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isnt-it-pretty · 3 years

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Inquisitor as a Companion

(template via dextronoms)

Based on this post I made about Young!Inquisitor AU, Ft. Reluctant Dad!Cullen

Inquisitor's Name: Evelyn Trevelyan (Age: 13)

Alternate name: When high enough friendship, she asks to be called Ellie.

Race, Class, & Specialization: Human, mage, spirit healer

Varric's Nickname for them: Wildflower. A special option will appear when relationship with both Varric and Evelyn is high enough, where the Inquisitor can question why he calls her Wildflower. Varric will explain it’s because Wildflowers still grow strong and beautiful, even in the harshest of climates, and that really sounds like our girl, doesn’t it?

Default Tarot Card: The Tower - Changes, conflict and disruption of life. Bad news and calamity.

How they are recruited: Evelyn is there at Haven. She nervously approaches the Herald and introduces herself as a Spirit Healer, and asks if there’s anything she can do to help. The Herald has the option to tell her that there is no place for children in the Inquisition — thus sending her away and keeping her from joining the Inquisition, or to tell her that they are sure they can find work for her.

Where they are in Skyhold: Sits in between the battlements gazing out across the mountains, her legs dangling off the edge. If the third option is chosen in her personal quest, and Cullen is not taking Lyrium, she can be found in his office.

Things they Generally Approve of: Allying with the mages. Saving everybody in Haven. Executing Gereon Alexius or Knight-Captain Denam. Allowing Cole to stay. Becoming Inquisitor for what’s right. Allying with the wardens. Arresting Florianne. Allying with Abela in the Arbour Wilds. Pro mage actions, generally merciful actions. Saving and helping people.

Things they Generally Disapprove of: Siding with the Templars, or conscripting the mages. Evelyn will attempt to leave the Inquisition if either of these happen, saying she refuses to be captive again, but can be persuaded to stay. Saying that they will become the Inquisitor for personal power or vengeance. Exiling the wardens. Letting Celene die. Any pro templar actions, letting people die when they can be saved. Siding with Ishmael. Making mages tranquil. Lying to Dorian about his father’s letter.

Mages, Templars, Other?: Being a mage raised in the circle at Ostwick. Evelyn dislikes templars. If asked why she dislikes Templars when her relationship is too low, Evelyn will say she doesn’t wish to speak of it. If asked when it is high enough, Evelyn will explain that the Templars in her circle were cruel. When the circle fell, the Templars attempted to kill as many mages as possible; many of her friend’s died. She won’t explain what she means by cruel, and will only say that some things that are better left unsaid.

Friends in the Inquisition: Dorian, Cole, Varric. Cullen, after reaching Skyhold. Kieran, if Morrigan had him.

Romanceable?: No. Evelyn is thirteen and as such there is no options for it.

Small side mission: Evelyn asks that the Inquisitor please gather a series of herbs. There is a list of them, from Elfroot to Andraste’s Grace. When they are given to her at Haven or Skyhold, she says that they will make excellent potions.

Companion quest:

Post Wicked Eyes and Wicked Hearts and Here lies the Abyss, Cullen will approach the Inquisitor, asking if they have seen Evelyn recently. The Inquisitor has the option to question when they became so close, why he’s asking, or as a romance option: “I didn’t know you’re good with kids.” No matter the choice, Cullen ends up explaining that Evelyn gifted him tea to help with headaches, and since then they’d grown closer. He’s been teaching her to play chess, however she seemed agitated over the last few days.

Optional: The Inquisitor can investigate Evelyn’s bedroom, which is above the garden. In it, they will find the blankets pulled off the bed and piled in the corner, as if she’s been sleeping there. On the bare mattress, there is an envelope and a letter. The letter is from Evelyn’s parents, who express their joy over finding out their daughter is alive, and their concern for her wellbeing. They say that they wish for her to return home to them. The Inquisitor can also find a journal forgotten half under the bed. In it, Evelyn talks about her growing friendship with Cullen, and how he was more like a father to her than her own father ever was, despite being a former Templar.

