Resource: Personal Stories

Lary Brooks is a fighter. 

At just 2 1/2 years old, he was diagnosed with acute lymphocytic leukemia, a bone and blood cancer that nearly took his life. Lary survived thanks to the life-saving treatment he received at St. Jude Children’s Research Hospital in Memphis, Tenn.

“I was a week from dying when they found it,” Lary recalled about his childhood cancer diagnosis. “From 1979 to 1982, I was under treatment — 1,800 units of chemo and radiation.”

Those intense treatments took a severe toll on his body that affected nearly every aspect of his life, even as an adult.

“I’ve had my L4, L5 vertebrae blown out because of so many spinal taps,” he said. Doctors used the painful procedure to monitor his progress throughout childhood.

Lary’s courage in the face of pain earned him the name “OK Kid.” When the doctors at St. Jude asked him how he felt during these intense procedures, he always responded, “I’m OK.”

But from the time he was young, Lary said, he felt like he hadn’t been able to live life to its fullest.

“At one time, I had my left arm in a full cast and my right arm in a half cast,” he said. “I stepped into a hole while playing with my sister and ended up breaking my wrist.”

Today, at age 47, Lary lives with his family in New Hope, a small town southeast of Huntsville. He suffers from osteopenia and scoliosis. The lingering effects of his childhood cancer caused a loss of spine density and chronic pain that often leaves him unable to work.

‘I’m ready to go back to work now’

Over the years, Lary has found jobs in construction, as a waiter and as an automotive tech. But each job ended when he was injured or needed care.

Most recently, Lary suffered a fall that required major facial surgery to reconstruct his jaw. The surgery left him with more medical debt and yet another battle to get the care he desperately needed.

Originally, doctors told him he’d be recovering for six to eight weeks. But now it’s looking more like Lary won’t be able to work for six months.

“I’m ready to go back to work now, but I’ve got to get released from the doctors,” Lary said, anxious to return to his life. 

Yet with no health insurance, he can only access emergency care. That means he can’t see the specialists he needs to manage his everyday issues — or the crippling pain that comes from them.

Without access to the prescriptions he needs, Lary is left with few pain management options. They provide little to no relief.

“I don’t have insurance, so I can’t treat my problems as they come up, and everything just deteriorates,” he said. “The only thing I’m able to do … is over-the-counter pain medication, but it doesn’t work.”

Alabama’s failure to expand Medicaid to cover adults with low incomes has left nearly 200,000 residents like Lary in the health coverage gap, unable to afford private insurance but not eligible for Medicaid. Our state is one of only 10 yet to accept federal funds that would offer coverage to folks like Lary.

Without Medicaid expansion, Lary must either rely on expensive emergency room visits for temporary relief or continue to endure debilitating pain every day. As he recovers at home from his most recent surgery, he’s left with few options.

A life in pain

“I walk around with a pain level of 10, 24/7, seven days a week,” Lary said. “The only thing I can think about or stay focused on is my body pain because it’s like my brain will not allow me to focus on anything else.”

Lary said his pain is compounded by the limitations placed on health care providers due to the opioid crisis.

“I ask the doctors if there’s any way that I can get help to where I can still stay at work on a full-time basis,” he said. “But with the opiate crisis, they won’t prescribe chronic pain medication without me being established in a pain clinic. So I’m reduced to going down to part-time at work but struggling with my pain all the time.”

Lary’s mother, Brenda Brooks, said finding payment assistance through local hospitals for Lary’s care has become a part-time job itself. She often digs through past tax returns, prints out the past few months of bank statements and tracks down medical records from different doctors.

Brenda said that even with his extensive medical history, Lary has been denied for disability benefits many times. And it hasn’t been for a lack of his mother trying.

“Last time, the disability doctor told us Lary is able to work, as something like a truck driver? He’s not supposed to lift over 25 pounds. Tell me how that works,” Brenda asked.

‘I just wait until I can’t stand it anymore’

So for now, Lary keeps trying to find work while not being able to afford coverage or consistent care. He said he manages by spacing out care, or sometimes avoiding it altogether.

“It’s mainly just choosing the right time to go to the doctor,” he said. “I mean, with my pain and everything, and me being a diabetic, I’m usually having to wait probably six months in order to go.”

Ideally, Lary should be able to go to the doctor monthly. But living in the coverage gap forces him to make tough decisions about whether to seek care when he needs it.

