Roughly 5.7 million children who are eligible for Medicaid or CHIP in the United States are not enrolled, according to estimates from the Kaiser Family Foundation — largely because their parents never believed the family could qualify. Marcus Matsuda came within fourteen months of permanently joining that statistic.
I met Marcus in early March 2026 at the Omaha Public Library’s Millard Branch, where I was covering a free Medicare and Medicaid enrollment assistance event hosted by Nebraska’s State Health Insurance Assistance Program. He wasn’t there for Medicare — at 48, he’s still a decade away from standard eligibility. He’d come, he told me later, because he was desperate to understand whether any program in existence could give his family a little more room to breathe.
Marcus is a pharmacy technician with more than two decades of experience. He earns $63,000 a year. His wife, Keiko, works part-time at a dental office and brings home roughly $16,000 annually. On paper, $79,000 a year for a family of four in Omaha sounds manageable. In practice, Marcus told me, it has felt like running on a treadmill set slightly too fast.
A Budget That Looked Solid Until It Wasn’t
The math started coming apart about two years ago, Marcus explained, when their younger son — now two years old — was born and Keiko’s ex-husband stopped paying child support for her eight-year-old daughter from a previous relationship.
The child support order requires the ex to pay $650 a month. As of March 2026, he had not made a single payment in fourteen months. That is $9,100 in unpaid support that simply evaporated from the family’s monthly calculations.
Layered on top of that absence is childcare. Their two-year-old attends a licensed daycare near their home in south Omaha, which costs $1,380 a month — a figure Marcus said he recites like a reflex. “That’s the first number I see every time I open our bank account,” he told me. “It’s like it’s just always there, waiting.”
Between the missing support payments and the daycare bill, Marcus said the family’s usable income has shrunk to a point that startles him when he maps it out. Their mortgage, utilities, groceries, and car payments leave almost nothing for savings — and nothing for emergencies.
What He Didn’t Know About CHIP
Marcus had never seriously investigated whether his children might qualify for any government assistance. His assumption — shared by millions of American families — was that his salary disqualified him from anything meaningful before he even looked.
At the library event, he pulled aside one of the certified application counselors, a woman named Diane who works with Nebraska’s Department of Health and Human Services, and started asking questions. What he heard surprised him.
Nebraska’s Children’s Health Insurance Program — known locally as KidsConnection — provides coverage to children in families whose income falls between Medicaid’s eligibility threshold and 200% of the Federal Poverty Level. For a family of four in 2026, 200% of FPL is approximately $62,400 per year. At $79,000, Marcus’s household sits above that line.
But Diane walked him through a piece of the eligibility calculation he hadn’t considered: because some need-based assessments can account for a household’s full financial picture, and because the family’s net position after childcare and unpaid support was significantly different from the gross income figure alone, there were still doors worth knocking on. She also flagged Nebraska’s child support enforcement system — a pathway Marcus had not yet formally pursued.
The Application Process — and What Came Back
Marcus submitted a CHIP application for his two-year-old in mid-March 2026, just days after the library event. The process, he said, was more straightforward than he expected — Nebraska’s DHHS portal allowed him to apply online and upload income documentation directly from his phone.
As of early April 2026, the CHIP application is still pending. Marcus received a request for additional documentation in late March — specifically, a written explanation of the childcare expense and its impact on household finances — and he submitted it the same day it arrived. He described himself as cautiously optimistic, but careful not to plan around an outcome that isn’t confirmed.
“I’ve learned not to count on anything until I see it in writing,” he told me. “But even just having someone look at our situation seriously — that felt like something. Like being taken seriously for the first time in a while.”
The Child Support Enforcement Path
Separate from the CHIP application, Marcus opened a formal case with Nebraska’s Child Support Enforcement program, a state agency that helps custodial families locate non-paying parents, establish legal orders, and enforce payment through wage garnishment or license suspension.
Marcus said he had hesitated to involve the state because of concern about how Keiko’s daughter would be affected emotionally, and because the relationship between Keiko and her ex is already strained. But after fourteen months and more than $9,000 in missed payments, he felt there was no realistic alternative.
As of early April 2026, the enforcement case is active. The agency located the ex-husband, who is employed, and initiated the wage garnishment process. That is the small win Marcus referenced when I first approached him at the library — not money in hand yet, but a formal mechanism finally set in motion.
Where Things Stand — and What Marcus Is Still Carrying
When I sat down with Marcus for a longer conversation a few weeks after the library event, the picture he described was neither a recovery story nor a crisis. It was somewhere in the complicated middle — which is where most families actually live.
The CHIP application for his two-year-old is pending. His eight-year-old does not appear to qualify based on the household income level. The childcare bill is unchanged at $1,380 a month. The mortgage is manageable — barely. And the first wage garnishment payment for back child support has not yet arrived.
What has changed is Marcus’s understanding of the landscape. He now knows that assumptions about income thresholds are worth verifying, not guessing at from the outside. He knows that state-level enforcement programs exist and are free to access. And he knows that a single conversation with the right person — in this case, a benefits counselor at a library on a Tuesday afternoon in March — can open doors he didn’t know existed.
Marcus told me he wishes he had had this conversation sooner. Not because it solved everything — it hasn’t — but because the cost of not knowing is real, and he paid it for more than a year without understanding there was an alternative approach available to him.
Sitting with him at a table near the library’s periodical section, surrounded by other families doing their own quiet navigating, I kept thinking about how many people never make it to events like the one we were both at that day. How many people run the same mental calculation and arrive at the same wrong answer: We make too much. There’s nothing for us.
The truth, as Marcus is slowly learning, is messier and more effortful than that — and more exhausting to navigate than any single library event can fully address. He left that afternoon with a folder of printed information, a case number for child support enforcement, and a cautious sense that something was finally moving. Whether the CHIP application comes through or not, he told me, he is at least no longer standing still.
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