RESEARCH TO POLICY: HEALTHCARE
Caught in the social safety net
Andrea Campbell gives a firsthand perspective on the effects of means-tested social insurance programs.
The single biggest flaw with means-testing, in Campbell’s view, is that the income limits and other restrictions can make it harder for people to break free of social insurance programs.
When a nursing student named Marcella Wagner swerved to avoid another car on a freeway in northern California, in February 2012, her entire life changed. Wagner, who was seven months pregnant, skidded off the road, crashed, and was paralyzed from the chest down.
Amazingly, doctors were able to deliver Wagner’s baby in healthy condition, but she would need extensive daily assistance. Wagner and her husband, Dave Campbell, who worked for a small manufacturer and earned $39,000 a year, have only been able to afford that assistance through Medi-Cal, the state version of Medicaid.
Medi-Cal is a means-tested program, meaning it has restrictions on personal wealth: Essentially, recipients are subject to income limits, and may only have $3,150 in assets beyond a house and one vehicle. So Campbell and Wagner have to be comparatively poor to get health care: low income, no retirement savings, no college savings for their child.
“It’s a huge hole, and it’s one that people don’t know about,” says Andrea Campbell, a professor of political science at MIT and an expert in social policy.
Photograph by Stuart Darsch