Leliana can be questioned about Evelyn’s location, to which she will respond that Evelyn left a few days previous, but Leliana has been keeping tabs on her. If the bedroom was investigated, there is an optional dialogue to ask about the letter. Leliana explains that she also received one — a formal request from Ostwick to return Evelyn Trevelyan to her parents. She says that it is a delicate matter, and has been discussing it with Josephine before bringing it to the Inquisitor’s attention. If the journal was found, the Inquisitor can also ask what Leliana knows of Evelyn and Cullen’s relationship, to which she will respond, “it’s sweet, isn’t it?” and mention how she doesn’t see Cullen smile more than when he’s with her.

The Inquisitor can gather a party and head to The Hinterlands, where Evelyn can be found at the crossroads, healing. When approaching her, if any mage is in the party, they comment that she’s been overusing her magic, and seems exhausted. A cutscene will begin upon speaking to her.

Evelyn looks up, and before anybody can speak says “I won’t go back. You can’t make me.” The Inquisitor can scold her for leaving, ask why she ran away — or if the letter was found, tell her she’s causing problems for the Inquisition, or ask why she doesn’t want to return to her parents. To the first option, Evelyn will apologize guiltily, but refuse to return to Skyhold. To the second, she will say it’s complicated. To the third, she will become agitated and say that the Inquisition has caused problems for her, too, and that she won’t return just because somebody else says so. If questioned about her parents, Evelyn will look down and explain that they hate mages. They let the Templar’s take her as a child, and even when she wrote letters explaining the Templar’s hurt her, her parents only told her that it was Andraste’s will.

After this conversation, the Inquisitor can either let her remain in The Hinterlands, causing her to leave the Inquisition permanently, threaten her to get her to return to Skyhold, or persuade her to return to Skyhold.

Another cutscene begins after returning. Cullen, Leliana, and Josephine meet them at the gates, with a richly dressed couple who are introduced as Lord and Lady Trevelyan. When her mother goes to hug her, Evelyn flinches. The Inquisitor can decide to send her away with her parents, or keep her with the Inquisition.

Option 1: Send her home with her parents. Evelyn will refuse to look at the Inquisitor, but will relent. She returns to Ostwick with her parents, permanently leaving the Inquisition. The Inquisitor receives a sizable amount of gold in return. Cullen will later comment that it’s quiet around here, and that he must admit, he misses her. Varric will be angry that she was sent back with the people who enabled her abuse. Vivienne will say that it was good of the Inquisitor to send the girl home.

Option 2: Evelyn remains with the Inquisition. Lord and Lady Trevelyan accuse the Inquisitor of abducting their daughter, and that there will be consequences for the action. Unlocks the war table mission Smooth Things Over with Ostwick, which will have the option for Josephine to send dignitaries to handle the situation (results in a letter of apology from the Trevelyans and an amount of gold to care for their daughter, a note from Josephine at the bottom says it was likely forced by the Ostwick Viscount), or Leliana to have the Trevelyans assassinated (results in a letter from Ostwick saying there will be no further action will be taken against the Inquisition.)

Option 3 (only attainable if the letter and Journal were found): Cullen will care for Evelyn. Cullen sputters a response at this, but will accept, saying she’s an easy kid to handle. The Trevelyans are unhappy, but will accept it when Leliana mentions that they did give up their parental rights when she was sent to a circle, and that Cullen is a former Templar. Evelyn can be found in Cullen’s office from then on. After What Pride had Wrought, upon entering Cullen’s office, a cutscene will trigger. The Inquisitor walks through the garden to find Evelyn and Cullen playing chess. Evelyn smiles and mentions finding Varric before running off. Cullen says she’s grown quite good at the game. He thanks the Inquisitor for allowing her to stay with the Inquisition, and that he’d miss her terribly if she were to leave, at which point the scene ends. In Trespasser, Cullen mentions his daughter in passing while speaking with the Inquisitor. If romanced, he says he hoped that the Inquisitor is okay with it. NPCs can be overheard mentioning “Evelyn Rutherford” in reference to a powerful Spirit Healer.

