Political Humor

Depends on the state, mine only started participating in the Medicaid expansion program a year or two ago. Here low income families can have functional Medicaid coverage until you're 18, then you get put on a limited care program that really only covers emergent care. However, both the child and adult programs recently got semi-privatized. Now the sate pays BCBS and Humana to run the Medicaid program for the state, letting them determine what coverage is like.

So even in southern states where there is a Medicaid program, the adults rarely have coverage for everyday healthcare needs. It's mainly there to make sure there's some way to reimburse emergent care facilities.

Some places are totally just not doing it right

Repugnantcans: "It's not that we don't know how to govern, it's just that government is inherently bad compared to the free market"

It seems like it's up to the state to set the barrier for entry to their Medicaid system. In my state, the limit was <$24k yearly income, and I think that's gone up since I last looked. In a friend's state, it was <$12k to qualify, which is a lot harder to survive on.