Surviving the U.S Health Care System
At 18, I lay in a hospital bed, staring at the blank ceiling, the hum of machines filling the silence. The walls around me felt sterile and suffocating in their unfamiliarity. I had been there for weeks, long enough to lose track of time and for the fear to settle deep in my bones. The diagnosis was tuberculosis—something I had never imagined would become part of my story. But as terrifying as the illness was, an even greater weight loomed over me: the cost of it all.
My first thought upon hearing the diagnosis wasn’t about treatment, recovery, or the risks ahead. It was, “Can we afford this?” At just 18, I found myself consumed by questions no young adult should have to ask. Health care was never a simple decision—it had always been a calculation.
Coming from a South Asian immigrant family, I had always known that health care was a privilege, not a guarantee. Doctor’s visits were carefully considered financial decisions, prescriptions stretched as far as possible, and medical bills were a source of quiet dread. Insurance never covered everything when we had it, and the fear of unexpected medical debt was always present. So as I lay in that hospital bed, hooked up to monitors and awaiting treatment, my mind wasn’t just on getting better—it was on whether my family would be able to afford it.
In the days that followed, I had to navigate every aspect of my treatment—not just as a patient, but as someone desperately trying to understand the financial implications of being sick. Would my treatment be covered? How much would we have to pay out of pocket? What would happen if we couldn’t afford it? I had to ask the hospital staff directly, my voice small yet desperate, “Is this covered? Will we have to pay for all of this?” The answers were vague, filled with paperwork, policies, and uncertainty. I spent a month in that hospital, each day bringing the same gnawing question: Will I be able to leave without leaving my family in financial ruin?
When I was finally well enough, I had to plead my case with the hospital, filling out stacks of paperwork as an 18-year-old trying to prove I needed financial assistance. I was fortunate—I managed to get my costs covered. But what about those who couldn’t? What about the young adults, the immigrants, the uninsured Texans who find themselves in the same situation but don’t have the means to fight their way through the system? What happens to them?
Through my work with Partners in Health, Young Invincibles, and within the public health advocacy sphere, I have met many young adults who delay care for this reason—because the cost of seeking help can be just as terrifying as the illness. Many people from my community avoid hospitals entirely, relying on home remedies and hoping symptoms will fade on their own because they know that a single hospital stay could financially devastate their families. Others never get the chance to negotiate their bills because they don’t know how, don’t have the language skills, or simply don’t qualify for assistance. They fall through the cracks of a system never designed for them.
Texas has one of the highest uninsured rates in the country, yet our leaders continue to ignore the crisis young adults face when trying to access health care. Elected officials and decision-makers must understand that medical care isn’t just about insurance coverage—it’s about ensuring that no one is forced to choose between financial ruin and their health. We need accessible and transparent hospital assistance programs, Medicaid expansion that includes young working-class adults, and policies that prevent health care from becoming a financial death sentence.
No one should have to plead for the right to get better. At 18, I had to ask if I could afford to survive. At 23, I still ask myself the same question every time I get sick: Can I afford health care? Language and culture should not impede the care people receive, yet for many, these barriers make health care inaccessible. Texas lawmakers can change this—by expanding Medicaid, strengthening hospital financial assistance programs, and investing in policies that ensure young adults can access care without fear of economic hardship. Supporting these efforts means supporting the health and well-being of Texas’ youth, giving us the chance to thrive without the constant fear of medical debt.
Bhakta, Misha, TX
United with Uvalde
Located near the southwestern edge of Texas, Uvalde is a historically close-knit community known for its strong family ties, rich Hispanic heritage, and enduring local traditions. However, on May 24, 2022, this small town was forever changed by a tragic mass shooting at Robb Elementary School that claimed the lives of 19 children and two teachers. In the wake of this unimaginable event, Uvalde’s resilience and unity have shone through as residents, advocates, and initiatives—such as United with Uvalde—have come together to mourn, heal, and push for necessary systemic reforms. The region’s cultural fabric, built on mutual care and shared responsibility, underscores the urgent need for accessible, culturally competent health care—especially mental health services—for the young adults and families who call Uvalde home.
