Commentary Health Systems

On Medicaid, Shame, and Not Being Silent

Anonymous

Shame is a powerful cultural and political tool that has been used to keep people from accessing the resources they need. Shame has kept my name anonymous in this article, but it will not stop me from accessing health care, telling this story, or encouraging others to do the same.

This piece is published in collaboration with Echoing Ida, a Strong Families project.

When the Obamacare exchanges became open for enrollment this fall, I eagerly went online to check out my options for affordable health care in my state. It was exciting to know that I could potentially afford health insurance. I considered how my life would be affected: doctors’ visits, blood tests, checkups, an eye exam, a teeth cleaning—all the things I’ve longed for as an uninsured adult.

After wading through a sea of questions about my income and expenses to determine my eligibility, I discovered what I had not considered a possibility:

I qualify for Medicaid.

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Wow. Am I that poor? For so long I made just enough money to not qualify for Medicaid. Now, I do qualify.

While I was relieved to know I wouldn’t need to pay out-of-pocket each month for health care, I felt uncomfortable. I had originally intended to write about my experiences navigating Obamacare, how I’m weighing the options or different health-care plans in my state. But how was I going to write about that now? I couldn’t possibly share my experiences navigating Medicaid in public.

My initial thoughts and feelings were rooted in shame. I didn’t want people to know my income is so low that I qualify for Medicaid. I still don’t. that’s why this piece is being published anonymously: I can’t bear the thought of my name being tied to this story. But I am writing this piece, because it needs to be written. Shame has bought my anonymity, but it hasn’t bought my silence.

Shame is a tool. It keeps people immobilized, silent, and afraid. It keeps people in closets, in hiding, invisible.

Shame is discreet. Using EBT cards only when you go to the grocery store alone because you don’t wanted be outed about receiving food stamps. Using cash when you’re food shopping with friends or acquaintances who don’t know how you usually pay for your groceries. Being vague about what you do for a living because you’re on unemployment insurance while you pursue your dreams. Writing anonymous articles about navigating Medicaid because you don’t want the public to know you’re on a publicly subsidized program.

Contrary to the popular mythology of the “welfare queen” living lavishly and unapologetically on public assistance, some of us do not feel a sense of entitlement to use the programs for which we qualify. Part of this comes from an otherization of welfare—“Oh no, I’m not one of those people” or “I don’t want people to think—or know—I’m one of them.” This is an internalization of the public shaming of the safety net.

And I’m sure this is only one of the reasons why nearly 700,000 people nationwide who qualify for Medicaid haven’t enrolled in the program.

Money and time is spent to keep the “welfare queen” mythology alive, not only informing budget cuts, but also the minds of people who qualify for public assistance but decide not to use it. Shame is ridiculous. It will have you believe you deserve nothing—that you don’t deserve the resources you qualify for, resources that can support your livelihood.

Still, the truth of the matter is that the economic climate of the United States has made public assistance widely used. People are working jobs they’re overqualified for, and underpaid to do, to make ends meet, and they still need publicly subsidized programs to hold it all together. The use of programs like SNAP (the Supplemental Nutrition Assistance Program, commonly known as food stamps), Medicaid, and unemployment insurance are not uncommon among my peers—a generation of college-educated, upwardly mobile folks using public assistance.

Ultimately, I am moving forward with my application for Medicaid. I want health care and have gone long enough without it. Shame will not pay for my medical bills, exams, prescriptions, or my well-being. For me, the question has become: How do I discuss the process of accessing Medicaid in public, online? In the past, I haven’t had a problem strategically using my personal experiences to leverage critical analyses of systemic policy problems and cultural dilemmas. But in this case, I am unwilling to go there. This is not a past-tense situation I triumphantly overcame, outgrew, or no longer need. This is now. And I am unwilling to pay the cost of my public vulnerability. To be Black, female, poor, and visible is not respectable; it is, in fact, dangerous.

Tanya Fields, a pregnant unwed mother of four children and the executive director of the BLK Projek, spoke up during the bell hooks and Melissa Harris-Perry conversation at the New School in New York City last month. She spoke about how she has been shamed and silenced because of the number of children she has as an unmarried Black woman. And she faced serious backlash for speaking up about the respectability politics she was experiencing in her community. She has been told that her motherhood and marital status are her personal business, not to be discussed in public places. She has been called names. She has been told that she is what’s wrong with the Black family. And she still has an organization to run and a family to take care of.

While Fields’ experiences are not with Medicaid, they are telling of what is at stake for a Black woman speaking publicly about the truths of our life circumstances that do not fit neatly into respectability—the truths that expose us to potential public shaming, stereotyping, and scapegoating.

The work of increasing health coverage is also to remove the stigmatization of publicly subsidized programs. Shame is a powerful cultural and political tool that has been used to keep people from accessing the resources they need. Shame has kept my name anonymous in this article, but it will not stop me from accessing health care, telling this story, or encouraging others to do the same. Audacity is the first step in dissolving shame, and I intend to be courageous.

News Politics

Anti-Choice Democrats: ‘Open The Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

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Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

News Politics

NARAL President Tells Her Abortion Story at the Democratic National Convention

Ally Boguhn

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates.

Read more of our coverage of the Democratic National Convention here.

Ilyse Hogue, president of NARAL Pro-Choice America, told the story of her abortion on the stage of the Democratic National Convention (DNC) Wednesday evening in Philadelphia.

“Texas women are tough. We approach challenges with clear eyes and full hearts. To succeed in life, all we need are the tools, the trust, and the chance to chart our own path,” Hogue told the crowd on the third night of the party’s convention. “I was fortunate enough to have these things when I found out I was pregnant years ago. I wanted a family, but it was the wrong time.”

“I made the decision that was best for me — to have an abortion — and to get compassionate care at a clinic in my own community,” she continued. “Now, years later, my husband and I are parents to two incredible children.”

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Hogue noted that her experience is similar to those of women nationwide.

“About one in three American women have abortions by the age of 45, and the majority are mothers just trying to take care of the families they already have,” she said. “You see, it’s not as simple as bad girls get abortions and good girls have families. We are the same women at different times in our lives — each making decisions that are the best for us.”

As reported by Yahoo News, “Asked if she was the first to have spoken at a Democratic National Convention about having had an abortion for reasons other than a medical crisis, Hogue replied, ‘As far as I know.'”

Planned Parenthood Federation of America President Cecile Richards on Tuesday night was the first speaker at the DNC in Philadelphia to say the word “abortion” on stage, according to Vox’s Emily Crockett. 

Richards’ use of the word abortion was deliberate, and saying the word helps address the stigma that surrounds it, Planned Parenthood Action Fund’s Vice President of Communication Mary Alice Carter said in an interview with ThinkProgress. 

“When we talk about reproductive health, we talk about the full range of reproductive health, and that includes access to abortion. So we’re very deliberate in saying we stand up for a woman’s right to access an abortion,” Carter said.

“There is so much stigma around abortion and so many people that sit in shame and don’t talk about their abortion, and so it’s very important to have the head of Planned Parenthood say ‘abortion,’ it’s very important for any woman who’s had an abortion to say ‘abortion,’ and it’s important for us to start sharing those stories and start bringing it out of the shadows and recognizing that it’s a normal experience,” she added.

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates. In April, Clinton called out moderators for failing to ask “about a woman’s right to make her own decisions about reproductive health care” over the course of eight debates—though she did not use the term abortion in her condemnation.