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Comment by hotpotamus | Hacker News Reader

Speaking as a marginally disabled US citizen - it's a terrifying place where if I become too disabled to maintain employment, I'll lose my health insurance and then my access to healthcare. I guess it's good that a lot of people are making money though; it seems like the advertising business is going gangbusters too. I don't really consider that much of a national purpose, but it seems pretty hard to get everyone to agree on what that would be anyway.

Edit: I'm rate-limited so to answer the apparent question everyone has: I live in Texas; it's not exactly friendly regarding Medicaid, but I don't know what it takes to qualify.

https://www.keranews.org/health-wellness/2023-08-16/medicaid...

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I'm really sorry your comment is getting so much pushback. I have a brother with some Medicaid benefits in Texas who can never live independently. He's mute, can't take care of his own hygiene, and can't swallow food, so needs to be fed through a stomach tube. Medicaid is constantly trying to deny him nursing benefits, and he can't ever hold more than $2K in any of his accounts or he would lose SSI.

People have this fantasy that the social safety net takes care of people that can't take care of themselves, but that's really not the case. It is extremely easy to lose benefits and hard to get them in the first place for various services, with very long waiting lists for some things.

HN is an interesting place, but the bubble of privilege is more like a concrete dome sometimes. I'll sometimes tell people to imagine getting hit on the head with a hammer and then being unable to continue working their cushy office jobs (that could also describe my employment to some degree), and how they'd adapt, but that tends to get downvoted.

I suppose I'm actually rather fortunate to some degree; a lot of my issues could likely be resolved with a hip replacement, and I'm told the latest ones are very robust and can lead to nearly full natural function, but I haven't quite built up the courage to replace part of my skeleton with metal and plastic. As I say, I'm rather happily employed these days, but I've also been throught the odd layoff, so I know how precarious things can be.

I don't understand this... you would qualify for Medicaid. And it covers everything. No copays. Better than private health insurance.

Medicaid coverage often has many requirements to qualify. Most notably, in many jurisdictions, there is an aggressive asset limit that requires you to liquidate almost everything you own, in order to get coverage when disabled or elderly. Those limits can apply retroactively up to five years, and can also prevent disabled people from being able to marry, because they would lose benefits due to a partner's assets.

The Medicaid trust is the way around that. It's not a great solution, but it's at least something if you're in that position and have the time to plan.

I live in Texas, and as far as I know as an adult man, I'd not qualify since it is not a medicaid expansion state. Perhaps if needed I could move to a different state, but that poses plenty of problems as well. My plan is mostly to save every dollar I can in the event that I'm unable to find suitable employment. I'm actually pretty happy with my job now, but it seems inevitable that that changes; every employer I've ever had is now out of business or consumed by private equity and a shell of what it was. I guess that's helping the GDP though and I should be happy? I'm not particularly though.

Have you actually been disabled with significant health needs on Medicaid? It sucks super, super hard.

Managing your medicaid "benefits" is a part time job

https://millerestateandelderlaw.com/medicaid-out-of-pocket-c...

Just magically qualify huh?

Agreed that the Health Insurance situation (I call it Mafia) is terrible in the US. A perfect example of where we are not even close to being good let alone great. We have great doctors, hospitals, research but the middle man insurance mafia is destroying it for decades now. I honestly don't know what can be done.

I don't know if Single payer is a good solution in a country of our size but I am willing to try anything compared to what we have today.

Also note their use of 'marginally disabled' here. If you have a disability but are still considered 'able to work' you don't qualify for medicaid or medicare. Keeping health insurance becomes super important and ACA plans not only have very thin networks, but are often exceedingly stingy when it comes to approving specialty meds even if your doctor considers them medically necessary.

I have friends who are disabled, and get free healthcare through Medicaid. Where does this fear come from?

One got a full CAT Scan and a full neurological consult, and a EEG due to a history of seizures, all for free and within a week.

Seems not always ?

https://millerestateandelderlaw.com/medicaid-out-of-pocket-c...

Seems can vary by state too

https://www.medicaid.gov/medicaid/cost-sharing/out-pocket-co...

Medicaid rules vary from state to state.

I'm pretty sure some states (conservative) reject federal medicaid dollars simply because they are ideologically opposed to government funded healthcare.

It's not hard to imagine these same states make the bureaucracy of obtaining low income healthcare benefits arbitrary, difficult to navigate, and counter-productive as way to 'prove' government healthcare doesn't work.

Oh that's one of the big hidden costs is just the amount of paperwork ( in many cases physical paper ) to document, submit in triplicate, and then waiting and waiting and waiting

If you're unemployed in the US then you'd most likely qualify for Medicaid though

Depends on how you became unemployed. There is a long wait for Medicare if you "voluntarily" left your last position, even if you were forced out by cowards who wanted to keep their record clean and be able to say they never fire anyone.

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