Annemarie Morse: Working Too Much to Qualify, Too Little to Get By

Annemarie Morse, grew up in the China area of Maine and has moved around since, now living in Palermo, right next door. After four years in Lewiston, Annemarie is currently 28 and after parting ways with difficult roommates, they are living on their family’s property rather than in their own townhome.

Annemarie has been on and off MaineCare, Maine’s Medicaid program, since the end of 2019, when they first went to a crisis unit and were, in their words, “faced with my mental health full on.” They’ve had health insurance through their employer a few times in between, but at one point, they had to quit a job because it didn’t offer coverage, and their income was too high to qualify for MaineCare. This coverage gap — earning too much to qualify for MaineCare but not enough to comfortably afford private insurance or a stable housing — is one many Medicaid recipients know well. “I have been able to access health care, but it’s usually at the cost of other things like … being able to earn enough money to live in a dignified living situation,” they said.

The income limits attached to MaineCare have been a source of frustration. Annemarie was recently notified that they were working too many hours and would need to cut back to keep their coverage — but falling below 30 hours a week would put their SNAP benefits at risk. “Such a weird catch 22,” they said. “I don’t know how you can work 30 hours a week and also, unless you’re making, like, minimum wage or below that, also meet the health care requirements.” Annemarie currently works per diem with youth in recovery, and that same instability has already cost them their food assistance. “I haven’t had SNAP since February because of the work hour requirements and not having consistent hours weekly,” they said.

Asked why consistent access to health care matters so much to them, Annemarie didn’t hesitate. “If I did not have the access that I’ve been able to have, I don’t think I’d be here,” they said. They described mental health and physical health as inseparable: “Mental health is just as much a part of physical health, like they’re intertwined.” Even now, they carry real worry about the months ahead. “I’m pretty worried about going through winter again, it’s hard,” they said.

Over the years, Annemarie has been to crisis units on multiple occasions, been admitted to emergency rooms, and been transferred to specialized mental health units at other hospitals. That care eventually helped identify a pattern tied to their cycle, one that had made certain stretches unbearable. Since then, they haven’t had to be readmitted, but they’re still searching for the right ongoing care, since few providers specialize in or are even aware of their condition. The medications aren’t accessible yet either, they said, “because there just haven’t been enough people trying things.” They have tried to find a solution by participating in medication trials, but the side effects can be very hard on the mind and body.

Today, Anne-Marie is on MaineCare, but holding onto consistent care has been its own challenge. A doctor they were seeing in Waterville moved out of state, and their primary care provider serves in the National Guard, which means she’s sometimes “on call doing things out in the world.” Getting the appointments they need has not been easy. Still, they’ve been able to stay on medication for ADHD, which they said “has been helpful.”

New work requirements moving through Medicaid worry Annemarie in particular, given how closely they already have to track their hours to stay under the income threshold. Their per diem schedule is unpredictable by nature — some two-week pay periods bring just one shift, others bring eight or ten when coworkers go on vacation. That flexibility works for them: “It’s good for me because I can choose … I can rest more, and on the weeks where I have the energy and the ability, I can work more.” A blanket work requirement, they said, doesn’t account for the range of jobs and circumstances people are working within. They also see a deeper unfairness in tying survival to strict income caps while, in their words, “they make tax cuts and stuff for all these corporations. And it’s like that’s somehow okay. Little human beings aren’t allowed to have a cup of coffee for their budget, but all of these CEOs can afford yachts and stuff.”

Looking ahead, Annemarie hopes to work for themselves someday, chasing independence, but they’re candid about the uncertainty of it all: “Five years in this world is kind of a pipe dream.” The business they imagine is an art studio open to people struggling with addiction, people with disabilities, and people experiencing homelessness — a place to provide jobs and let people “create things that are good to them and express themselves.” They pictured it as a community space with a closet, a kitchen, and a shower, “just a very decent spot.”

Asked what else they’d want the world, and their lawmakers, to know, Annemarie’s answer was simple: “Health care is a human right, and we should fight to be able to have health care.”