Medicaid Matters:

For millions of Americans, Medicaid is a lifeline. For me, Medicaid allows me to live in my community rather than being forced to live in an institutional setting. Medicaid is the only insurance that covers home and community-based services. Private insurance companies don’t cover PCA services. Without my PCA, it would be impossible for me to live in my apartment.

Living at home with support is much more cost-effective than living in a nursing home. A semi-private room in a nursing home costs $7,756 per month on average. The average monthly cost of a private room is $8,821. Overall, this comes to $93,072 and $105,852 a year, respectively. On the other hand, my PCA hours cost a little over $50,000 a year.

Medicaid allows me to live an independent life. Medicaid allows me to shower, eat, and use the bathroom. Activities of daily living aren’t optional. A non-disabled person wouldn’t be expected only to use the bathroom a couple of times a day. This is not uncommon for people like me.

Up until two years ago, I practiced “pee math,” a term I learned from Kathleen Downes. I would go a long time without drinking fluids. In school, I used the bathroom once a day, usually after lunch. I was jealous of my classmates who would come to school with iced coffees and energy drinks. I wanted them to understand that having something to drink regularly is a privilege many people with disabilities don’t have.

Having a reliable PCA is crucial for me. The only way to get the services I need is through Medicaid. Medicaid allows me to live life like any other 22-year-old woman. In the future, I hope to find a job. However, I worry about how it will impact my Medicaid coverage. Medicaid must be expanded to accommodate all Americans in need. Without Medicaid, the lives of people like me could be turned upside down. Medicaid needs to be expanded because care can’t wait. People’s lives depend on Medicaid’s services.


Parker, Tim. “The Median Cost of a Nursing Home.” The Balance, The Balance, 25 Oct. 2021,

1 comment

  1. Thank you for explaining how being able to drink as much as desired (and as recommended) is too often an unattainable luxury for those who tray on Medicaid-funded PCAs. We need a comprehensive cradle-to-grave health care system that goes not mandate impoverishment for eligibility!

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