Through my collaboration with Community Health Development Inc. (CHDI), the federally qualified health clinic serving as the primary care hub for the entire county, we established United with Uvalde. This initiative focuses on community-led mental health advocacy for survivors and families, helping to coordinate culturally competent resources and support in the aftermath of the Robb Elementary School shooting. My involvement with Young Invincibles aims to amplify youth voices in state-level policy discussions about health care equity. I contributed to patient-centered interventions at Texas Children’s Hospital, integrating mental health screening and skills training into routine pediatric care. These efforts reflect my goal of reducing barriers to care by championing policies that recognize mental health as integral to overall well-being.
As I near graduation from the University of Houston’s Master of Social Work program, my coursework has further strengthened my commitment to health care advocacy. In my Social Policy Analysis course, I researched the expansion of Medicaid to fund better school-based mental health services—an assignment highlighting the legislative complexities of accessible and affordable treatment. Similarly, in Confronting Oppression and Injustice, I conducted a case study examining how systemic inequities, such as language barriers and limited provider availability, disproportionately affect rural and minority communities. By applying these academic frameworks to real-world advocacy, I strive to ensure that my clinical endeavors not only alleviate individual distress but also inform broader policy solutions that challenge oppressive structures and promote health equity.
One policy avenue where my clinical experience can significantly impact is advocating for legislatively mandated and sustainably funded integrated behavioral health services in public schools, particularly in rural and under-resourced communities like Uvalde. Drawing on concepts from my advanced coursework in social policy analysis, case formulation, and trauma-informed practice, I recognize that embedding mental health professionals within educational settings improves early detection and intervention while mitigating stigma by normalizing help-seeking behaviors. Under this model, students who exhibit warning signs or experience chronic stress have direct access to culturally competent clinicians who collaborate with families, teachers, and community stakeholders to ensure holistic and equitable care. By coupling my clinical insights with policy-level advocacy—amplified through organizations like Young Invincibles—I aim to address systemic barriers, confront oppression and injustice in service delivery, and propose solutions that integrate mental health services seamlessly into children’s daily environments, thereby fostering healthier school climates and stronger community well-being.
Through United with Uvalde, I have witnessed firsthand the profound impact that dedicated resources, empathetic care, and persistent advocacy can have—yet the need remains significant. Elected officials and decision-makers must recognize that young adults in Texas want to heal, thrive, and contribute to their communities. We need a health care system that meets us where we are, addresses early warning signs, and acknowledges the unique challenges faced in rural settings. By addressing these gaps, leaders can stand with us in solidarity, ensuring that tragedies do not define our futures and that our collective well-being is prioritized every step.
Choudhury, Aproteem, TX
Systemic Health Care Failure with the Marginalized Community
My environment and the people around me have shaped who I am today. Much of my identity and beliefs are owed to my mother and the daily struggles she has faced. One of the biggest challenges she endures is poverty, which has affected not only her life but also the lives of her four children, including me. Witnessing the hardships brought on by financial instability has given me a deeper understanding and appreciation for my mom. Many of these struggles stemmed from a lack of awareness about available resources and a lack of support from her family. The barriers placed before my mother taught me the importance of asking questions and maintaining a mindset that challenges limitations. Ultimately, her experiences helped me recognize that her challenges were personal and part of broader systemic issues.
These struggles have inspired me to focus on financial accessibility and advocate for policies that provide resources to those who are unaware of their options and those who are less privileged. If the government truly wanted to address these critical issues—particularly in health care and financial awareness—it would ensure that information reaches even the most remote communities and underserved populations.
Like many students and young adults today, my mom only intended to escape her environment. She wanted more out of life but wasn’t sure what that looked like. She enrolled in college to leave home, making decisions that would impact her for the rest of her life. However, without fully understanding the importance of engaging in her education and preparing for life after graduation, she struggled academically and was placed on academic probation. Her college career ended just as quickly as it began.
