Medicaid helped save her daughter’s life. Angelica wants it to be there for other Alabamians, too

By Whit Sides, Cover Alabama storyteller, Alabama Arise

By the time Angelica McCain was 17, she had moved out of her family’s home in St. Clair County, east of Birmingham. Since then, she has worked full time in the service industry, where health coverage never comes easily.

Now a single mother of two living in Irondale in eastern Jefferson County, McCain finds herself in a familiar struggle. She is fighting to ensure her children have access to the same Medicaid coverage that helped her growing up.

“I was on Medicaid with my brothers,” McCain said. “My mom worked three jobs, my dad didn’t work much, and that was the only way we could have health care.”

That early experience shaped her perspective and fueled her advocacy today. Working in the service industry for much of her adult life – where health insurance is rarely offered – Angelica often falls into Alabama’s health coverage gap. People in the gap have incomes too high to qualify for Alabama Medicaid, but too low to afford private coverage.

Angelica had coverage during her pregnancies, only to lose it shortly after giving birth.

“Medicaid would cover me while I was pregnant, then drop me afterward,” she said. “It’d be great if our country cared about parents after the babies are born.”

Alabama lawmakers in 2022 extended the postpartum Medicaid coverage period to one year after childbirth, up from the previous cutoff of just 60 days. It was a step in the right direction – but it wasn’t enough to ensure families can get the health care they need.

The life-saving importance of Medicaid coverage

In February, Angelica was able to obtain health insurance for herself for the first time in her adult life through the Marketplace created under the Affordable Care Act. She said it’s not cheap, but she’s got to take care of herself to be around for her daughters.

A recent health scare demonstrated just how important health insurance is for families like Angelica’s. Medicaid coverage proved life-saving when Angelica’s daughter needed major cancer surgery last year.

“First of all, I thought, ‘Oh my God, is Medicaid even gonna cover this because of how big it is?’” she said. “But it covered everything. They did it all. That saved me from being like $200,000 in debt from five days in the hospital.”

Her daughter, now 10, fully recovered. But Angelica said the experience reaffirmed the critical role that Medicaid plays for Alabama families, especially in rural communities.

Tired of the status quo

Angelica is outspoken about the misconceptions and stigmas that often surround federal programs serving Alabama families. She said that in the past, more than half of her paycheck would be spent on private insurance. She said her sister is still in the same situation, facing the choice between paying for groceries or health care.

“I get very, very tired of the status quo,” Angelica said. “I’ve worked in this state for 17 years, and I still didn’t have health care to show for it. It’s not about laziness. It’s about survival.”

Angelica said she often feels like leaders in Washington, D.C., and Montgomery can’t relate to folks like her. When House Speaker Mike Johnson recently claimed to reporters that many young Americans on Medicaid are just “playing video games all day,” it struck a nerve with Angelica.

“He must be out of his mind,” she said bluntly. “They have no idea what’s happening to working-class folks underneath them.”

‘That emotional weight is crushing’

For Alabamians like Angelica, Medicaid is not just a lifeline. It’s a matter of dignity for working families. But the program faces numerous threats at the federal level.

The U.S. House voted 215-214 in May for a budget bill that would cut $800 billion from Medicaid and Marketplace coverage over the next decade. The bill now awaits Senate consideration. If these cuts are enacted, health coverage could become more expensive or inaccessible for tens of thousands of Alabamians.

The bill also would remove additional federal incentives for states to expand Medicaid to cover adults with low incomes. Alabama is one of 10 states yet to expand Medicaid, leaving nearly 200,000 people in the state’s health coverage gap.

Medicaid is an essential part of Alabama’s health care infrastructure. More than 1 million Alabamians – almost all of whom are children, older adults, or people with disabilities – receive their health coverage through Medicaid.

“Children… that’s my heart,” Angelica said. “And it breaks my heart to think there are kids out there who will potentially die, and then families will go under. That emotional weight is crushing.”

If Medicaid were to face cuts or further restrictions, Angelica said her family’s most basic needs could be jeopardized. When times are already tough, she said she doesn’t know if families like hers can take another hit.

“I’d fear their teeth falling out. I’d fear not being able to get my daughter glasses. And I’d fear going into debt just trying to keep them healthy,” she said.

An empowered advocate gets results

In February, Angelica accepted an invitation to share her story at an advocacy day that Cover Alabama and the American Cancer Society Cancer Action Network co-hosted at the State House in Montgomery. There, she met other Alabamians living in the coverage gap. She also spoke at a news conference, where her message to legislators was simple: Expand Medicaid and stop targeting vulnerable communities who are just trying to get by.

Angelica met with state lawmakers to discuss how her family and others would suffer under a bill that originally would have removed thousands of children from their Medicaid coverage by placing unaffordable requirements on parents with low incomes. Thanks in part to Angelica’s in-person advocacy, the bill’s sponsor agreed to remove the most concerning language from the plan. The bill ultimately did not pass. (Read more here about Angelica’s crucial role in advocating against this legislation.)

Ever since, Angelica said, she has felt more empowered to share her story and help make a difference for working families and people with low incomes across Alabama.

“There are so many people that benefit from Medicaid who don’t fit the stereotype,” she said. “We live in rural Alabama, and we live in cities. We’re white, Black, it doesn’t matter. They’re people like me, just trying to do our best for our kids.”

About Alabama Arise and Cover Alabama

Whit Sides is the Cover Alabama storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

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