!B for Benefits --- agk's phlog 12 May 2021 @ 1329 --- written on Galaxy J3 while Evy sweeps --- I went back full-time at work in February. Evy is full-time nights at her hospital. Now that we're married we both lost SNAP benefits (food stamps). That's a sudden drop in our grocery budget of almost $400 when we're eating for three. In two months when the baby is born Evy will go on unpaid maternity leave. Her union helped her understand eligibility and how to apply. She keeps Medicaid (state health insurance) for the rest of our pregnancy. By the grace of God we live in a state that expanded Medicaid under the Affordable Care Act. I probably lose my Medicaid because we married. We'll do the financial arithmetic and look close at eligibility requirements this week. I can't afford my employer- sponsored health plan's deductible and the coverage isn't great, so I might just let myself be uninsured again for five months, be careful, and cut my meds in half as needed. After maternity leave, she'll hopefully be able to transfer to a PRN position at the hospital and work only a handful of days per month. She'll breastfeed and do most of the newborn care this time around. Her parents live two hours away. I'll still work fulltime and be in nursing school, God willing and the creek don't rise. Three months after our income drops off a cliff we should again be eligible for SNAP food stamp benefits. I should be able to reapply for Medicaid then too, and hopefully get reinsured in time for my annual women's health checkup, prescription renewal appointment, and dental cleaning. The baby will have CHIP state health insurance if we do things right, which will pay for vaccinations and pediatrician visits. We're super grateful for these benefit programs. It changed my life to move to this Medicaid expansion state. For 16 years before I moved here I was uninsured. I went over 10 years without my meds, which surely shortened my life. When I did get them it was often on the black market. I only dependably got basic healthcare in the few years after my friends and I started a free health clinic in a disaster zone. We used the temporary outpouring of post-disaster donor generosity to fund it. Outside those three years, I tended to my own dental infections, bought antibiotics on the black market, did small surgeries on myself, called a friend for home care when I had a potentially life-threatening bowel obstruc- tion, and toughed out years of partial deafness. I didn't have the knowledge or $40 worth of equipment to do the easy outpatient procedure that restored my hearing when I moved here. Without an insurer to negotiate for me, and prices jacked by billing cartels, clinical care wasn't an option. This fall I'll pay for nursing school at the state school with a federal loan. The hospital where I work will repay some of the loan if I get excellent marks, stay fulltime, and do a year of indentured service after graduation. The repayment program isn't contractual -- they may change policy and not pay with no penalty. I'm trusting them, but at their mercy. We're an at-will employment state. I have no union. I can even be fired without notice or cause. I wish I could go part time and be more involved in our daughter's first two years, but that would just kick the can down the road. Evy and I are incredibly privileged. We got our bachelor's degrees without debt. We managed thanks to federal Pell grants, work-study, and going to one of only two highly- selective "work colleges" in our country that guarantee the cost of education (in our case, $100,000) in exchange for labor. Cassie received a Pell grant, worked in some of the most difficult public service jobs in our country continually for twelve years in healthcare shortage areas since grad- uation, paid faithfully on her debt all twelve years, and was summoned to court by the Sheriff during the pandemic when the owners of her debt changed terms without sending notice. Anne wrote the Low Resource Medicine essays on this gopher hole. After many years responding to emergencies on ambu- lance and fire services in a destitute urban district and the poorest rural county in her state, she works in Alaska for months every year, timezones away from her seven-year- old, to pay down half a million in med school student loans. Public guaranteed benefits like Medicaid, CHIP, WIC, SNAP, and the Pell grant are foundational to my life, ability to work in my field and help patients, and start a family with my spouse. The benefits could be better: automatic not application-based, expanded to higher income levels or universal, not means-tested. Nonetheless, they're bulwarks against abusive rent-seeking industries that immiserate and kill many in my country---and against capricious employers. A safety net helps people feel secure enough to imagine living well and generously. Missouri and Idaho recently passed Medicaid expansion by ballot initiative. The people know Medicaid expansion changes lives. The Missouri legislature blocked the will of the people for now. The Iowa legislature is moving to do the same. I hope the people remember their power, and undistracted by immiseration under parasitical rent-seeking industries, remove the traitorous lawmakers. The worst rent-seeking should be outlawed and illegal rent- seeking prosecuted. Debt accumulated under outlawed terms should be forgiven, debtor prison sentences commuted, debtor criminal records expunged. This would be the Jubilee pract- iced in the ancient world and proclaimed by Jesus. We must also have our Bismarckian social insurance. With- Without social benefits, we become serfs and холо́пы on manors of some sort for generations to come. Don't feel shame or resentment about benefits. Recognize them as guarantors of freedom. Social benefits must be won, ext- ended, and defended.