There is a persistent myth in American life that working in healthcare means you have access to healthcare. Walk into almost any dental office in the country and you will find assistants, receptionists, and billing coordinators doing skilled, essential work — often without the employer-sponsored benefits their patients assume come with the job. Curtis Washington, 31, is one of them.
Curtis responded to a call for sources I posted on social media in late November 2024, asking to hear from people actively navigating government benefits programs. His message was short: “I just got denied for BadgerCare and I’m not sure what to do next. Would love to talk.” We connected over video call the following week, and he spent nearly two hours walking me through a situation that, as I would come to learn, is far more common than the income-eligibility charts make it look.
A Job With No Safety Net
Curtis has worked as a certified dental assistant at a small private practice in Milwaukee’s Bay View neighborhood since 2021. He earns $44,200 a year — a middle-income wage that sits comfortably above the poverty line but nowhere near the threshold at which affordable private insurance becomes realistic. For three years, the clinic offered a group health plan. Then, in August 2024, the practice owner sent a staff email announcing that due to rising premium costs, the group plan would end on September 1.
“They gave us a $150 monthly stipend to go find our own coverage,” Curtis told me. “Which sounds helpful until you actually go look at what plans cost.”
His fiancée, Priya, is finishing her graduate degree in social work at UW-Milwaukee and carries student health insurance through the university. Their household income, combined, runs just above $52,000. Curtis described the weeks after September 1 as a slow-motion unraveling. He takes a low-dose generic sertraline for anxiety — a medication that costs roughly $28 a month without insurance at a pharmacy like Walmart. He also discovered, when he went to refill an antibiotic prescription in October after a sinus infection, that the out-of-pocket cost without coverage was $87 for a ten-day course.
“I stood at the pharmacy counter for a full minute just staring at the number,” he said. “I knew I needed it. But $87 is $87.”
The BadgerCare Plus Application — and the Denial
In early October 2024, Curtis applied for Wisconsin’s BadgerCare Plus, the state’s Medicaid program for low-income adults. He found the application portal on his phone at midnight, he told me, after a particularly bad evening of avoiding his bank statements.
The problem was his income. Wisconsin has not adopted the full Medicaid expansion under the Affordable Care Act. According to the Wisconsin Department of Health Services, BadgerCare Plus covers childless adults up to 100% of the Federal Poverty Level — which in 2024 translated to approximately $15,060 per year for a single individual. Curtis’s salary of $44,200 put him at roughly 293% of the FPL. He wasn’t close.
The denial letter arrived by mail on October 22, 2024. Curtis described reading it at his kitchen table before work. “It was very official looking. Very final feeling,” he said. “I just set it down and went to brush my teeth.” He laughed a little when he told me that. The irony of a dental worker brushing his teeth after reading a healthcare denial was not lost on him.
Scrambling Through the Paperwork Maze
What Curtis did next is what many uninsured adults do: he searched online, found contradictory information, called two different numbers that directed him back to the same automated system, and eventually gave up for several weeks. He described himself honestly — he knows he has a tendency to avoid financial stress rather than confront it head-on.
Priya, his fiancée, pushed him to contact a certified application counselor. Through a community health organization based in Milwaukee’s near south side, Curtis connected with a navigator — a federally funded role that helps consumers enroll in coverage through Healthcare.gov. According to Healthcare.gov, navigator services are free to consumers regardless of income or plan type.
The navigator appointment was the first time, Curtis told me, that anyone had sat down and actually explained the numbers to him in plain language. She told him that at his income level, he qualified for a premium tax credit through the ACA marketplace. She also told him he had nine days left in the open enrollment window.
The Outcome — and the Parts That Still Don’t Add Up
Curtis enrolled in a silver-tier marketplace plan on December 12, 2024, with coverage starting January 1, 2025. After applying his premium tax credit, his monthly cost is $218. The full unsubsidized premium would have been $389. By any technical measure, the system worked — eventually.
But the picture Curtis painted for me was more complicated than a clean resolution. His new plan carries a $1,500 individual deductible and $45 specialist copays. His sertraline is now covered as a Tier 1 generic at $10 a month, which genuinely relieved him. The antibiotic problem is mostly solved. However, he found out in February that a dentist he’d been seeing — a different practice from where he works — is out-of-network on his new plan. A routine cleaning he’d already scheduled cost him $190 out of pocket.
“I work in dentistry,” Curtis told me, still audibly frustrated. “I should have known to check that. But I was so relieved to have any coverage that I just signed the thing.” It is the kind of detail that is easy to miss when you are enrolling at the last minute with nine days left on the clock.
As of early April 2026, Curtis is still on the same plan, now in its second year. His premium has increased slightly to $231 a month after the annual recalculation of his tax credit. He and Priya are planning their wedding for late 2026, at which point they expect to move to a joint plan through her expected employer after graduation. That transition, he told me, is something he is already dreading — “another round of applications and paperwork” — though he said it with a tired laugh rather than panic.
What Curtis’s Story Reflects About the Coverage Gap
Curtis’s situation is not unique to Wisconsin, but Wisconsin’s partial Medicaid expansion makes the floor particularly low. Unlike the 40 states and the District of Columbia that have adopted full Medicaid expansion under the ACA — covering adults up to 138% of the FPL — Wisconsin stops at 100%. That gap between 100% and 138% affects an estimated 90,000 Wisconsin residents, according to reporting from the Kaiser Family Foundation.
The irony that Curtis kept returning to during our conversation was the job itself. Dental assistants handle sterilization, patient prep, and clinical support in environments that carry real occupational exposure risk. Many work for small independent practices that operate on thin margins and cut benefits when costs spike. The people closest to patients, in many cases, are the least protected.
When I ended our second conversation in March 2026, Curtis said something that stayed with me. He said he had started actually opening his bank statements again. Not every week. But most weeks. For someone who described himself as someone who avoids looking at numbers when they get bad, that felt like the real marker of progress — not the enrollment confirmation email, not the insurance card, but the slow return of the capacity to look.
He is not out of financial stress. His prescription costs are manageable now, his coverage is real, but the $1,500 deductible hangs over him. The out-of-network dental bill still irritates him. And the whole four-month gap — the scrambled pharmacy runs, the denial letter, the nine-day enrollment sprint — is not something he can get back. The system eventually absorbed him. It just took longer than it should have, and cost him more than the $150 stipend ever covered.
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