I’m Too Rich for Medicaid, Too Poor to Pay My Bills

Kathy grew up in New England and spent most of her life working hard and building stability. She worked for over 20 years at a payroll service company providing tech support for payroll software used by McDonald’s restaurants. “When I graduated, I got a really good job at a payroll service, and I was there for 21 years.” 

Her steady job allowed her to become a homeowner at a young age: “I had my first house at age 26. I had multiple cars. I had a motorcycle and two antiques… I worked hard and I had fun, but I was responsible.” 

But everything began to change when her health started to fail—slowly at first, and then all at once. 

Kathy’s hearing loss began when she was just 19. After a childhood of urinary tract issues and a bladder surgery at age five, she was used to “just taking a pill” to manage issues as they arose. A new doctor switched her to a then new medication, Cipro, for recurrent infections: 

“When I was about 19, I had a new doctor who said, ‘Oh, Bactrim is not working for you. Let’s switch you to this great new drug, Cipro’. . .And that’s when my hearing loss started. I took it for 10 years.” 

Over time, she began to experience severe symptoms: ringing in her ears, neck and body pain, and eventually an ectopic pregnancy. “My whole body fell apart,” she remembers. When she finally connected Cipro to her hearing loss and asked doctors about it, she was dismissed. “I finally did start asking questions, like, ‘Hey, is this from the Cipro?’ They’d be like, ‘Oh no, it’s not from the Cipro.’  Long story short, it was.” 

As her hearing worsened, it began to threaten her livelihood. Her long-term payroll job ended, and she took a position where she was asked to take calls despite clearly communicating about her hearing loss: “They trained me on phones… and I’m like, ‘You guys know I can’t hear, right? I struggle. On the phone I won’t be able to hear.’”  

Financially, things steadily deteriorated. Her pay was cut repeatedly: “My pay just kept going down and down and down. I was losing my house. I was behind in my mortgage.” Ultimately, she lost the house and moved back near her parents. 

Eventually, Kathy took a job at a garden center, which proved more physically demanding. “I did merchandising, where you move the flowers around. I loved that job, it was so fun, but I would just walk to my car in so much pain because I was 48 years old and trying to prove to myself, ‘I can do this.’” Over time, the work severely damaged her back: “I had herniated discs and a bulging disc in my back.” These injuries have led to worsening neck problems, carpal tunnel, and other orthopedic issues: “The doctor looked at my MRI and said, ‘You are at risk of being paralyzed if you get into an accident. You have such a bad herniated disc in your neck. We need to do a spinal fusion.’ It was terrifying.” 

All the while, her hearing continued to deteriorate. “I had a hearing aid in one ear, and I was nearly deaf in the other. I think I had like 4 or 12% word comprehension.” 

After seeing an ear doctor, Kathy decided to apply for Social Security Disability. “The doctor looked at my hearing chart and said, ‘I’ve never seen anybody come in here with hearing this bad. You won’t get denied if you apply for Social Security.’ Well, that wasn’t true. It took me two and a half years to get approved.” 

While she waited, Kathy’s life savings steadily dwindled. “It took me three years, but I did finally get disability… Just enough time for me to spend the money that I earned my whole life—what I had left.” 

Today, Kathy lives in what she calls the “loophole in the middle.” Florida’s Medicaid rules make it nearly impossible for someone like Kathy to qualify. “I’m too rich for Medicaid, but too poor to pay my bills,” she says. She receives disability income and has a low lot rent compared to most Florida housing, but her budget leaves almost nothing after basic bills. “Before food, I have $587 a month. Food is about $400 or $500 a month. So we have $137 left over for fun things like copays and the medication Medicare won’t pay for.” 

The financial strain leaves Kathy and her partner, Shane, with very little to fall back on when unexpected events happen. “We lost his van and his car [in Hurricane Ian]. He lost his job in July. He’s over 50, and he’s having a really hard time. He’s got no health insurance. . . What are we going to do?” 

Kathy wants policymakers to understand the impossible situation faced by Floridians like herself who earn too much to qualify for Medicaid, but too little to receive the Marketplace tax credits. 

“If I had a legislator in front of me, [I’d talk about] the people that are in this kind of loophole in the middle—who make too much money to qualify for any help. We need some program to help. I want to work. . .There just needs to be some program for people that are stuck in the middle there, where they make a little bit too much money to qualify.” 

Kathy’s story lays bare a system where one illness, one drug, one job loss can unravel decades of hard work, and where one can be simultaneously ‘too rich’ and ‘too poor’ to receive support.