“I spread it out and then choose what pain level I’m in before I either go to the ER or I just wait until I can’t stand it anymore,” Lary said.

It’s a piecemeal plan for pain management caused by living in the coverage gap. When things do become unbearable, his mother said, it’s never without a cost.

“We still owe UAB Hospital for surgery, like $11,000,” Brenda said. “That’s not including the doctor visits. That’s just the surgery and the hospital time.”

On top of that, Lary said his debt at Huntsville Hospital, the closest to his home, is nearly $30,000.

A mother turned warrior

Lary said his mother has been his greatest advocate. A substitute teacher, she has taken up the fight to get her son the care he needs.

“I’ve called everyone — local lawmakers, even Gov. Kay Ivey,” Brenda said. “I’ll do whatever it takes to get him the care he deserves.”

Finally, she reached out to Cover Alabama to share her family’s story.

“I want everyone to understand that people in the gap like Lary just need fair coverage. They aren’t looking for a handout. He pays taxes, so I don’t think it should even be looked at that way,” Brenda said.

Medicaid expansion could help Lary access the specialists he needs without relying on the emergency room for short-term fixes.

“If I could get in to see a good doctor and stay with them, I’d be able to live a normal life,” he said.

For now, Lary’s lack of health coverage affects his freedom and autonomy as an adult, including his relationships.

For Lary, the effects of living without insurance extend beyond his physical health. He recently had to ask his uncle for $3,000 to pay for treatment. He said it was a tough blow mentally.

And romantically, he finds it difficult to find partners or companionship because he feels like “there’s always a catch.”

“I’ve met lots of women, but when I told them exactly what my story was, most of them decided to walk out because they thought it was too much trouble,” he said. “That’s why I’m 47 and still single.”

Hope for a better Alabama

Lary remains hopeful and tries to keep a positive outlook. But he said it’s important to be honest about the isolation he goes through daily.

“It messes with your confidence a little bit,” he said. “I want to be a productive member of society. I don’t want to feel like a burden.”

Medicaid expansion would help Lary live a more fulfilling life, free from the constant worry of mounting medical debt and inadequate care. It would give him and thousands of other Alabamians the chance to work rather than being sidelined by a lack of support.

“You’ve got all these people in this state alone living in the gap,” Lary said. “Imagine how many more in other states like Texas. If we can’t work, our state doesn’t get the tax money.”

For Lary, this is more than a political issue — it’s a matter of survival. As he continues to fight for his health, he holds on to the hope that the system will change one day. In the meantime, Brenda will keep advocating for her son, hoping her calls to lawmakers won’t fall on deaf ears.

“I’ve sent out so many emails and only ever got one response,” Brenda said. “They are supposed to represent people in their area, especially those who need the help. And they’re supposed to push to get what their constituents need, like expanding Medicaid.”

‘The honest way’

Lary said caring for him as a child and not being able to “fix it” was a traumatic experience for his family. He said that’s his constant motivation now: wanting to fix anything he can for others.

Even while recovering from surgery, Lary still finds time to help others. He’s a member of St. Jude’s alumni program, which allows cancer survivors like him to work with doctors to develop new treatments for kids living with bone cancers similar to the one he fought.

“I’m trying to do things the honest way,” Lary said. “I just wish there were systems to help me keep doing that.”

About Alabama Arise and Cover Alabama

Whit Sides is the Cover Alabama storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

When I first spoke with Jolene Dybas, 2023 was coming to an end. Lots of people were attending in-person events confidently and hoping the worst of the COVID-19 pandemic was firmly behind us.

Jolene, however, was still coming to terms with a new reality after moving to Mobile from Florida in 2019.

“I barely go out,” she said. “And when I do, I don’t want people to see me like this.”

I asked her why she preferred to keep such a low profile. That’s when she shared the full story of what it’s like living in Alabama’s health coverage gap. This gap includes nearly 300,000 people who earn too much to be eligible for Medicaid but not enough to afford private health coverage. Alabama’s Medicaid income eligibility limit for adults is one of the country’s most stringent.

“I’ve lived in many other states, and I never saw a person with no teeth until I moved here. I never thought that it could happen to me, but here we are,” she said in disbelief.

The toll of a medical emergency

Jolene’s story begins with good news. Her daughter was accepted to the University of South Alabama (USA) to study nursing. Jolene moved to Saraland, right outside Mobile, to help support her.

Soon after, though, a medical emergency threw a wrench in her family’s new beginning. 