**Note, if Cullen resumes taking Lyrium, a different cutscene will trigger. In this one, Cullen tells Evelyn that he be expected to take care of her. She argues that she can take care of herself, but he won’t hear it. She rushes away in tears, and Cullen sighs. Upon seeing the Inquisitor, he tells them that they should have send her home, and that keeping her there is too dangerous, at which point the scene will end. Evelyn can no longer be found in Cullen’s office, and is instead in the spot on the battlements she was on before. If asked about Cullen, she simply says she doesn’t want to talk about it. If this happens, Evelyn will disappear after Corypheus is defeated and will not be a playable character in Trespasser. Cullen does not seem to remember her very well in the DLC, having difficulty recalling her name.

Tarot card change

Option 1: The Tower, crossed out to show she is no longer playable.

Option 2: The Star - meaning hope, faith, renewal.

Option 3 (Cullen off Lyrium): The Sun - meaning positivity, joy, fun, warmth.

Option 3.5 (Post cutscene, Cullen taking Lyrium): The Hermit, inversed - meaning isolation, loneliness, and withdrawal.

#inquisitor as a companion #inquisitor as companion #inquisitor trevelyan #evelyn trevelyan #dragon age #dragon age inquisition #my writing

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wesleyhill · 4 years

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Hagar the Theologian

A homily on Genesis 21:8-21, preached at Trinity Episcopal Cathedral, Pittsburgh, on the Third Sunday after Pentecost 2020

I would speak to you in the name of God, the Father, the Son, and the Holy Spirit, Amen.

Our Old Testament reading for this morning is disturbingly resonant with contemporary headlines, isn’t it? An African woman is divorced by her wealthy and powerful husband and is left to try to keep her child alive by herself.

When we meet her in today’s lesson, Hagar the Egyptian is a slave to the patriarch Abraham and his wife Sarah. Abraham, remember, was called by God when he was a moon-worshiper in Ur of the Chaldeans, and God made Abraham a promise that he would become the ancestor of many nations. “Look towards heaven,” God said to Abraham, “and count the stars, if you are able to count them…. So shall your descendants be” (Gen. 15:5). And Abraham believed this promise, and the Lord reckoned it to him as righteousness.

But then time starts to pass, and Abraham’s wife Sarah becomes impatient. At 76 or 77 years old, Sarah says to her husband, “You see that the Lord has prevented me from bearing children” (16:2). So Sarah concocts a plan. She arranges for Abraham to marry her Egyptian slave-girl Hagar, thinking that if Hagar becomes pregnant, the son that she bears for Abraham will be his heir. Maybe that is the way God intends the promise of offspring to be fulfilled.

Abraham agrees to this plan, and he conceives a child with Hagar, and immediately this creates bad blood between Hagar and Sarah, Abraham’s two wives. Sarah complains to Abraham, “I gave my slave-girl to your embrace, and when she saw that she had conceived, she looked on me with contempt” (16:5). Abraham, in effect, throws up his hands and tries to step away from the situation. “Your slave-girl is in your power,” he tells Sarah; “do to her as you please” (16:6). And Sarah does. She “deals harshly with her” (16:6), and Hagar flees.

By the time of our reading this morning, Hagar has had her son, Ishmael, and has returned to her mistress Sarah. Sarah, too, has finally had a son, a miracle child, Isaac. At the opening of our reading, Sarah sees Ishmael “playing” with her son Isaac (21:9). It’s hard to know what exactly is in view here. Some Bible readers have wondered if there are sexual connotations in this word, so that what Ishmael is doing with Isaac perhaps amounts to some kind of sexual abuse. Other readers have pointed out that, in the original Hebrew, the word for play sounds very similar to Isaac’s name — so Ishmael may be “Isaac-ing,” which is to say, “playing as if he were Isaac,” jostling for the position of the true heir, and trying to displace his half-brother.

