Trapped in America's Safety Net

Moreover, because Dave is employed, he and Marcella would be in a particular version of the program called “Share of Cost” Medi-Cal. It works this way: as a family of three with one disabled member, they are allowed to keep $ 2,100 of Dave’s $ 3,250 monthly earnings to live on. The rest of Dave’s earnings, $ 1,150, would go to Medi-Cal as the family’s share of cost. That is, any month in which Marcella incurred medical expenses, she and Dave must pay the first $ 1,150. To our surprise, if Dave earned more money, the extra amount would also go to Medi-Cal: the cost sharing is a 100 percent tax on Dave’s earnings. I figured out later that the $ 2,100 my brother and sister-in-law are to live on puts them at 133 percent of the federal poverty level for a family of three. Essentially, the way they meet the income test is for Medi-Cal to skim off Dave’s income until they are in fact poor. Brian noted that they are “lucky” that they are allowed to retain that much income; if Marcella weren’t disabled, the amount they’d be allowed to retain would be even lower than $ 2,100. And this is how things will be indefinitely. In order to get poor people’s health insurance, Dave and Marcella must stay poor, forever.