Jolene woke up one day and realized something was off. When she began experiencing heavy bleeding, her fears were confirmed. She rushed to the hospital and was told she needed an emergency hysterectomy to save her life. Jolene also would need intensive treatments, and she would have to stop working while she recovered.

“I quit counting after 10 ER visits and two hospital visits,” she said, describing her new reality of living with chronic pain and recovering from surgery.

Jolene soon lost health coverage when she was no longer able to work full-time as a customer service agent. Her financial situation got so bad that debt collectors began issuing threats of wage garnishment.

“My hours dropped down to part-time. I couldn’t afford emergency medical bills,” she said. “I’m in a place where I’m no longer self-sufficient, and it is killing me.” 

When the hospital bills and prescription costs started to pile up, one of Jolene’s doctors at the USA Hospital encouraged her to apply for financial assistance through the hospital.

“I want people to know that I had a medical emergency and needed blood transfusions,” she said. “If it weren’t for USA Hospital taking up my case, I wouldn’t be here today.”

A temporary lifeline

Thanks to USA Hospital’s financial assistance programs, Jolene received assistance with her medical debt. She also learned she was eligible for a lifeline: Medicaid coverage. Since she was a parent who was too sick to work and had no income, she was one of the few working-age adults eligible for Medicaid under Alabama’s restrictive guidelines.

“Not many good things came out of the pandemic, but hey, it allowed me to get the help I needed and stay on Medicaid when I needed it most,” she said. “That all came crashing down, though.”

After the COVID-19 public health emergency ended in 2023, Jolene found out her health coverage was about to end. Like thousands of other Alabamians, she was rolled off Medicaid coverage during a process known as “unwinding,” or a return to pre-pandemic eligibility requirements.

Jolene had resumed working part-time as her health allowed – and that small amount of income made her ineligible under Alabama’s bare-bones Medicaid eligibility limits. Parents in a two-person household, for example, do not qualify for Alabama Medicaid if they make more than just $3,684 a year.

Jolene said she felt like she had just gotten to a good place managing her health, but losing Medicaid coverage left her with no other options for affordable health insurance. The worst thing about her ordeal wasn’t her surgeries or learning to live with chronic pain, she said. It was finding out she could no longer afford daily medications or dental care.

“Losing Medicaid will leave me with no choice but to go to the ER when my conditions get worse because I can’t afford my medications,” she said.

‘I don’t want them to see me like this’

Living without coverage means making more sacrifices than Jolene had imagined.

“When I lost my insurance, I wasn’t able to go to the dentist,” she said. “My teeth got worse and worse. I only have four teeth left because all I can do is get them pulled when I have a problem.”

Jolene hasn’t visited family since moving to Alabama.

“I can’t even go home to visit because I can’t show them the shape I’m in. I don’t want them to see me like this,” she said. “Where I come from, you don’t see people with no teeth in their head, but in Alabama, I can’t even afford dentures.”

Jolene has lived in several other states before, including Minnesota, Mississippi and North Dakota. She said Alabama’s refusal to expand Medicaid creates unnecessary hardship for its residents.

“If people were well in Alabama, they’d be able to work more. I know I would,” she said.

Minnesota has chosen to expand Medicaid and make other investments in its residents’ well-being. In 2021, lawmakers there passed a historic dental health package that helped ensure Medicaid participants could access dental care and eased administrative burdens for providers.

“They just don’t see things like this,” Jolene said of living in other states with more access to health care and coverage. “There’s no support [in Alabama]. I just thought things were the same everywhere.”

Jolene said living in the coverage gap in a state that hasn’t expanded Medicaid has her missing home.

“If I went home to Minnesota, there is no way I would have this problem,” she said.

‘It can be different’

Jolene’s experience has turned her into an advocate for all Alabamians facing the same problems she does.

“A lot of people in this state don’t know that it can be different. You deserve more,” she said. “Your state leaders are failing.”

Alabamians’ quality of life is suffering the longer we wait to expand Medicaid, Jolene said.

“This has got to be the most expensive place I’ve ever lived. Alabama has taught me a really hard lesson: They don’t care about us,” she said.

Living in other states has offered Jolene a window into the costs of Alabama’s failure to ensure health care access for all of its residents.

“I feel like the death rate is higher here because we all have to wait for adequate care until it’s too late,” she said. “So instead of taking care of that, we’re letting our money slip out of our hands to pay for expansion in other states.”

