“I’m always on high alert,” said Robin, a mother of two from Oklahoma. She is balancing getting quality care for her daughter with autism, and making ends meet. Restrictive eligibility requirements mean she’s had to stay in a lower-paying job or risk getting kicked off of Medicaid.

Robin is one of roughly 40 million others who live on this eligibility cliff – folks who are forced to live in poverty in order to avoid a small increase in income triggering the loss of their public assistance benefits.

Robin’s 12-year-old daughter Sydney lives in an inpatient care facility in another state, which is 500 miles away, or a 9-hour drive. 

“It’s hard for me to see her. Her needs are so high that my state couldn’t meet her needs, so my state is paying for her to be safe in a good facility,” she explained. When Robin cannot make the trek, she has family, such as her father, to visit. But the costs of hotel, food, and travel add up. 

In 2020, Oklahoma voters expanded Medicaid through SoonerCare via a constitutional amendment, covering people ages 19 to 64 with incomes at or below 138 percent of the federal poverty level. The amendment was enacted in 2021.

 “It saved our lives. It saved my life. It saved Sydney’s for sure. Everyone should have access to healthcare and get their needs met,” Robin said.

Before the expansion, Robin tried to receive care through marketplace and employer-sponsored insurance. Despite these attempts, she couldn’t access high-quality ABA Therapy for Sydney until two years ago, delaying the interventions that could have started at two years old rather than ten years old to develop coping skills and manage the severity of her behaviors. Still, 10 states have not expanded Medicaid for their citizens. 

Robin is terrified of more Medicaid cuts. “I can’t take any job. I have to make a certain amount to keep her on SoonerCare.” Robin is careful, not making over $2,200 a month, so that her daughter’s care is not lost due to income limits. 

“Unless I’m a CEO or there’s a job that makes $1.2 million a year—because that’s how much it would cost—I am literally forced to be in poverty. It’s why I don’t get married because I don’t want it to affect her Medicaid,” she added.

Without Oklahoma’s Medicaid expansion, Sydney would not thrive. Robin noticed a change in her behavior since getting appropriate care, such as increased happiness and comfortability and a decrease in aggression. Instead of six personnel to calm Sydney down, Sydney only needs one person. “That’s a huge improvement. It’s mainly because there is a direct care worker there,” Robin said. The facility refuses to use restraint devices, utilizing compassionate care. 

It’s a big difference from her experience with the family policing system, where it is not uncommon for parents of children with disabilities like her to face higher scrutiny. They have not been understanding of her daughter’s avoidant food intake disorder, or meltdowns that occur sometimes during speech services.

As she shares her family’s journey on TikTok where she advocates for a better system that covers more people, she’s had strangers attack her parenting. But she continues to share her story, because Robin believes that awareness and getting rid of shame are important when discussing children with autism, especially as they navigate changes out of their control. Of course, she keeps details like Sydney’s facility private for safety. 

“I’m trying to volunteer, share content, and get her story out there, because I really want to help other people. I feel relieved, and I feel very grateful. I would hope that other people like Sydney or other families also get help,” Robin said. She emphasized the need for protection and care for children with autism, citing therapeutic, residential, and inpatient care as a necessity. 

But like any mother, she misses her daughter. “Hopefully, someday I can get her home, but I’ll have to change a lot of things here.”

According to Washington University in St.Louis’s Center for Social Development, almost a third of U.S. workers receive public benefits such as SNAP, WIC, or Medicaid to keep a household afloat. In order to keep their benefits, many working-class families are forced to remain in jobs and economic positions that do not allow for economic mobility. One solution would be to expand eligibility and access to public programs, especially considering the rising cost of everything that’s putting more and more people in precarious situations.

“My life would change dramatically if I could contribute financially and put more money into the economy. However, if funding went away for Sydney’s care, there would never be a chance for me to work with taking care of her. My job is making sure she is taken care of for the rest of my life,” Robin explained. 

And if she did want to return to her original field as an AV tech and camera operator, she is worried that she wouldn’t be qualified as the industry changed with constant shifts in the media and technological landscape and her mentors retiring. 

Despite this, she is grateful for the facility that takes care of her daughter, educating others on her platform about her experiences navigating the healthcare system.

Robin shared the training that staff go through to provide care for Sydney, citing that they will remove any workers who trigger any meltdowns. They prioritize her preferred workers. They are currently working with Sydney to adjust to public places such as the beach and a local trampoline park as they work on growing her coping skills.

Robin is worried about national legislation that is attacking access in healthcare, as witnessed with the government shutdown in late 2025, where Republicans fought extending the subsidies for the Affordable Care Act.

“So far, she’s there right now, they’re getting paid, and I got approved for SoonerCare this year. Now this November, I will turn in my paperwork. Whatever they ask me to do, I’ll do whatever it takes to keep her there. I’ll volunteer, but I have to make that threshold,” Robin said.

Instead of dollars being poured into attacking immigrants and used for senseless wars, funding can support everyday Americans needing care. Americans deserve a healthcare system that prioritizes quality of care and affordability. No one should be forced to choose between health and wages to make ends meet.