Zoë is one of the hundreds of thousands of people in Missouri that falls in the Medicaid coverage gap. She has lived in many cities in Missouri and has faced immense difficulty in finding physicians that can adequately provide the care she needs and in the rare occasion that she does, she is not able afford the cost of consistent care. Zoë is a trans woman and takes estrogen and progesterone in order to support her medical transition. For many years Zoë also took an anti-androgen medication called Spironolactone which caused many serious life altering side- effects that led Zoë to need more medical attention that she was unable to receive due to lack of health insurance.
Zoë tries to be proactive about her mental health and has pursued therapy and medication to treat her depression and PTSD. This has limited her ability to find and maintain full time employment despite having a Master’s degree and Master’s of Fine Arts in Creative Writing. Zoë has turned to alternative ways of finding affordable medication through apps like goodRX. Though helpful in locating discounted medication, the medication is not always in a nearby location and has led Zoë to drive an hour and half out of town to get the medication she needs at a price she can pay. Zoë was lucky enough to have transportation to pick up medication far from home but does not always have transportation which has led to missing critical appointments and routine check-ups.
Throughout the years Zoë has applied for disability but has been denied each time. While living in St. Louis she qualified for a local program called Gateway that assists uninsured adults in St. Louis City and County up to 100% of the Federal Poverty Line. This lowered Zoë’s monthly cost of medication from $200 to $20 and alleviated a huge financial burden for her. Unfortunately, through bureaucratic confusion, Zoë received a letter that she was kicked off Gateway Insurance after applying for food stamps.
Last year Zoë had to have emergency gallbladder surgery, a procedure that cost her $50,000. At this time she was also committed to psych care for 10 days, adding an additional $20,000 to her medical bill. Zoë’s bill of $70,000 will be sent to collections in October, leaving Zoë to consider bankruptcy as the only way to clear her financial debt. When asked what expanding Medicaid could do for her life Zoë states, “if I could get Medicaid it would allow me to build my life again. I could be so much more independent. I wouldn’t have to beg on the internet for basic medical needs. I could finally start healing. I need to be going to a doctor. I need it”.