First, understand the Prisoner’s Dilemma with a 90-second video.

Then, understand that Medicaid pays for the majority of long-term support services for people with disabilities, the blind, and the aged in America, and that the rules are different in each jurisdiction and income-limits for Health Care for Workers with Disabilities.

Then, understand that federally, there is the home-bound rule, which requires persons to be at home when Personal Attendants are there.

Because d/Deaf people are often given up on, we Deaf people have lower levels of access to higher education. Here are statistics I found from the Rochester Institute of Technology. But we often have jobs within the Deaf community, or in a sheltered workshop, such as (in my opinion) Gallaudet University.

Finally, understand that we people with disabilities often live in low-income housing out in the boonies, and if we can’t drive, we have to rely on mass transit, which may not pick us up.

Because Medicaid Rules Vary Jurisdictionally, It Often Functions As A Poverty Trap

From this Vox article about a woman, Marcella, with an acquired spinal cord injury. I first read in 2016 that made me briefly consider actuarial work. The emphasis has been added by yours truly…

“At first I thought I would be a great help to Marcella and Dave as they negotiated this web of programs. After all, I’d been teaching and writing about social policy for years, first at Harvard and then at [the ]MIT. But I was soon humbled by how immensely complicated the programs are on the ground, and shocked by how penurious.”

…

Brian saw the look on our faces. “Medi-Cal is a poor person’s program,” he said with a shrug. “And it’s not really even insurance — it’s a loan.” Thus, any inheritances Dave and Marcella might receive will go to Medi-Cal. Any Medi-Cal services that Marcella uses after the age of 55 will be added to a tab that she will rack up over the rest of her life; when she and my brother die, the state will make a claim on their estate for reimbursement, as Logan will no longer be a minor at that point. He will inherit nothing.

Read the article paywall-free at the following Internet Archive Uniform Resource Location. https://web.archive.org/