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Doing hard things - taxes and health insurance

Updated: Apr 10

My time in front of the computer has looked much different the last two years. Instead of working on articles for the newspaper, writing my novel or keeping up with my blog, I've been preparing tax returns and navigating online health insurance applications.


It's not something I ever considered part of my path. No life I could have imagined included researching the exemptions to the 10% penality for taking an early withdraw on an IRA or trying to make sense of the modified adjusted gross income needed to calculate advanced premium tax credits on Healthcare.gov.


All I knew when I applied for a job with Pisgah Legal Services is that I wanted to help people. I wanted to be a part of a nonprofit with a strong social justice and anti-poverty mission. Little did I know PLS had just launched a new program in the western counties to help residents navigate two of the most difficult systems in the U.S. - health insurance and taxes.


So I said yes to joining this amazing nonprofit law firm and committed myself to learning new processes and being an advocate for North Carolina expanding Medicaid and for Congress to once again expand the child tax credits that were pulling children out of poverty during the pandemic.


I'm happy to report Medicaid has been expanded, making 600,000 more people eligible for affordable health insurance in NC. Meanwhile, Congress is dragging its feet on making changes to the CTC. Celebrating the small and individual wins is what keeps me going day to day.


A single mother filing several years' worth of taxes and receiving over $30,000 in refunds to take care of her children. A family living at the homeless shelter getting their own place to live thanks to a $12,000 refund. A cancer patient in their 50s being approved for free health insurance for the first time in their life.


The injustices within the system continue though. A mom who stays at home to raise two special needs children won't benefit from the child tax credit because she doesn't have any earned income to report on her taxes. Even though 600,000 more people are now eligible for Medicaid, people in Western North Carolina will still struggle to find a medical, dental, or mental health provider that accepts Medicaid.


I have faith more providers will begin accepting more Medicaid patients now that expansion has happened, but it will take time - time many people don't have because they've already been delaying the proper medical, dental and mental health attention they've needed for decades. Woulda, coulda, shoulda, but I can't help but to think where NC would be now if we'd expanded Medicaid when the Affordable Care Act was implemented in 2013.


The work is challenging and often disheartening when you can't get the outcome you want for the consumer. It can be emotionally draining. I had a consumer this morning who was sick. She'd been coughing for weeks but had been unemployed for more than a year and didn't have any health insurance. As I tried to explain the process for applying for Medicaid, she just let out a big sigh.


"I feel so frustrated and stupid," she said, not being able to figure it out on her own. "I went to Cornell!"


I wanted to laugh, but I could feel the anxiety in her voice. I assured her she was not stupid. Our health insurance system is not set up in a way for folks to understand it. It's like the government hopes you get so frustrated that you give up before you get through all the hurdles. There's also so much healthcare and tax fraud out there, it muddies the waters even more for people.


At the end of the day, we have way more positive outcomes for folks than we do disappointments. Most people are truly appreciative of the help we provide in navigating these systems and they trust us enough to return to us for support each year.


While my writing habits have had to take a backseat lately, I'm determined to make space for it even in the midst of a entirely different career path. It's been an incredible lesson in taking risks and being brave enough to try something completely out of my comfort zone. For me, it's a daily practice of staying curious about the work, accepting I don't have all the answers, and being vulnerable enough to ask for help when I need it.


If you're struggling without health insurance or haven't filed a tax return in the last several years, please reach out to PLS for free help. If you can make the call, we can walk you through the steps one at a time.



The Pisgah Legal Services staff.

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