I called NY State of Health to change my mailing address. I ended up on Medicaid.

How a simple phone call exposed yet another bizarre crack in our Byzantine healthcare bureaucracy.

My younger son and I moved in with my partner and his two two sons a few months ago, which has obviously meant changing our address on multiple forms and fronts—drivers license, banks, credit cards, utilities, doctors offices, etc. I thought I’d taken care of all of these administrative tasks, but when I recently logged into the New York State of Health website, our ACA administrators, to see if they had published any news or information about how, exactly, the so-called “One Big Beautiful Bill” would affect the cost of ACA health insurance coverage, I realized they still had my old address.

First I tried to make the address change online. Impossible. The only solution was to call a toll-free number directly, so I buckled down for what I figured would be a long wait listening to hold music, then a short discussion with an agent. I figured I could kill two birds with one stone and ask this agent my most pressing and seemingly simple question: Will I and millions of other Americans covered by either the ACA or Medicaid have health insurance come January 1, 2026, and, if so, how much will it cost?

Why, you might ask, am I not getting my health insurance through domestic partnership with a man who has good corporate-sponsored health insurance? The quick, absurd, and uniquely American answer is this: though my love and I are domestic partners in every sense of those two words—we share an address, a bed, a life, chores, parenting, plans for our future, and a deep, abiding love—New York City does not consider us legal domestic partners, as he is already married. That his wife has been living with early onset Alzheimer’s for over decade; that she lives in our garden apartment, with her own separate entrance, where she is cared for 24/7 by a rotating cast of caregivers; that she no longer recognizes her husband nor her sons? None of these circumstances legally matter. The only thing that matters in the eyes of both the law and our health insurance system is that marriage contract. (I’ve already written extensively about the absurdities of this here.)

Current requirements for legal domestic partnership in New York City.

These antediluvian laws and hoop-jumping stipulations about who can and cannot get health insurance in our country are, in fact, how I ended up covering my ex-husband under my corporate-sponsored health insurance during most of the five years between our separation and divorce. Even though he’d moved 3000 miles away from me and our kids. Why did I cover my ex-but-not-yet-officially-ex-husband’s health insurance for so long? Because back then he didn’t have access to his own health insurance. And had he become really sick or found himself in a car accident, I, his then still-wife, would have been still-liable for his hospital bills.

“Hi!” I said to the New York State of Health agent. I told him I had two quick issues I needed to deal with that day: I wanted to change my address, and I wanted to know how the so-called ‘Big Beautiful Bill’ would affect my coverage.

The agents who answer the phones at New York State of Health, I should note, are unusually knowledgable, helpful, and kind, and this agent was no exception. But I could also tell he’d probably been handed a script, and he was sticking to it.

“Let’s deal with the address change first,” he said. Then he started asking me a bunch of questions about my 2024 taxes, my presumed 2025 earnings, and my expectations for 2026 income. This was not the short, “Here’s my new address” conversation I was expecting. It was a deep dive into my personal finances. Which, because I’m currently a writer and solopreneur, can vary wildly from year to year. Some years, like last year—ironically the same year this publication won a Webby for the Best Independent Publisher—my expenses were greater than my income. But thanks to the ACA, I’ve had low-cost health insurance since 2021.

By the time we’d reached the end of this Q&A, I’d somehow given New York State of Health permission to see and use my private federal tax forms as proof of yearly income. Then the agent said, “Great, the address change is now in the system. You should be getting your Medicaid card in the mail by the end of this week.”

“Wait, what?!” I said. I did not want to be on Medicaid, I told him. Or, rather, being on Medicaid under any other administration would have been fine. A relief, even. But today, Medicaid, as anyone paying attention to the news knows, is on the chopping block under the so-called “One Big Beautiful Bill,” which not only has been widely reported to include cuts to Medicaid, SNAP, and Social Security, but is also so deeply unpopular in both red and blue states that, just yesterday, Trump and his lackeys tried to rename and “rebrand” it as either the “Working Families Tax Cut Bill” (lol) or the “Working Families Tax Plan” (rofl).

Alas, it was too late. Thanks to a computer algorithm, I was automatically switched over from my regular low-cost ACA plan to Medicaid.

“Would you like to apply for SNAP benefits as well?” he asked.

“SNAP? No! Wait, seriously, I just needed to change my address! And to ask you if you know whether the ACA will still be around on January 1, 2026. That’s four months from now. And we both know the ‘big beautiful bill’ aims to get rid of it.”

“We cannot speculate on anything that hasn’t happened yet,” said the agent.

“Of course we can!” I said. “Or at least I can. Because it’s in the bill. But okay, sure, I understand you can’t say anything right now on the record. At the same time, those of us who will be out of health insurance in four months kind of need to know what’s happening. We can’t suddenly be uncovered.”

“We cannot speculate on anything that hasn’t happened yet,” he said again, and then again and again, each time I tried rephrasing my question.

“Look, this is important,” I said. “We both know that that bill aims to kill the Medicaid you’ve just given me, as well as the tax credits for the ACA.” I told the man that this past August, in fact, fearing this upcoming upheaval in my coverage, I’d applied for a job at my local Trader Joe’s, a company known for its excellent benefits and good working conditions.