Back home, she found herself in survival mode, applying for every government assistance program that could provide even the slightest help. Time and again, she was denied assistance due to strict eligibility criteria. At times, this left us without electricity or hot water. Sometimes, it led to homelessness or forced us to move in with estranged family members. The lack of financial resources didn’t just impact her in the moment—it created a cycle of poverty that became harder to break over time. From the inability to access quality education to struggling with medical costs, the system seemed designed to keep her trapped in the very conditions she was trying to escape.
When my parents married, my mom’s benefits were reduced due to my father’s income level. On top of that, she faced daily struggles with Type 1 diabetes. Once she lost her Medicaid/Medicare coverage, she had to rely on my father’s employer-provided insurance, which required them to pay a percentage of the cost for insulin, medical equipment, and other essential expenses.
More times than I can count, my father would be at work while I cared for my younger siblings, only to witness my mom’s blood sugar drop dangerously low, leaving her unconscious. My siblings and I would do what we could to revive her, but there were times when we had to call EMS. Sometimes, the medics were able to stabilize her at home, but if they couldn’t do so quickly enough, they would strap her onto a gurney and rush her to the hospital. Each hospital visit meant another bill for transportation and care. With my father as the sole provider and my mother receiving limited government assistance, these medical bills continued to pile up. Poverty wasn’t just about a lack of money—it affected every aspect of our lives. Health care, government assistance, and daily survival were all interconnected, reinforcing a cycle of poverty that felt impossible to break.
After my parents divorced, my mother’s health declined drastically. Her organs weakened, limiting her mobility. As my siblings and I grew older, my mother’s income decreased, along with the benefits she received. With little support from her own family, she applied for housing assistance, SNAP, WIC, and eventually, SSI. However, receiving these benefits meant she had to meet strict income limitations, restricting her ability to earn additional money without jeopardizing the support she relied on.
My mother was only aware of the resources she was told about. When she realized that life could be more than just survival, she was already caught in the web of financial hardship. Witnessing her struggles has fueled my passion for fighting policies that address the root causes of poverty, such as inadequate health care access, flawed government assistance programs, and the lack of affordable education. These systemic barriers keep countless families trapped in poverty, and dismantling them is at the core of my political mission.
Ganiyu, Qudus TX
The Cost of Survival: Navigating Health Care as a Young Adult in Texas
Access to health care in Texas is not just about whether someone has insurance or can afford a doctor’s visit—it is about survival. As a young adult navigating this system, I have faced challenges that go beyond policy failures. My experience reflects the consequences of a system where limited resources create barriers to care, leaving vulnerable individuals without the support they need.
I was diagnosed with HIV after surviving a hate crime. Health care access became a critical concern in the aftermath, yet the system was not designed to ensure my stability. Even as a U.S. citizen, I encountered targeted discrimination—not just from individuals but from institutions that should have been a source of protection.
While working at a nonprofit dedicated to legal advocacy, I lost my job unexpectedly, along with my income and health insurance. This left me scrambling to find life-saving care in a system where access is conditional and health care is treated as a privilege rather than a right. My experience underscores the dangers of an inequitable system—one where those who need care the most are often left behind and where even those fighting for justice can find themselves without support.
Without access to essential health care, survival becomes uncertain. That is why it is crucial to create systems that ensure everyone—regardless of status, background, or circumstance—can receive the care they need to live healthy and stable lives.
Texas, despite being one of the wealthiest states in the country, continues to fail its young adults—especially those of us who are already marginalized. I have witnessed firsthand the consequences of a broken system. Having lived near the border, I have seen people trafficked, exploited, and disappeared. Public health resources that should have been used to protect vulnerable populations were misallocated and manipulated by corrupt individuals for personal gain. I have seen funds meant for public health initiatives siphoned into systems of harm, used to cover up human trafficking operations rather than prevent them.
My identity as a Latino has been tainted by this corruption. Public health is supposed to be about healing, safety, and equity, yet I have seen it weaponized against the very people it is meant to protect. It is this reality—not just my HIV status—that has driven me to pursue a career in public health. I have seen how surveillance systems fail to protect those at risk, how health care resources are deliberately mismanaged, and how policy decisions actively contribute to suffering instead of alleviating it.