Jolene said she believes shifting our state’s policy priorities is crucial.

“Why does Alabama still have a grocery tax? I’ve never had to pay that before. Then, we don’t have Medicaid expansion but they’re worried about building bridges and prisons?” she said. “It’s very, very selfish.”

Taking action for a brighter future

After learning nearly 300,000 other Alabamians like her would benefit directly from Medicaid expansion, Jolene started reaching out to lawmakers urging change.

“I’ve written letters to my legislators and Governor Ivey. I’ve called TV stations. I don’t know how they can’t afford to expand Medicaid because people are desperate,” she said. “What does money matter when it’s already there and it is costing lives not to use it?”

One of the states Jolene previously lived in, Mississippi, recently saw meaningful progress toward closing its coverage gap. The Republican-led Mississippi House passed a bill in February to extend Medicaid coverage to more than 200,000 adults with low incomes. That legislation now awaits consideration in the Senate.

Expanding Medicaid is “a topic that should transcend politics,” Mississippi House Medicaid Committee Chairwoman Missy McGee told reporters. “Sometimes, it’s OK to do the right thing because it’s the right thing.”

Jolene said her daughter will graduate soon, and she thinks her family’s time in Alabama is coming to an end. Jolene said the cost of waiting on our state to expand Medicaid is simply too high.

“I thought Mississippi was bad, but it’s not this bad,” she said. “I’m sick of Alabama not caring. If they can’t get their act together, I’m not staying here.”

About Alabama Arise and Cover Alabama

Whit Sides is the Cover Alabama storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

When Diana Isom became pregnant with her first son, Keenan, back in 2021, it was what she’d always wanted.

“My husband and I had been trying for years. I was so happy, but immediately started thinking about timing,” Diana said.

Timing is always a big consideration for most first-time parents, but for Diana and her husband, Luke, things were a little more complicated. When Luke lost his job suddenly, he had to start training in a new technical field. This meant he lost the private health coverage they had previously.

Even though Diana was working full-time hours as a health care worker, she was paid hourly and offered no benefits. She faced a frightening new future: being pregnant with no health coverage.

“I knew I was fully on my own when the medicine I needed was $200 a month and I’m out here with no insurance. Zero options,” Diana said.

Diana, now 26 years old, was raised in Vestavia Hills. Her parents, native to Panama, moved to the United States more than two decades ago when she was 4 years old.

“When I was a child, my parents came to this country so I could have a better life and a better education. I was taught that America was freedom and happiness… and that hard work can get you whatever you want,” Diana said.

Building a life despite uncertainty

As she got older, Diana said she remained positive and worked hard so she could have opportunities her parents never did.

“When the DACA [Deferred Action for Childhood Arrivals] (policy) was passed in 2012, kids like me, who grew up here in America, qualified as ‘Dreamers.’ I was so excited to be able to get a work permit! I’ve been working ever since,” she said.

Under federal DACA provisions, Diana also could access her driver’s license, a Social Security card and other important documents. These documents could help her secure a job, a home or even just a doctor’s visit.

When Diana and Luke got married, she received a green card. But she decided she would begin the lengthy immigration process in 2017, to make everything “official.”

She grew up in Alabama and wanted to start her own family here. Even so, she had to spend five years – and thousands of dollars – to gain citizenship status.

“My life is here,” she said. “I don’t want to have to go back to Panama. My friends are here. My job and family are here.”

When she was growing up, Diana said, other kids bullied her about her status. Even though Alabama was all she had ever known, she still felt a gnawing sense of insecurity.

“In really bad times in my life, people would threaten to call immigration or ICE on my family,” Diana said. “So I jumped through all these hoops and saved up thousands of dollars to make sure that never happens again. Not for me, and not for my son.”

The stress of being uninsured during pregnancy

In 2021, the Isoms received the good news that Diana would finally receive her citizenship. There was only one hitch: It wouldn’t take effect until three months after her baby was due.

Most Alabama mothers with low incomes now are eligible for Medicaid coverage for up to one year after childbirth, thanks to the state’s postpartum coverage extension in 2022. Even though Diana now had her green card, she had to pay out of pocket for health care during and after pregnancy because of a five-year Medicaid eligibility waiting period.

So she faced it alone.

“I had horrible prenatal depression. No one talks about that. It’s awful,” Diana said. “All the stress of not having insurance and my husband working on a temp basis. He either gets hired on or he’s fired. Every time. That stress is crazy!”