Whatever the case, Sarah, Abraham’s first wife, reacts with jealous fury. She turns to Abraham and says, “Cast out this slave woman with her son; for the son of this slave woman shall not inherit along with my son Isaac” (21:10). Sarah can’t even bring herself to say their names. She reacts without pity and without mercy. It was Sarah’s plan in the first place for Hagar to have a son, but now that Isaac is on the scene, Sarah doesn’t want to share what she views as her son’s rightful inheritance. So Hagar and Ishmael have to go.

Perhaps most disturbingly of all is the way God seems to side with Sarah in ejecting Hagar and Ishmael. God says to Abraham: “whatever Sarah says to you, do as she tells you, for it is through Isaac that offspring shall be named after you” (21:12). Not only is Hagar losing her human community; she seems also to be losing her God.

The next morning, Abraham gets up early, and he gives Hagar and Ishmael a bit of bread and a container full of water and sends them off into the desert. With minimal provisions and an unforgiving landscape ahead of them, Hagar and Ishmael are going to their death.

A story like this is so familiar to many of us that we can easily ignore how unbearably tragic it is. Martin Luther, the Protestant Reformer, lingers over the tragedy of it: “Surely this is a piteous account, which I can scarcely read with dry eyes, that the mother and son so patiently bear their ejection and wander into exile. And so Father Abraham either stood there weeping, following the wanderers with his blessings and prayers, or else he hid by himself off in a corner, where he cried over his own fate and that of the exiles."

With barely enough provisions to survive for a handful of days, the African slave woman and her son are banished into the wilderness to suffer death alone.

The feminist Old Testament scholar Phyllis Trible, in her classic book Texts of Terror, writes this about Hagar: “As one of the first females in scripture to experience use, abuse, and rejection, Hagar the Egyptian slave claims our attention.” Trible wrote those words in 1984. How much more are they true today! Hagar claims our attention in 2020 too because we know Hagar’s face. We who live in the era of #MeToo and Black Lives Matter, we know about victimized women of color. It’s no wonder that Delores Williams says: “The African-American community has taken Hagar’s story unto itself. Hagar has “spoken” to generation after generation of black women because her story has been validated as true by suffering black people. She and Ishmael together, as family, model many black American families in which a lone woman/mother struggles to hold the family together in spite of the poverty to which the ruling class economics consign it. Hagar, like many black women, goes into the wide world to make a living for herself and her child, with only God by her side.”

And yet, for me, the worst part of this whole story is that God doesn’t seem to be by Hagar’s side. God seems to have abandoned Hagar and her son to suffer their fate. Martin Luther says that if you read the story from Hagar’s perspective, it looks for all the world like even God has forsaken Hagar. God is the friend of Abraham, so if Abraham divorces Hagar and sends her out into the desert to die, then why would she not think that God is the one breaking faith with her and sending her out to die?

And isn’t that where so many of us today live our lives too — in the fear or the dread certainty that God has indeed written us off and left us to suffer our fate alone? It’s no wonder so many people in our world today can identify with Hagar’s story. As Phyllis Trible says, “[A]ll sorts of rejected women find their stories in [Hagar]. She is the faithful maid exploited, the black woman used by the male and abused by the female of the ruling class, the surrogate mother, the resident alien without legal recourse, the other woman, the runaway youth, the religious fleeing from affliction, the pregnant young woman alone, the expelled wife, the divorced mother with child, the shopping bag lady carrying bread and water, the homeless woman, the indigent relying upon handouts from the power structures, the welfare mother, and the self-effacing female whose own identity shrinks in service to others.”

And, if all that weren’t enough, Hagar is the Godforsaken. She is the one for whom God is not there, not present, not ready and available to help and to save.

Eventually the water that Abraham had given to Hagar runs out. All her options now exhausted, Hagar leaves her son under a bush. Then she walks away from him so that she won’t have to watch him die of dehydration, and she begins to cry out and weep.