My thinking on this front was simple: I could work the 28 required hours for health benefits, meet my neighbors, help them bag their groceries, never take the job home, and still have enough time to research and write articles for this publication and finish my new novel. Also, no one in my shrinking industry wants to hire a 59-year-old woman anyway (I’ve tried, and tried), and I would not have to sell my soul or go against my own moral compass to have health insurance, as I once did in my work as a VP at a high-end marketing agency helping to market products for (oh, the irony!) the pharmaceutical industry: a job whose only lasting benefit was that I was able to appropriate the brand manifesto I’d written in 2015 for Estring, a vaginal estrogen ring, and give it to a fictional character named Emily. Thus providing a year’s worth of excellent, low-cost health insurance through my union, the WGA, for me and my kids. (But only for one year. I only earned $45,000 writing on that show. And you have to earn approximately $40K a year to stay on WGA health insurance.)

Related: every time I try to explain to my friends in Paris, where I lived in my twenties, about the kinds of pretzels we Americans have to turn ourselves into in this country just to get health insurance—a benefit bestowed by other governments on all of their citizens, no matter their jobs, wealth, health, or marital status—they cannot comprehend how this can be true in the richest country on earth.

I explain that living in the richest country on earth might actually be the problem because of our increasing income inequality, our antediluvian ideas about who gets health insurance and how (through corporate jobs, marriage, domestic partnership, etc.), and the unfettered millions health insurance companies spend on lobbying: $155,683,543 in 2024 alone. Living in a rich country does not translate, for the majority of us, into being rich ourselves. Or even these days into being middle class or keeping our heads above water. And now the divide between rich and poor in the U.S. is about to grow ever more drastic and dangerous thanks to the “Big Beautiful Bill” or however Trump wants to brand it. Yesterday, the Wall Street Journal reported that, in 2024, the U.S. had 1,135 billionaires, up from 927 in 2020.

And the so-called big beautiful bill just gave all those billionaires massive tax cuts in exchange for your, mine, and every other U.S. citizen’s health, wealth, and well-being. (Yes, it’s really that simple.)

Also? Good luck to everyone trying to get a Covid vaccine this fall. I finally nabbed an appointment at a nearby CVS next week, but only because I have two underlying conditions: I smoked in my early twenties, back when planes had smoking sections and you could not exit a bar without smelling like an ashtray (ugh, I know, so stupid!), and I went deaf from Covid in 2022. These make me eligible to get the vaccine at my age (59) when the cut-off is now 65+. (Here’s my unprofessional advice: if you don’t have an underlying condition, but you want the vaccine and are under 65, just lie and say you have one. No one is checking, and that’s where we are, circa 2025, in this bizarro fascist timeline. We are forced into lying to stay healthy.)

Even with my underlying conditions, I had to ask my doctor to send a prescription to CVS, as, unlike in years past, we now need one in order to get the shot. Which, don’t get me started, except to say this: RFK, Jr., if you’re reading this, I hope you realize that your legacy of misinformation, chaos, ineptitude, and utter lack of scientific knowledge or rigor will be the unneeded suffering and, yes, deaths of countless Americans.

Two days ago, my Medicaid card arrived in the mail, the same day my rejection from Trader Joe’s landed in my inbox.

I won’t even go into what I felt or how I cried reading that rejection, after spending so much time on that application and putting my faith in its ability to provide health insurance come 2026. The last time I wrote about such things, in 2014, my essay went viral, and I was asked to speak about it on several news shows.

But then, in a painful twist, the parenting writer at the New York Times decided to blame my lack of health insurance not on our country’s healthcare system or systemic financial and cultural inequalities, especially for divorcing women who find themselves needing breast scans and surgeries, but rather on my own “poor judgment…bad judgment, a lack of savings and a sense of entitlement.” Worse, she accused me of lying. In the paper of record. To wit: “her New York-apartment-dwelling, sold-a-television-pilot self might be feeling stretched, but couldn’t really feel the desperation she was laying claim to.” The author of this Op-Ed then trolled for comment traffic for the New York Times by ending with a deliberately divisive question: “When you read Ms. Copaken’s story, or even the little I’ve shared here, do you identify with her or dismiss her — and more interestingly, why?”

Your only two options, folks: identify with me or dismiss me. As if the game isn’t a priori rigged against most of us. As if those of us who are just trying to do no harm, produce good work, earn a modest living, and have the ability to see a doctor when we’re sick without going broke are asking for too much and suffering from “a sense of entitlement.”

Some historical context: my viral essay came out eleven years ago. I’ve grown hoarse ever since, screaming about the inequities and insanities embedded in our healthcare system and begging for a single payer system. Somehow, at the end of my sixth decade—a mere six years before I’ll be eligible for Medicare, if it still exists when I turn 65—I and so many of my fellow Americans are still playing health insurance frogger whenever we lose a job, lose a spouse, or lose our minds trying to keep up with the whiplash of health insurance policy changes. Instead of finally instituting the kind of single-payer, universal health coverage most advanced countries take for granted, our government just keeps moving the goal posts, creating half-assed, corruptible, Byzantine systems, meant to mollify and enrich the insurance industry at the expense of our health.

Assuming my health insurance will end on January 1, 2026—which I do assume—I figure I now have four months to book all the doctors appointments and tests I need for the next god-knows-how-many more years until retirement. This is no way to live. But it is, my fellow Americans, an excellent way to die.

From Physicians for a National Health Program