Diana said finding the care she and her baby needed while pregnant became like a second job.

“It’s so mentally draining,” she said. “Ever since they rejected me from Medicaid, I’ve been crying and crying. I’m so numb with the whole process, but I couldn’t give up.”

When she realized the couple’s private insurance had lapsed and no other lifelines were in sight, she began researching resources. She went to a free primary care clinic serving mostly Hispanic patients. But she found it difficult to navigate materials provided in Spanish because her first language growing up was English. And the clinic couldn’t provide all the prenatal screenings she needed.

The experience left Diana lonely and struggling to bond with her child throughout her pregnancy.

“Most people get regular ultrasounds. Without insurance, the hospital I went to only offered me the bare minimum. I got to see my baby two times: at the beginning and at the end. That was it,” she said.

‘I shouldn’t have ever been left behind’

Diana’s local hospital was her only option. As she continued to be billed for more than $1,500 a visit, she said she spent many nights wondering how her new family could afford it all.

“You do what you have to do, and I made it all work for my child because that’s what my parents did for me,” she said. “I shouldn’t have ever been left behind, and now neither should my baby.”

After a 19-hour complicated labor and delivery, baby Keenan was born in early 2022. Three months later, Diana joined him in gaining full American citizenship.

Diana thought her citizenship ceremony would lift her spirits and give her family the celebration they needed after a stressful pregnancy, but the process proved a bit impersonal and underwhelming.

“We drove nearly four hours to the immigration office. When I sat down, there was just an officer calling in on Zoom. I was looking at an iPad screen when I ‘became an American,’” she said.

Diana said she is grateful for her new status, but her time as an uninsured mother was a stark reminder that the playing field is not equal for everyone who lives in Alabama.

“People like me who have been in this country for so long… we pay taxes,” she said. “You’re telling me I pay into it, but not benefit from it?”

Though most undocumented immigrants live in a family with a full-time worker, they have limited access to employer-sponsored coverage, a Kaiser Family Foundation report found. And while they pay the same taxes as citizens, they often are employed in low-wage jobs and industries that are less likely to offer employer-sponsored coverage, like Diana is.

Medicaid expansion is the path to a healthier future for Alabama parents

Diana was ineligible for Medicaid after her pregnancy, both because she was not yet a citizen and because Alabama had not yet extended postpartum coverage to one year.

She would now qualify for Medicaid coverage during and immediately after future pregnancies if she met the income eligibility standards. 

Alabama remains one of 10 states yet to expand Medicaid. That means tens of thousands of Alabama parents still have no affordable long-term path to the health care they need as they seek to provide for their families.

Hundreds of thousands of Alabamians stand to gain access to health coverage if our state expands Medicaid. In the Huntsville metro area where Diana and her family live, that includes more than 11,000 people in Madison County and nearly 3,000 people in Limestone County.

Diana said her difficult journey has turned her into a fierce advocate for Alabama mothers.

“Medicaid expansion is a given,” she said. “The stuff I had to deal with in my pregnancy; the days I had to cry myself to sleep. I was always thinking, ‘Today is gonna be the day that something bad happens to my baby.’”

The Isoms’ new son, Keenan, is now insured under Alabama’s Medicaid program. Diana recently returned to work, and her husband was hired on full time after completing workforce training. They soon will be covered by his health insurance. 

Diana said having coverage for both baby and mom has been such a relief to their family.

“I’ve been able to let go of so many things I was worried about before: being deported and away from my child, or how I was going to be able to go to the doctor, even just sleeping at night,” she said. “No one should have to go through what I did. No one.”

About Alabama Arise and Cover Alabama

Whit Sides is the Cover Alabama storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

Just outside the Forecast Salon in Homewood is a gigantic mural painted along the wall. It features every color of the rainbow jumping out into the street. You’re up close with a 10-foot disco ball painted right beside a unicorn and two massive blue and purple manicured coifs.

Forecast’s owner Brittany McNaughton (friends call her Mert) chose the bright and welcoming mural as a manifestation of her personal philosophy.

“Big! Bold! Sunshine!” she says as we look at it. “The vibes are all there!”

Mert and Forecast’s co-owner, Mark Hyde, had a lot to look forward to in February 2020.

They had just reopened their salon in Homewood, just south of Birmingham, after an extensive expansion. Forecast had to shut its doors for three weeks. The renovations brought the space up to 16 chairs and almost doubled the original floorspace. The future looked bright.