But this is not the first time Hagar has found herself in exile. When she fled from her mistress Sarah’s harsh treatment on a previous occasion, she had also ended up in the wilderness. Hagar had run out to the desert, and God had met her there. God had found her, and just like God did with Abraham, God made a promise to Hagar that her son, Ishmael, would be a great nation too, so numerous “that they cannot be counted for multitude” (16:10). And then, absolutely remarkably, Hagar had spoken to the Lord and even dared to give the Lord a name: “You are El-roi.” Then she said, “Have I really seen God and remained alive after seeing him?” (16:13). The Hebrew name that Hagar gave to God means “God of seeing,” or, we could translate it, “the God who is seen.”

This is an absolutely stunning moment in the plotline of the Bible. Hagar the African, Hagar the slave, Hagar the Egyptian foreigner in the household of Abraham, received her own vision of God, apart from her mistress and her husband. She beheld God, and she dared to give God a name. In biblical religion, no one is able to see God and live (Exod. 33:20). And yet Hagar saw God. God revealed himself to Hagar.

As I was reading the story of Hagar’s exile again this week to prepare for this sermon, I found myself thinking back to a parable of sorts from the Christian philosopher Basil Mitchell. Mitchell asks us to imagine a country under military occupation. There is a group of resistance fighters who are trying to stand up for what’s right in this occupied territory, and one night, one of the members of the resistance meets a stranger. “The Stranger tells the partisan that he himself is on the side of the resistance — indeed, that he is in command of it, and urges the partisan to have faith in him no matter what happens.” That turns out to be easier said than done, because although the resistance fighter trusts the Stranger, the Stranger does a lot of things that seem to call that trust into question. “Sometimes he is seen in the uniform of the police handing over patriots to the occupying power,” and in moments like that, it is nearly impossible to go on trusting the Stranger. But he does. He does trust, and it is precisely the disparity or mismatch between his faith and the way the Stranger behaves “which constitutes the trial of his faith.”[1] What the resistance fighter has to do is appeal to what he knows about the Stranger from their first meeting over against what he sees of the Stranger’s behavior in the present. He has to tell himself, “Even though it doesn’t always look like it, the Stranger is on my side.”

That is exactly what is happening as Hagar cries out on behalf of her dying child Ishmael. She has already seen God. God has already met with her and made a promise to her. Now it looks like that promise was a lie and God has abandoned her to die. But Hagar won’t accept that. Instead she weeps and “lift[s] up her voice” (21:16). Hagar doesn’t acquiesce to her circumstances; she protests. She laments. She asks, in spite of all appearances, for help.

One of the saints of the church, Bishop Isidore of Seville, once said that what Hagar was doing as she cried there in the desert was crying out (unbeknownst to her) to Jesus, who hung forsaken by God on a tree. Bishop Isidore says that it is no accident that as Hagar cries out, her son is lying under a tree. She left him there under a shrub or bush, but if you look closely, says St. Isidore, that bush is a tree — the tree: the tree where slaves have been lynched, the tree where criminals have been hanged, the tree that represents all the misery and evil of our violent world, the tree to which God’s feet and hands were nailed outside Jerusalem over two thousand years ago. Although everything in her present experience seems to say that God has left her to die alone, Hagar appeals to the God of the cross. If you like, Hagar appeals to God against God. (As Luther says, biblical faith is “to press toward God against God and to call out.”) Hagar runs for refuge to the God revealed in the suffering and death of the cross, even as she flees from the God who is hidden, inscrutable, and terrifying.

And then the text says: “God heard the voice of the boy,” as he lies there under the cross. “[A]nd the angel of God called to Hagar from heaven, and said to her, ‘What troubles you, Hagar? Do not be afraid; for God has heard the voice of the boy where he is” (21:17). “Then God opened her eyes, and she saw a well of water. She went, and filled the skin with water, and gave the boy a drink” (21:19).

