Who are America’s working poor? The official definition is those Americans who spend at least 27 weeks a year in the labor force and yet have incomes below the federal poverty line.

I am one of those Americans.

I work all year as a freelance writer and about 35 weeks as an educator. And yet my adjusted gross income remains well below the federal poverty line, making my family eligible for Medicaid. I came of age during the Reagan Revolution when Republicans promised cutting regulations and taxes would increase corporate profits that would trickle down to the middle and lower classes.

That’s not what happened. As historian Heather Cox Richardson recently reported, “A February 2025 report from RAND, a nonprofit, nonpartisan research organization…found that if the system in place before 1975 had stayed in place, the bottom 90% of Americans would have had almost $80 trillion more in 2023 than they did.”

Put another way, in reporting by the Washington Post, “Between 1930 and 1980, only the bottom 90% saw their incomes rise. After 1980, only the top 1% saw their incomes rise.” At the same time that wages for the working and middle classes stagnated, costs for basic living expenses, particularly housing and education (still one of the best ways to increase lifetime income) have exploded. But perhaps more than any other expense, nothing in the U.S. has increased like health care. In 1980, the nation spent $247 billion on health care. By 2024 it had jumped to $5.3 trillion.

The cost of insurance, deductibles, co-pays and treatment is so great that, should a family’s income move slightly over the poverty line and lose eligibility for Medicaid, something referred to as the “benefits cliff,” it can be economically devastating. While my two underage children and I are healthy in the general sense, because my daughter was born with Down syndrome, cataracts in both eyes and hypothyroidism, she has high medical needs. She had four eye surgeries her first year and weekly physical, occupational and speech therapies her first three years.

Each of her first 10 years, she went under general anesthesia for various procedures. We’ve long referred to ourselves as “frequent flyers” at Akron Children’s Hospital. Committed to doing all I could to set my daughter up for maximal success given her diagnoses, I could not work a traditional job after her birth. Instead, for 10 years, I proofread legal documents, a job I could do most anywhere, including waiting rooms. Even with that income, which was essential, our family remained well below the federal poverty line.

When my daughter’s appointments became less frequent, I transitioned back to teaching, yet my income continues to place us below the poverty line. I could not have met all my daughter’s needs without Medicaid. I have three college degrees and a resume full of experience, but because wages have remained stagnant while health care costs have skyrocketed, most full-time jobs would mean falling off the benefits cliff: we’d lose Medicaid for expensive health insurance with far less coverage that would result in a net reduction of my household income, and far less comprehensive medical care.

In an interview in 2024, Republican Ohio gubernatorial candidate Vivek Ramaswamy said he believes Medicaid and Medicare were mistakes and that Medicaid recipients should be required to work. But like so many statements coming from today’s Republicans, Ramaswamy’s is a fiction meant to mislead voters.

According to the Kaiser Family Foundation, in 2024, 64% of “Medicaid covered adults (age 19-64) who do not receive benefits from Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) and are not also covered by Medicare” worked either full time (44%) or part time (20%). Those who didn’t work were caregivers, ill or disabled, attending school, retired or unable to find work.

The victim-blaming trope that the poor are poor because they’re lazy is something I’ve heard often but not observed.

It’s a myth.

I’ve worked for years in schools where most students’ households were below the federal poverty level. I’ve lived for decades in a neighborhood that is economically diverse. I’ve witnessed no more reticence to work in poor communities than I have in rich ones. Most people are doing all that they can to take care of their families as best they know how.

America spends far more on health care than any other nation. And yet we are less healthy and have lower life expectancies than any other rich country. The problem isn’t the poor, working or not. The problem is our systems. 

This column was first published in the Akron Beacon Journal on Sunday, February 15, 2026.