Then the COVID-19 pandemic hit, and their world stopped.

“We’d been open for five years, but when 2020 happened, it felt like I had to go dark,” Mert said. “This massive adrenaline rush told me I had to stop expanding and keep my business afloat.”

Mert had just brought on some new stylists, and she said she probably could have hired even more. But soon she learned that the pandemic was shifting her focus from growth to her staff’s “mental capacity.”

Mert said that’s when she realized the shutdown would be longer than three weeks. And it wasn’t just about closing the physical doors to the shop.

“We went from managing everyone’s safety to all of a sudden seeing where our staff was just not doing so well,” she said.

More than just a paycheck

In a rare move in the salon industry, Forecast offers to pay for a portion of its stylists’ health insurance. After two years, they also contribute to employees’ 401(k) retirement accounts.

Another benefit that Mert said was useful during the pandemic was flexible scheduling. She said stylists are encouraged to take personal days off, especially for mental health.

“Whenever you have someone that’s not doing great personally or mentally outside of work, they bring that energy in with them into the workspace, and it can affect the people around you,” Mert said.

Gov. Kay Ivey allowed barbershops and salons to reopen in May 2020 after the initial wave of pandemic shutdowns. It was a first step toward returning to business as usual. But for stylists, that meant getting up close and personal again – and many weren’t ready.

“We work in such an intimate space,” said Mark, Forecast’s co-owner. “We’re up close, touching our clients. It sometimes takes years for these young stylists to build up trust but also build up a shell that can protect them from negative energy or venting clients day in and day out.”

A focus on mental health

Mark and Mert decided to shore up the salon’s career development offerings beyond just continuing education on hair. They brought in local therapists, healers and self-help experts to discuss mental health. Their goal was to help teach stylists how not to take the stresses of personal care work home with them.

“Moving out of the pandemic, I saw a need to bring in programming focusing specifically on mental health and not just hair,” Mert said.

Mark and Mert agree that they can’t do it all. But they said they try their hardest to provide as much as they can for their staff.

“Nowhere is perfect,” Mert said. “I set standards for mental health here in the salon, but I’m not trained to treat anyone’s problems. I’m trained to do hair. That’s where therapists and doctors come in.”

More money in the pocket for both stylists and salon owners

Mert said she hopes that one day all salons will offer health insurance and other benefits. But she also said she knows that’s not a realistic option for all salons. And unfortunately, that means many stylists will have no affordable option for health coverage unless Alabama expands Medicaid.

Across Alabama, about 10,000 stylists and other personal care workers would benefit from Medicaid expansion. More than 220,000 Alabamians are caught in the coverage gap, unable to afford health insurance. Another 120,000 or more are stretching to pay for private or employer-based insurance.

Part of Forecast’s recent renovation was expanding to hire more younger stylists and apprentices into their already robust education program. Not everyone at Forecast would qualify for coverage under Medicaid expansion, but most newer stylists likely would, Mert said. 

Both owners agree that it would be nice to be able to pay stylists an extra $200 to $400 every month. That amount could help cover their groceries or a car payment.

“It’s expensive to provide insurance as a business. That’s why a lot of people don’t do it,” Mert said. “Medicaid expansion would end up creating more revenue for the business and put more money into that stylist’s pocket.”

The benefits for the local economy wouldn’t end there. Jefferson County could realize upwards of $298.6 million in additional economic impact in year one as a result of closing the health coverage gap. Medicaid expansion also would extend coverage to more than 22,500 county residents who didn’t have it before.

I asked Mert what Forecast Salon would do with the extra money when the day finally comes.

“As a business owner, I already know what I’m gonna do with that money,” she said. “Invest it right back into our people.”

ABOUT ALABAMA ARISE AND COVER ALABAMA

Whit Sides is the Cover Alabama storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

Social media can be overwhelming. Like a lot of people, I’ve found myself stepping back from it lately. There is one thing I will never scroll past, though: baby pictures. (Well, that and jokes.)

And Eryn Mullins is good for both.

Eryn is a new mom and hairstylist from Sumiton, a small town in Walker County in northwest Alabama.

I spoke to her the week she returned to work after her maternity leave. Thanks to her husband’s insurance, she and her baby were well cared for during labor, delivery and the postpartum period.

The smiles in her family photos jump through the screen. It’s hard not to think she’s got it all together.

