I Treat Patients on Medicaid, and I See That Work Requirements Will Destroy the Safety Net

As more states join Kentucky in trying to impose work requirements for people who receive Medicaid, I could not help but think of a patient of mine whom I’ll call Linda.

Linda is a healthy 42-year-old woman who came in a few months ago with pain in her left foot.

“Every morning when I wake up, it’s like a knife in my heel” she said, grimacing, and held her foot up for me to see.

“Is it cancer? It’s so painful. What could cause that pain?”

I examined her tender foot and launched into my well-practiced explanation of the problem: plantar fascitis, an inflammation of the tissues connecting the heel and toes, which is very common and in some cases very painful. I swiveled back from the computer with a handout and was stunned to see Linda weeping in relief. “I just, I really thought it was a tumor in my bone,” she sighed, and folded the tissue I offered into a tiny square.

I am accustomed to seeing patients for routine complaints like this. So it is easy for me to forget how scary it is to wonder about mysterious symptoms and imagine the worst.

This is why I’m so concerned when I hear about additional restrictions placed on Medicaid coverage. Access to health care provides us dignity in our vulnerable moments when we are well and sustains us in the rare circumstances when the worst we imagine comes true. And the worst can happen to any of us. I have seen how quickly disease or injury can punish the body, and how completely an addiction can take hold and alter the course of a life. And I have seen how patients like Linda struggle not only to make ends meet, but to get the medical care they need.

Work Requirements Threaten Medical Safety Net

Most of my patients, including Linda, are on Medicaid. Medicaid is health insurance provided by the government for the most vulnerable among us — the poor, disabled, and elderly. The coverage is not generous, but it is comprehensive. It provides a safety net. Across the country, policymakers are fraying that safety net by imposing work…

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