You know, it's better now than it was several years ago. It used to be that there was generally no Medi-cal for adults in California. Unless you were severely disabled and on SSI when you would then get Medicare (not the same thing as Medi-cal). Obamacare gave the individual states options to expanded coverage to anyone who really needs it who is financially eligible. Calif opted in to that - other states did not. (Too many federal "strings" on the money, I believe, is a common reason why they did not.)
When I was in grad school I was looking at how US social services programs worked at cross-purposes. (Basically, some would cancel each other out - you take a payment for childcare so you can go to school or get training and your foodstamps were reduced, etc. That sort of thing. It trapped people on welfare.) As part of that, I did research on the Medicaid program. Now, this is from over 25 years ago, so it may no longer be accurate. But at the time, the Feds sent money to the states to run their Medicaid programs, as there was significant lobbying in DC to ensure that the states had control (which is a long history/tradition) of the money. As long as they met minimum Fed regulations, how the states set up and ran their programs was up to them.
California was/is actually one of the more progressive states. (Bernie's is a benchmark that Cal is nowhere near, though, yet.) I did my grad school in Texas, so I was looking at government social services in Texas. At that time, there was no medical program for single adults, unless you fit into one of a very restrictive number of categories (severely disabled, etc.) regardless of your financial resources. You could be sleeping in a ditch with only the clothes on your back to your name and there was no government medical program to help you. (If you'd had a heart attack or something that left you disabled in that ditch, you could apply for SSI, but that takes two years. If you had SSI you could be covered under Medicare, not Medicaid.) There were, if memory serves, actually well over two dozen different Medicaid programs running at the same time in Texas, each with its own criteria and a maze of regulations and requirements. If you were a child and were accepted into a Medicaid program, you could get basic care. Thankfully. Texas, of course, was worlds ahead of some of the Southern states (Mississippi, etc.). I have no idea what the situation is there now and don't want to look at it.
I gave up working on that project because the more I dug, the more depressing it became. When i was interviewing people about their experiences, for a paper, I came across some true horror stories. People died who shouldn't have. People were left invalids needlessly. I wish I had not been redlining my energy being a single parent living on school financial aid and odd jobs in a place with no public transportation. But I was, and I simply could not cope with all that in addition to juggling trying to keep us afloat on a daily basis. That information should have been distilled and published. Not that any good might have come out of the paper, as it probably would only have made a small circle of rounds in academia, but there could have been something, some little thing, that it helped with.
Sigh.
Missed my chance.
Well, nothing to do about it now, other than to remember what the options other than NHS or private insurance are here - and what happens if we have to go back. If you're healthy, it's not quite the big deal. If you have medical issues, it drives everything you have to do. If you have issues that mean you periodically cannot work (assuming you can get a job with good insurance), you ... well, it's better here. Let's just leave it at that. Healthcare is considered a public good here, not a marketed commodity, as it is in the USA. It's not a for-profit '"bidness" here.
Thank God. Seriously. Thank God.