But Eryn will be the first to tell you that it wasn’t always this way. Things were much different for her just a few years ago.

‘A million things to worry about’

“Straight out of beauty school, there’s a million things to worry about,” Eryn said. “When I was 20, I suffered from extreme panic attacks, and I needed to be hospitalized. After that, it still took eight months and four or five different medications to get to a steady place.”

Eryn was diagnosed with a panic disorder that gave her “anxiety that you couldn’t just fix.” Her condition required regular doctor’s visits and consistent medication. Thanks to her dad’s insurance, she was able to keep everything under control.

Then Eryn turned 26. That’s the age when young adults are no longer eligible for their parents’ insurance under the Affordable Care Act. And things started to look very different.

“I was on my dad’s insurance, and then suddenly, I wasn’t. I was uninsured for three years after that,” Eryn said.

“I got a hospital bill for $2,500, and that’s when I decided I was going to try my hardest to not go to the doctor ever again.”

Cold turkey

One thing Eryn didn’t plan for was having to come off all her medications immediately. For her, “cold turkey” meant no prescription refills. It also meant no talk therapy and no visits with a psychiatrist to manage her mental health.

“I experienced so many adverse side effects that put me back in the hospital, suffering from withdrawal,” she said. “We all have brains; not all of them are healthy. Mine wasn’t.”

Any way Eryn looked at it, she was paying hundreds of dollars out of pocket every few months. Sometimes it was for a hospital stay. Once, she spent $400 for just one routine visit with a mental health provider.

“I worked in a high-stress environment my first year as a stylist,” she said. “It’s a vicious cycle. I needed mental help but couldn’t afford it.”

Being uninsured is expensive. And without consistent medical or mental health coverage, those expenses mount for many stylists. After facing a $2,500 medical bill while uninsured, Eryn told herself she would do whatever she could to avoid going to the doctor.

Unfortunately, Eryn is not alone in receiving eye-popping medical bills while uninsured. Most of her coworkers are uninsured, she said, and seeing them navigate that is heartbreaking. More than 22% of people in Walker County are facing medical debt along with her right now.

In all, 6,108 people in Walker County do not have health coverage. That number would drop by more than half if Alabama expanded Medicaid to cover adults with low incomes.

Across Alabama, about 10,000 stylists and other personal care workers would benefit from Medicaid expansion. More than 220,000 Alabamians are caught in the coverage gap, unable to afford health insurance. Another 120,000 or more are stretching to pay for private or employer-based insurance.

‘Hanging up the apron’

Hairstylists often can set their own schedule, but that means income fluctuates. And especially in the beginning, they are paying for all their own supplies and losing a lot of money.

“Starting off as a new stylist is the hardest part,” Eryn said. “There’s no method to the madness.”

Eryn said it is becoming more common to see coworkers “hang up their apron.” That’s code for leaving the hair business altogether, often to train in another industry.

“It’s exhausting,” she said. “I feel like everyone I know is always putting money back, for every little (and big) thing. And you have to be really lucky to even have any left over for medical bills.”

Eryn said she loves what she does and doesn’t plan on quitting anytime soon, though she jokes about it sometimes.

“There are days where I debate working at Big Lots or Walmart. It’s steady, and they probably get insurance at full time,” she said.

A path forward

After seeing so many friends walk away from behind the chair, Eryn said she didn’t know how she would make it as a mom and a stylist.

“We were expecting our first baby soon, and I had no idea how I would handle maternity leave,” she said. “I was able to make a deal on my booth rental, but that’s it. If I didn’t have the support of my husband, I don’t know if I could even afford a child.”

Through it all, Eryn said she still would choose to become a stylist all over again.

“I’m glad I stuck with it,” she said. “It was a rough few years, but now I get to coordinate my life and schedule the way I want, which is much better for my mental health. I think that’s probably true of any career.”

Eryn said she hopes discussing her experiences can help improve life for hairstylists and other Alabamians living without health coverage.

“I wanted to share my story because it’s worth it to me if even one person feels less alone,” she said.

ABOUT ALABAMA ARISE AND COVER ALABAMA

Whit Sides is the Cover Alabama storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

The Cover Alabama coalition held its first Lobby Day on March 21 on the steps of the State House in Montgomery. Faith leaders, community advocates and people living in Alabama’s health coverage gap spoke about the importance of Medicaid expansion for their families and communities. Advocates then met with lawmakers to urge them to save lives and create jobs by expanding Medicaid.