I don’t know what kind of wilderness you may be wandering in this morning. I don’t know what shadow or foretaste of death you may be facing. Whatever it is, hear the word of “Hagar the theologian” (Trible): When you are rejected, when you even feel abandoned by God himself, there is hope. God is in the wilderness, and God is to be found there, on the tree, suffering with you, bringing you salvation, and redeeming your life from the grave. Trust God. Trust the God of the tree. Trust the God revealed in the cross of Jesus Christ our Lord.

Amen.

[1] See Fleming Rutledge, And God Spoke to Abraham, pp. 225-32.

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dinafbrownil · 5 years

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The Deep Divide: State Borders Create Medicaid Haves And Have-Nots

ST. LOUIS — Patricia Powers went a few years without health insurance and couldn’t afford regular doctor visits. So she had no idea cancerous tumors were silently growing in both of her breasts.

More From The Midwest Bureau

If Powers lived just across the Mississippi River in Illinois, she would have qualified for Medicaid, the federal-state health insurance program for low-income residents that 36 states and the District of Columbia decided to expand under the Affordable Care Act. But Missouri politicians chose not to expand it — a decision some groups are trying to reverse by getting signatures to put the option on the 2020 ballot.

Powers’ predicament reflects an odd twist in the way the health care law has played out: State borders have become arbitrary dividing lines between Medicaid’s haves and have-nots, with Americans in similar financial straits facing vastly different health care fortunes. This affects everything from whether diseases are caught early to whether people can stay well enough to work.

It wasn’t supposed to be this way. The ACA, passed in 2010, called for extending Medicaid to all Americans earning up to 138% of the federal poverty level, around $17,000 annually for an individual. But the U.S. Supreme Court in 2012 let states choose whether to expand Medicaid. Illinois did, bringing an additional 650,000-plus people onto its rolls. Missouri did not, and today about 200,000 of its residents are like Powers, stuck in this geographic gap.

Powers briefly thought about moving to another state, just to be able to get Medicaid. “You ask yourself: Where do you go? What do you do?” said Powers, who was in her early 60s when diagnosed. “Do I look at what’s happening in Illinois, right across the river?”

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A recent University of Michigan study found Medicaid expansion substantially reduced mortality rates from 2014 to 2017. The researchers said Illinois averted 345 deaths annually while Missouri had 194 additional deaths each year. The same trends held for other side-by-side states such as Kentucky (did expand) and Tennessee (did not), New Mexico (did) and Texas (did not).

Dr. Karen Joynt Maddox, co-director of the Center for Health Economics and Policy at Washington University in St. Louis, said health care providers in her border city see how the coverage differences affect people. When treating Medicaid patients from Illinois, she said, doctors know procedures, equipment and medicines will likely be covered. With uninsured Missourians, they must consider whether patients can afford even follow-up medications after heart attacks.

Nonetheless, Medicaid expansion faces significant opposition in Missouri, a red state led by a Republican governor with GOP supermajorities in both legislative chambers.

Patrick Ishmael, director of government accountability for the Show-Me Institute, a Missouri free-market think tank, said offering Medicaid to people with incomes above the poverty level would drain resources from the state’s underserved poor and push up taxpayer costs. Though the federal government pays 90% of the cost of the expansion coverage, he said, Missourians contribute to that through their federal taxes. Medicaid already accounts for about a third of the state’s budget, which he said puts pressure on other priorities, like education.

“Missouri and other states need to think about whether they are a government that provides health care or a health care provider that sometimes governs,” he said.

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A Missouri Story

Powers, a minister in the St. Louis suburb of Hazelwood, used to get health insurance through her husband’s job selling lumber and hardware. After he was disabled in 2009, their coverage continued on and off for a while, and her husband eventually received Medicare, the federal insurance program for seniors and people with disabilities. But Powers had no insurance starting in 2012 as the couple struggled on, at most, $1,500 a month.

