Revised: November 20, 2024
An anonymous TJC client was on TennCare while her mom was pregnant. The client had never known a life where she couldn't go to the doctor or had to worry about medical costs. The client understood she would eventually roll off TennCare, but no one explained the Medicaid process to her or her mom.
In accordance with the Medically Needy Spenddown category, the client was able to stay on TennCare because she was classified as a “needy adult,” meaning she was of age but not disabled or fighting an illness. Because of this and private healthcare laws, both the client and the mother believed that she could stay on TennCare until she was 25 years old. But she was disenrolled at age 18.
After the pandemic was declared, the client was approved to stay on TennCare for a longer period. Losing Medicaid didn't cross her mind until renewal letters went out. The client filled out the application and mailed it. Then, TennCare requested that the client apply again. She completed the application online through TennCare Connect.
When the client received the notice from TennCare that she was denied, she felt helpless. The notice incorrectly stated that she made $2,000 a month and was therefore not qualified for Medicaid. In actuality, the client only made $8,000 a year and her mom made $1,000 a year.
A TennCare attorney said they didn't know why the letter said that and it was a mistake. This was devastating to the client because she was hopeful she would remain on Medicaid.
At the time when the client contacted TJC, she was working towards a master’s degree and had a plan in place to get another master's degree. She said she is not a person that is just trying to “mooch off the government. People are not trying to mooch. A lot of people just need help. I just need a little help. I am so close to where I want to be, and I just need a little help.”
In 41 states, the client would qualify for assistance. But she lived in a state that has not expanded Medicaid. She was struck with helpless anger. The client said:
There are a couple million Americans that qualify for Medicaid but can't get it because of the politicalization. It’s not a political issue. Everyone has to go to the doctor. Doesn't matter if you're republican or democrat. Every single human on this planet needs medical assistance at least one time or another in their life. We don't live in a world where there is a job that necessarily comes with medical insurance.
The client continued, saying, “There may be people who need health insurance more than me and may be in in worse situations than me, and they still can't get it because of the lack of sympathy.” The client said she could never fathom people not understanding that everyone has to go to the doctor. She went on to share that, “Cancer doesn't have a face, she can pick who she wants. Anyone can get cancer, lupus, or diabetes— illness doesn't know bad from good, and it doesn't really care. You could be a healthy person and then something just happens. It’s unfathomably cruel.”
The client thought she would be okay, as she found online resources and free clinics near her. But her biggest concern was her mom, who needs to go to the doctor at least once a year. The client shared the following:
It would be nice if our state legislature would acknowledge that people between 19 and 64 also have a right to healthcare. Stuff happens to those people too, even those of us who need something like SSI, or disability, or having extreme medical debt to even be considered. And then there is no guarantee you can get on Medicaid. It's just really cruel.
If 41 states opted into Medicaid, and we know that it works, then it's helpful. Finally, some of the most underserved populations in the country are getting something for their effort and existing. Because I promise if I could just pay, I would. If I could just support myself and my family, I would. I just need a little assistance until I can get there.