliefs. If someone had brought me to a "wellness farm" when I was newly sober with an infant, how would I have taken care of her and learned to live my life alongside my recovery? I was in outpatient treatment for a year. That's how long it took. In a couple of months I'll be 22 years sober. The payoff of the safety net is the survival and well-being of the humans in our society, who can then contribute in whatever way they can. The outright discarding of the safety net is akin to the creation of a concentration camp of poverty that few can escape. It is the forced severing of the social contract and norms Americans have embraced for so long: the basics of equality, opportunity, and desire for the common good. That means everybody. No exceptions. Every policy change we have seen introduced by our current government says the opposite: only those who can presently afford it should survive, regardless of circumstances. And now you're going to do it without a net.

Previously:

• Trump wants to cap lifetime Medicaid benefits, even for disabled people, the chronically ill, and people with Alzheimer's

• Former AmeriHealth director sues HBO's John Oliver over Medicaid segment (video)

• How Walmart uses medicaid and foodstamps to avoid paying its workers a living wage

• Mississippi state rep tells distraught mom to buy kid's lifesaving meds 'with money she earns'

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[1] Url: https://boingboing.net/2025/04/13/the-hidden-truth-about-medicaid-64-of-recipients-are-employed-workers.html

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