By skyforbes 
My caseworker’s fingernails are several inches long, long enough to curl in on themselves, long enough that — as she pecks away at an ancient computer — I can’t help but wonder if they interfere with her typing. I immediately realize my mistake. This isn’t the place for ideas like efficiency or speed. If it was, she’d have led me straight to her own computer, instead of wandering through a maze of partitions for an unoccupied desk, as it seems like each caseworker has to do upon returning to the room. She has no permanent desk or office, no computer or phone to call her own. She doesn’t even have a phone number or email address, at least not one she’ll give me. All she has are those hot pink talons and a world of time.
I find myself focusing on these small insanities, if only to distract myself from the situation at large. Because if I think for too long about where I am, and why, and how I got here, the urge to tear off my clothes and howl at the top of my lungs might overtake me. It’s like staring at the sun, only instead of going blind, I’ll just go crazy.
***
In June of 2014, through what I was later informed was a computer glitch, the Covered CA system (California’s iteration of Obamacare) reduced my listed income to zero dollars. In the basement of some derelict government office, vast, bureaucratic turbines sprang to life. With an income of zero, I qualified for Medi-Cal (Calfornia’s Medicaid), and my enrollment was automatically initiated. And since a Medi-Cal applicant can’t participate in the general insurance marketplace, Covered CA canceled my own health insurance plan.
It’s worth noting that at no point in this process was I contacted or notified. In fact, my insurance company was happy to cash my premium checks for the next two months for a policy that I was no longer covered under. It wasn’t until I called them with an unrelated question that I discovered my insurance had been terminated.
What followed were several months of phone calls, emails, and letters. I spoke with dozens of Covered CA spokespersons, Health Care Reform Call Center workers, and Health Net customer service representatives. I was even assigned a Covered CA Appeals Specialist. Everyone I spoke to told me two things: one, that my current situation was in no way my fault, and two, that there was nothing they could do to help. Any attempt to correct the Covered CA system was automatically reset by the Medi-Cal system, and Covered CA could not cross departments and contact Medi-Cal on my behalf (the mistake being entirely their own apparently didn’t make up for the absurdity of me suggesting one government health care provider contact another). My only hope was to speak with someone at Medi-Cal directly. Simple, right?
***
Over eleven million Californians are enrolled in Medi-Cal, roughly 30% of the state’s population, and the eleven million are often those most in need of medical care — low-income families, seniors, the disabled, pregnant women, and children. How does a single government agency handle such an immense bureaucratic workload? They don’t. At least not in my experience.
Covered CA provided me with several phone numbers to use to contact a Medi-Cal representative. All the numbers were disconnected. More phone numbers were listed on the Medi-Cal website. When called, no matter the time of day, a voice apologized for Medi-Cal’s high volume of demand, and said they would be unable to take the call. Then a click, and a dialtone. There were, of course, no email addresses listed.
I received a form in the mail that stated if I visited a Medi-Cal office in person, I would have to make an appointment in advance or else I would be unable to meet with my caseworker. The name of my caseworker? That space was left blank. The number to call to make an appointment? Also blank.
***
And so, on a sunny Tuesday morning, armed with a book and no appointment, I travel to the nearest Medi-Cal office. I expect a massive throng of people, although I hope otherwise, but what I don’t anticipate is the thriving economy that seems to have sprung up in the shadow of the Medi-Cal building. Hot dog vendors sell hot dogs. Men sell sodas and bottles of water from wheeled coolers. A collapsible booth for a phone carrier I’ve never heard of sells cut-rate phone plans and pay-as-you-go cellphones. A heavily bedazzled woman walks up and down the line repeating the phrase, “Hey buddy, want to make two hundred bucks?”
(I’m curious enough to ask the bedazzled woman what she’s talking about. She tells me that the government often provides low-income individuals with free or discount cellphones, and that if I request a phone inside, once back outside she’ll buy it off me. She says she sells them in bundles to a local store for $200 per five phones. I’m sure how that translates to $200 for me, but I’m afraid of what might happen if I question her math.)
As I shuffle in line toward the office’s front door, I can’t help but be impressed by the miraculous and cruel nature of capitalism. Where I might see an endless parade of those in need, these people see opportunity. They have found a way to profit off of the sick, the poor, the confused — they are efficient in a way that Medi-Cal could only dream of.
