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Who: Joyce Baker, 61, single and unemployed.

Circumstance: Joyce lives with her daughter and her daughter’s three children, ages 5, 6 and 7, in Skyway. She is technically unemployed, but provides care for the kids, getting them off to school and home after, plus other help as the family needs it. In the past, Joyce worked as a nanny or housecleaner.

Challenge: Joyce says she is in relatively good health. However, last year she had stomach problems, which led to a trip to Swedish Hospital where she received an ultrasound. Joyce tried applying for charity care, but may have filled out the paperwork wrong and was denied coverage. She defaulted on her $800 ultrasound bill, but would like to talk with providers at the hospital to try to clear up the claim. Now Joyce is struggling with ongoing pain in her left foot, pain that wakes her in the middle of the night and that she hasn’t been able to resolve with ice, rest or elevating her foot. She needs X-rays to identify the cause of the problem, but can’t afford them.

Current Coverage: Joyce doesn’t have health insurance now, and never has. The sort of domestic jobs she’s held, “they never offer health benefits.” When she needs medical help, she has gone to the Country Doctor Community Clinic in Seattle’s Capitol Hill neighborhood where she pays a discounted rate for her care and covers her own prescription costs. Joyce assumes she doesn’t qualify for Medicaid because she’s not disabled. She loves the care she receives at the community clinic, but sometimes needs additional resources — including X-rays – that she can’t get there.

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Options: Washington is one of the states expanding Medicaid coverage under the Affordable Care Act to provide care for more low-income people. State officials predict that 328,000 additional residents will qualify for Medicaid beginning Jan. 1 under the new rules, and that number would almost certainly include Joyce.

— Lisa Stiffler

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