Medicaid wasn’t an option for her. Missouri could have opened the program to more adults as early as 2010, in preparation for the health care law’s expanded coverage taking effect in 2014. Without the ACA’s expansion, adults who aren’t 65 or older or disabled don’t qualify, no matter how low their income. Missouri’s program generally covers only pregnant women and children from low-income families, parents with incomes about 22% of the federal poverty level and people who are poor and blind, disabled or 65 or older.

Powers and her husband earned too little for her to qualify for subsidies on the federal ACA marketplace, so she couldn’t afford to buy her own plan. And without insurance, Powers never saw doctors for routine health visits or screenings. She stopped taking her prescribed medications for high blood pressure and anxiety — until she could no longer do without her anti-anxiety medicine, Lexapro.

In early 2016, she discovered a place to get help when she gave her friend a ride to a St. Louis clinic for the uninsured called Casa de Salud, where health services cost less than $30.

Powers figured she’d ask about getting back onto Lexapro there. She got a thorough checkup. The doctor found a walnut-sized lump in her right breast, and a mammogram found a tumor the size of a grain of rice in her left. A clinic caseworker helped her sign up for a Medicaid program for breast cancer patients. She underwent surgery in April 2016, then had 35 radiation treatments and took follow-up medications.

She kept thinking she could have found the cancer earlier if only she had insurance. That would have meant less treatment and lower costs for taxpayers, who ended up footing the bill anyway. Research shows breast cancer in its earliest stage can cost half as much to treat as in later stages.

“Even if you didn’t care about the human cost, you should care about the economic cost,” said Jorge Riopedre, president and CEO of Casa de Salud. “Treating a disease at its first stage is always going to be much cheaper than treating it at its advanced stage.”

An Illinois Story

In neighboring Illinois, getting Medicaid through the expansion helped Matt Bednarowicz avoid debilitating medical debt after a motorcycle crash. He was able to go back to work after he was injured while delivering a package in mid-May 2018.

The wreck crushed his left foot, requiring doctors to insert pins in it. Without Medicaid, he would have faced thousands of dollars in medical bills.

“The debt would have been greater than I could comprehend overcoming,” said Bednarowicz, who is now 29.

His Medicaid kicked in “just in the nick of time” to cover the surgery, he said. It also allowed him to get psychiatric help for depression. More than a year later, he’s able to get around well — even jog — and works as a caretaker for an elderly man.

Having insurance helps people like Bednarowicz stay productive, said Riopedre.

“The person who gets sick can’t work, can’t support his or her family, can’t be a consumer and buy goods. If they’re not working, they can’t pay taxes,” Riopedre said. “It just is a tidal wave of downstream effects that if we can’t get it right, it’s going to have repercussions across the nation.”

Amid Controversy, Future Uncertain For Missouri

As the ballot measure push continues, Missouri Gov. Mike Parson, a Republican, recently created a task force to look into expanding Medicaid through a waiver allowing states to skip some federal requirements. His office referred questions to the state’s Department of Health and Senior Services, which in turn referred them to the Department of Social Services. Rebecca Woelfel, a spokeswoman for that agency, said the department doesn’t typically comment on potential ballot issues.

Ishmael, of the Show-Me Institute, said he hopes expansion doesn’t happen. He said the Medicaid system overall is wasteful, with outcomes often not fully justifying the expense. The cost of an expansion would depend on how it’s structured, he said, but “it could be a real budget-buster.”

The impact of an expansion on Missouri’s budget remains unclear. A February analysis by researchers at Washington University estimated it would be “approximately revenue-neutral.” But their estimates range widely for the first year depending on enrollment and other factors, from up to $95 million in savings for Missouri’s Medicaid program to costing $42 million more than not expanding.

Powers, whose husband died last year, said she fully supports Medicaid expansion.

But whatever happens, especially now that she’s suffering from heart failure, she’s grateful she won’t have to worry about being uninsured again. At 66, she’s now old enough for Medicare.

from Updates By Dina https://khn.org/news/the-deep-divide-state-borders-create-medicaid-haves-and-have-nots/

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