John is 55 years old and lives in Jasper County. He suffers from a bulging disk, which has led to hip trouble. He still experiences periods of immense pain despite having had two back surgeries. One of these surgeries caused permanent nerve damage, resulting in drop foot. John’s back trouble is a result of the labor-intensive work he did for many years. Now, his injured back leaves him unable to work. He has no dependents, so he is ineligible for Medicaid. Because he cannot work, he also does not qualify for federal subsidies on the Marketplace. When John is in too much pain to bear, he goes to the emergency room. This is the least cost-effective and least efficient option for him, but he has no choice. He cannot pay for a doctor’s visit, and he cannot afford the pain prescriptions that the emergency room doctors prescribe him. John wants to get well and be able to work again, but he will not be able to recover until he has coverage.