Upon entering PA school, I faced an unanticipated financial obstacle: the loss of employer-sponsored health insurance. Although I didn’t qualify for Medicaid at that moment, I was eligible for subsidized marketplace health coverage. Yet, even with assistance, the financial strain of monthly premiums and out-of-pocket expenses was considerable. To handle healthcare costs and essential living expenditures, I held a part-time job while being fully enrolled in the rigorous PA program. This balancing act was challenging but ultimately strengthened my resilience and commitment to the field, enhancing my empathy and understanding of the choices patients confront regarding healthcare access and affordability.

This situation illuminated the plight of those who fall through the gaps of the healthcare system, earning too much for Medicaid or Medicare yet unable to afford private insurance. In high-cost areas like Long Island, New York, earning above the poverty line does not ensure financial security, with many struggling to cover healthcare and basic necessities. My challenges underscored the shortcomings and exclusivity of the existing system, reinforcing my conviction that public healthcare initiatives should be broadened to encompass individuals above the conventional poverty threshold, ensuring that no one has to choose between health and financial security.

As an older, single PA student, I now depend on Medicaid for my health insurance. I connect with the concepts presented by Heidi Allen in her TEDMED talk, “The cost of being uninsured in America,” particularly the misconception that Medicaid patients cannot find providers. My shift from private insurance to Medicaid was seamless, allowing me to retain most of my healthcare providers and quality of care. Without Medicaid, I would be unable to afford private insurance, which would jeopardize my health at this stage. Therefore, I advocate for Medicaid expansion to enhance citizen care. In a prosperous nation like the U.S., no individual should be without insurance.

From an economic perspective, broadening healthcare coverage is sensible. As noted by Heidi Allen, increased coverage results in more primary care visits, encouraging vital clinician-patient interactions that can identify risky behaviors early on and potentially avert expensive chronic diseases. Expanded coverage can contribute to a healthier population and reduced healthcare expenses, but this necessitates avoiding unnecessary tests. Throughout my rotations in a hospital emergency department, I discovered that every test must be warranted, aligned with a specific diagnostic objective. If all providers embraced this principle, unnecessary examinations would decline, fostering cost-effective care.