Damnit America. For all the power you hold how could you f*ck up medical aid for your own people by this magnitude? The ROW (rest of world) simply can't wrap their head around it...
And even in other states that didn’t adopt the expansion, like North Carolina and Missouri, patients like Oregón still have hope of a transplant in a life-or-death situation. That’s because these states allow for a “medically needy” pathway, or a “spend-down” program, whereby patients can meet the Medicaid limit by deducting certain items, including unpaid medical bills, from their income.
In NC at least, these mostly happen not because of the spend-down rule. They happen because we have a public university, with a public hospital, that is supported through the state by the public to provide care for the poor.
I am keenly aware of this. I moved to Norway, which by all means has a lot of social programs. Most of which I am covered by due to my immigration status (marriage). Part of my requirements was to take Norwegian language classes and civics, along with many other immigrants. More than once, medical care was discussed, as it is outside the classroom mostly because folks hear the rumors and get curious if the healthcare system is like they hear.
Looks of shock for not having paid parental leave, which is pretty common in most of the world. And then the shock just seems to keep growing.
For the average person with insurance, however, there are a few perks, so I try to include such things. (Less with the waiting times, for example, and the quality of care if you can access it is fairly good). Still a dire sitution.