Finally I reach the head of the line, pass through a metal detector, and almost an hour after arriving I am inside the building. What greets me is a cliché of government bureaucracy. Several immense waiting rooms, stifling heat, crowds of people fanning themselves with pamphlets on diabetes and mammograms, clerks behind glass windows looking already exhausted at 10:00 AM, incomprehensible numbers being read over a loudspeaker. I realize only one waiting room is dedicated to Medi-Cal. Other people are here for work, for training, for food stamps. I also notice that I am, without exaggeration, the only white person in the entire building, and the irony is not lost on me that I am here to get off Medi-Cal. If you ever want proof of America’s racial inequities, just visit a Medi-Cal office (or, if you don’t have eight hours to spare, just ride the bus in Los Angeles).
In the Medi-Cal waiting room, I wait for an hour in my second line of the day (the one I foolishly assume will be my last) to explain my situation to a clerk. She hands me a slip of paper and tells me that if no one calls my name in thirty minutes, to get in another line. No one calls my name. I get in the second line. I explain my situation to a second clerk. She takes my slip of paper and tells me that if no one calls my name in thirty minutes, to see her again. Twenty five minutes later, someone calls my name.
My caseworker is friendly, patient, and deeply unsympathetic to my situation. She explains that I can’t just quit Medi-Cal, nor can I refuse it or cancel it. The system has to formally expunge me. And the only way to do that is to complete my Medi-Cal application as if I am a serious applicant, and let the system reject me for making too much money to qualify. I fill out two forms, her frightening fingernails tap out a few more keystrokes, and within five minutes I’m free to go. After months of dealing with this problem, I am understandably suspicious. I ask her how I can get in touch to see if it worked. She says I will not be able to contact her, but that she will call me within a week to confirm my removal from the Medi-Cal roles.
As I emerge into the fading sunlight of a day almost over, I realize that I am angry, deeply angry. Not from the lines or the paperwork or the time lost. I am angry because not a single person I spoke to responded with surprise, annoyance, or even commiseration. The fact that I make far too much money to qualify for Medi-Cal, that I had never asked to be on Medi-Cal in the first place, or that Covered CA openly admitted it was their mistake — none of it caused anyone to bat an eye. There was no switch they could flip or box they could check that would fix such an obvious error. There was no individuality or humanity they could bring to bear on the situation. Their solution was the same solution they had for everyone: to process me through the system.
They had internalized their own failures and inefficiencies, accepting them as inevitable and unsolvable. The faulty loudspeaker, the massive lines, the disconnected phone numbers, the blank form letters — they were all part of the same attitude of resigned acceptance, of bureaucratic malaise, itself likely caused by decades of far too little funding, manpower, and political attention. I envisioned a motto for Medi-Cal, emblazoned on a huge banner and hung in front of the office, “That’s Just The Way Things Are.”
***
Did she call me back? No, of course not. And when I contacted Covered CA, after waiting two weeks to account for processing, I was told I was still enrolled in Medi-Cal. I finally found a Medi-Cal number that worked — the deputy director’s office — where I was shunted to a supervisory office. I was told to expect a call from my caseworker in three days. After four I called back. I was told to expect a call from my caseworker in two days. After three I called back. I was told to expect a call from my caseworker that same day. The next day I called back.
Finally, on my fourth attempt, I was told that they had “resolved my issue.” The women I spoke with admitted that several people had worked on my problem, that my caseworker had been changed three times, and that at one point there’d been an office pow-wow on how to deal with me. Apparently simply kicking someone off Medi-Cal who didn’t belong on Medi-Cal in the first place was more complex than anyone had assumed. A few days later I received a letter in the mail informing me that my application for Medi-Cal had been rejected due to my income being well over their limit. A few days after that I re-enrolled in my original health insurance plan.
I suppose there are two very different political lessons to take away from my experience. The conservative perspective is obvious — the government’s cartoonish inefficiency, their stupidity and acceptance of mediocrity. But I think it’s also worth acknowledging a liberal belief — that few things are worse in America than being poor and sick. I was a clerical error, only passing through, but millions of people are not so lucky. Nobody wants to be on Medi-Cal. Nobody wants to be in that crowded, stifling office, wading through red tape to receive medical care.
As for me, after seven months I’m pretty sure I have health insurance. At least until tomorrow.