Medicaid has been a lifeline for me, but it is not a sustainable solution when policies and eligibility requirements shift with every election cycle. One change in leadership, one funding cut, and I could be left without the care I need to survive. Lawmakers must understand that health care access is directly tied to safety. When resources are limited, people become desperate, and desperation leads to violence, resentment, and harm. The solution is not to pit marginalized communities against one another but to ensure that everyone has access to the care they need so that no one feels forced to destroy another person’s life just to gain control over their own.
Policies must be in place to protect young adults from being discarded by the system—whether through job loss, health care cuts, or outright violence. We cannot allow scarcity to justify harm. The reality is that people like me should not have to fight this hard just to exist. I have done everything I was supposed to do—worked, studied, earned degrees, contributed to my community—yet I have been punished simply for being who I am.
This is not just my story; it is the story of countless others who fall through the cracks of a broken system, left vulnerable to exploitation, illness, and violence. Public health should be about protecting people, not endangering them. Until our policies reflect that, survival will continue to be a privilege rather than a right.
Garcia, Natanael, TX
The Importance of Specialized Mental Health Care
During my sophomore year, shortly after moving to Texas, I experienced a mental health crisis that derailed my life. Almost overnight, basic daily functions became nearly impossible. I started missing classes, stepped down from commitments, and felt strain in my relationships. Eventually, I learned that I was exhibiting symptoms of obsessive-compulsive disorder (OCD), a widely misunderstood condition for which treatment options are scarce across the country—especially in Texas.
For over a year, I was fortunate to access therapy through my university. However, I was only permitted to see my therapist biweekly and, for a long time, was unaware that specialized OCD treatments even existed. When I finally learned about Exposure and Response Prevention (ERP)—a highly effective therapy for OCD—I immediately reached out to my campus Counseling Center. Their first referral, after a long wait for a response, quoted me over $400 per session. It wasn’t until this semester that I was finally referred to an affordable ERP program—though even then, I had to advocate for myself to ensure my insurance was processed correctly.
I am incredibly grateful to be starting a personalized recovery plan, but the barriers I faced highlight a much larger issue. No one should have to navigate this level of inaccessibility, confusion, and financial burden just to receive essential mental health care. My experience has fueled my determination to fight for a more equitable Texas—one where no young adult is forced to suffer in silence due to a lack of resources and support.
Healy, Quinn, TX
Health Care Costs
As a child, my mother was always a public servant, which meant that I never had to worry about health care. I thought of it in terms of my glasses—relatively expensive but not always necessary. It was a manageable and essential cost, but I never feared being unable to afford it. Although I grew up in a low-income household, I always knew there was a safety net to care for my health care needs. I assumed the safety net would remain when I moved to Texas for college.
When you enroll in college, you must also sign up for insurance, so I assumed I was covered. I believed that if I ever needed medical care, my insurance would be there, just as it had been when I was younger. Unfortunately, I was mistaken.
During my first semester of college, I visited a doctor because I wasn’t feeling well. They recommended some tests, which were conducted, and I provided my Aetna insurance information. Months passed, and I assumed everything had been taken care of. However, in December, I received an unexpected text message billing me over $1,000 for testing fees.
I immediately panicked, texting my mother at midnight to see if she knew what was happening. She did not. I felt utterly alone, unable to comprehend how this had happened. Neither my mother nor I could pay a $1,000 bill. I had believed my school’s insurance would protect me, but instead, I was left frightened and in debt simply for seeking medical care.
Throughout my academic journey, I worked hard to earn a full-ride scholarship to college. I was always told that working hard in school would lead to success and ensure my needs were met. At no point was I informed that I would also need to secure an affordable health care plan, find a job to cover unexpected $1,000 medical bills, and still maintain high grades and participate fully in campus life.
The state of health care coverage in Texas put me in a precarious position. If Medicaid were expanded in Texas, I and millions of other students wouldn’t have to scramble to cover medical expenses. Now, all I can do is hope I don’t get sick because I simply cannot afford the cost of that “mistake.”
Health care is a necessity. Not having access to it or being afraid to seek it out could have devastating consequences. Every Texan deserves health care. Every family, employee, child, and student deserves the ability to care for themselves without fearing financial ruin. Expanding Medicaid would make that a reality, and it’s time for our elected officials to fight for a healthier Texas.
