Roughly 3.5 million veterans who are eligible for VA health care have never enrolled in the program, according to data published by the U.S. Department of Veterans Affairs. For many, the reasons are practical — they don’t know they qualify, they assume it’s only for the injured or the destitute, or they spent decades with employer coverage that made the question feel irrelevant. Linda Santiago was all three of those veterans at once.
I first connected with Linda through a veterans’ support group in Spokane, Washington. A coordinator there reached out after Linda had spoken at one of their monthly meetings about her experience trying to find affordable health coverage. I drove up to meet her on a Tuesday morning in February 2026, and we sat at the kitchen table of her apartment in the South Hill neighborhood while her 14-year-old daughter finished getting ready for school in the next room. Linda had coffee ready. She apologized for the clutter — there were lease renewal documents spread across one end of the table that she hadn’t yet filed away.
That detail was not incidental. Those papers were, in many ways, the reason we were talking at all.
A Rent Hike That Changed the Math
Linda Santiago is 64, fiercely composed, and the kind of person who tells you everything is fine before she tells you what’s actually wrong. She has managed marketing for a Series A startup in Spokane since early 2023, earning approximately $91,000 a year — a salary that sounds stable until you subtract what her life actually costs.
In August 2024, her landlord notified her that her monthly rent would increase from $1,620 to $2,106 at lease renewal — a 30% jump, driven by what the property management company described as “market alignment.” She had no ex-partner contributing to household expenses. Her daughter’s father has been out of the picture financially since 2019. And her employer, like many early-stage startups, offered no sponsored health insurance plan.
Before the rent increase, Linda had been purchasing a mid-tier plan through Washington’s ACA marketplace, Healthplanfinder. Her premium was $740 per month before any tax credit subsidy. Because her income placed her above 400% of the federal poverty level for a household of two — roughly $82,600 for 2024 — her advance premium tax credit was modest. After the rent hike absorbed nearly $500 more per month, that marketplace plan became functionally unaffordable.
The Benefit She Had Never Claimed
Linda served in the U.S. Army from 1980 to 1984, receiving an honorable discharge. She spent most of her twenties and thirties in corporate marketing roles that came with solid employer benefits, so VA health care never felt relevant. When those roles dried up during a company restructuring in 2021, she pivoted to startup work — and the benefits gap opened underneath her.
What she did not know, until a fellow veteran at the Spokane support group mentioned it in passing, was that her honorable discharge alone qualified her to apply for VA health care enrollment. No service-connected disability required. She had simply never looked into it.
According to VA eligibility guidelines, veterans who served on active duty and were discharged under conditions other than dishonorable may enroll in the VA health care system. Placement into a priority group — which determines copay levels — depends on factors including service-connected disability ratings, income, and combat service history. Linda, with no documented service-connected conditions and an income above certain geographic thresholds, was assigned to Priority Group 8 upon enrollment, which carries the highest standard copay structure.
The Enrollment Process: What Linda Actually Faced
Linda submitted her application for VA health care enrollment in October 2024 using the online portal at VA.gov. She told me the process was less complicated than she’d expected — but the emotional weight of it surprised her.
“I kept waiting for someone to tell me I didn’t really qualify,” she said. “I served 40 years ago. I hadn’t thought of myself as a veteran in the way that phrase usually means. It felt strange to be asking for something based on something I did when I was 20.”
She submitted her DD-214 discharge documentation, proof of income for the prior year, and a completed VA Form 10-10EZ. Within approximately three weeks, she received her enrollment confirmation and was assigned to the Mann-Grandstaff VA Medical Center in Spokane as her primary facility.
She dropped her ACA marketplace plan effective January 1, 2025. Her VA copays — $50 for primary care visits and $90 for specialty care, as structured for Priority Group 8 outpatient visits — still represent real out-of-pocket costs. But compared to $740 monthly in premiums, the shift was significant. Linda estimates she saves approximately $6,240 per year in premiums alone, even accounting for expected copay expenses.
What the Numbers Don’t Capture
When I asked Linda whether she felt relief after enrolling, she paused before answering. That pause told me more than her words did.
Her daughter, who has been on Linda’s plan as a dependent, does not qualify for VA coverage. Linda enrolled her daughter in Washington Apple Health — the state’s Medicaid program — in November 2024, once she confirmed the income thresholds. Children in Washington can qualify for Apple Health at household incomes up to 312% of the federal poverty level under the CHIP expansion, according to Washington State’s Health Care Authority. For a household of two, that threshold was approximately $75,480 for 2024 — and Linda’s daughter qualified independently of Linda’s income because of how the household size calculation applied.
The housing situation remains unresolved. Linda renewed her lease at the increased rate because relocating with a teenager mid-school-year was not a realistic option. She is now spending $2,106 per month on rent, which represents roughly 28% of her gross monthly income. She has looked into Washington State’s Housing Finance Commission programs but has not yet found a pathway that fits her income bracket and renter status.
“The rent thing is still hard,” she told me plainly. “The health insurance piece — I feel like I got that right eventually. But I’m still figuring out the housing. I don’t want to move my daughter again.”
What Linda Wants Other Veterans to Know
Linda is not someone who naturally asks for help. Throughout our conversation, she repeatedly framed her situation as manageable, as something she was handling, as not as bad as what others face. That instinct — to minimize, to defer — is part of why it took her until age 64 to look at a benefit she had technically held since she was 24.
As I was getting ready to leave, she said something that I’ve thought about since:
According to a VA Women’s Health report, women veterans are among the fastest-growing segments of VA health care enrollees — but remain significantly underrepresented relative to their total eligible population. Outreach gaps, assumptions about who the VA serves, and the kind of self-effacing delay Linda described all play a role in that number.
Linda Santiago is still at her South Hill apartment, still managing the lease she didn’t want to sign, still raising her daughter on a single income. She has a primary care provider at Mann-Grandstaff now. She has her daughter covered through Apple Health. The math is tighter than it should be for someone earning what she earns, but it is, at least, math she can make work.
That is not a triumphant ending. But it is a real one — and sometimes, in this reporting, those are the stories that matter most.
Related: Her Health Insurance Premiums Doubled to $1,840 a Month — and She Still Couldn’t Fill Her Prescription
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