JenkinsBey, Nadia, TX
From Coverage to Crisis: My Story of Losing Health Care and Fighting for Change
I remember turning 26 and suddenly losing my health insurance. I know what it’s like to go years without coverage, forcing myself to ignore pain and push through illnesses because the alternative—a single medical bill—could leave me in crippling debt for the rest of my life. My parents weren’t health literate, and navigating the system alone was, and still is, daunting and confusing. No one should have to face that fear. I want better for the people who come after me.
We live in a country with some of the most advanced medical technology in the world, filled with brilliant innovators. Yet, millions of people can’t access basic health care because of how fractured, inaccessible, and cruel our system has become. Beyond the financial burden, we must recognize the systemic inequities determining who receives care and who gets left behind. Insurance companies, driven by profit, do not care and routinely deny coverage, even when doctors advocate for their patients. Accessing care is intentionally difficult, requiring people to navigate endless paperwork, long wait times, and hours spent on the phone just to dispute a denied claim. And that’s for those who even have insurance.
For those who don’t? The barriers are even higher. Many people, especially in the gig economy, work full-time but don’t receive employer-sponsored health benefits, and they’re priced out of an exorbitant insurance market. In a system where health care is tied to employment, millions fall through the cracks, not because they don’t work hard but because the system was never built to support them.
And now, instead of fixing these problems, we’re talking about cutting Medicaid even further, making it even harder for low-income individuals to qualify for care. This is not just a policy issue; it is a moral failure. It is a travesty. It punishes the most vulnerable among us: citizens, non-citizens, working people, and those struggling to find work. It fails us all.
We can do better. We must do better. I urge you to support legislation that expands Medicaid and increases access to comprehensive health care. We must allocate resources to support community-based health care initiatives, ensuring that no one has to choose between paying rent and seeing a doctor. Health care should not be a privilege reserved for those who can afford it; it should be a fundamental part of a just and thriving society.
Invest in us so that we can reinvest in our communities. Prioritize the well-being of the people you serve. Support policies that give people the dignity of accessible, affordable health care. Our future depends on it.
Rodriguez, Georgia, TX
Falling into Reproductive Care
Growing up in a military family, I never worried about my health care. First, because I was a child and didn’t think about the costs associated with my yearly doctor and dentist visits. Second, because active-duty military service members are well taken care of by Tricare.
As I got older, I began to notice the cracks in the system, especially regarding reproductive care in the military. I saw how access to appointments could vary depending on the administration in office, how some of my concerns weren’t taken seriously, and how mental health was often disregarded for everyone. This became an issue I couldn’t ignore.
Even now, as a dependent of a military service member, I recognize my privilege when it comes to health care and reproductive care. I have access to birth control that lasts up to five years and a supportive family that prioritizes my reproductive health as a young woman striving for success. However, I also understand the challenges people outside the military face regarding health care and reproductive care, and I am ready to advocate on their behalf.
Sudderth, Daisy, TX
My Choice, For All My Life
Since I was very young, I knew that I did not want to give birth to children. That’s not to say that I may never want kids in the future—only that I have never felt comfortable being the one to carry them. Because of this, I knew I wanted to explore the available medical options to ensure I could make this choice for myself. In 2023, I was finally able to do so.
Accessing health care as a woman in Texas can be extremely difficult. With the help of my mom and online health care resources, we found a document listing providers in Texas willing to perform a salpingectomy for unmarried, childless women. I was fortunate to find a female doctor in Austin and one who accepted my health insurance. After a few consultations, she agreed to perform the procedure. At that moment, I felt an overwhelming sense of joy—I had been able to make a medical decision for myself without unnecessary barriers.
I know that, unfortunately, this is not the reality for many others in Texas. Even my mother, despite being married with four children, was denied a hysterectomy multiple times. Accessing affordable and comprehensive health care is essential, yet it remains out of reach for many. I am incredibly grateful that I received this procedure without significant pushback. Moving forward, I hope to advocate for increased medical accessibility so that all individuals can make informed decisions about their bodies and health care needs.
Woodard, Mack, TX