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Pasture-Based Pregnant Farmer. Medicaid before the Affordable Care Act

Theresa BrownGold's painting "Medicaid Insurance " for her art project, Art As Social Inquiry.

(oil on canvas, 40 ins. x 30 ins.) (Interview 1/2010)

Update 2021

I grew to love this painting over the years. I didn't love it at first. Maybe I felt I did not capture KayCee's youth or beauty. Maybe I came to appreciate KayCee's intensity in the painting. I don't know. Or am I remembering my own difficulties as a painter trying to get something real on the canvas? And feeling relief that I got her?

There is a lot of trying in my early paintings -- but that's not necessarily a bad thing. With the trying came a hit-or-miss innocence. My rule in 2010 was that if I felt the subject's spirit in the portrait, I had to keep it. Today, I still feel attached to paintings that capture the sitters' spirits. I'll never paint over them. I keep those works for myself. But getting a subject's spirit is not enough today.

Since I started painting 17 years ago (with a brief stint in my mid-twenties), I've identified more criteria on which to base a painting's success besides capturing the sitter's spirit. In the beginning I hadn't fully sorted out my process to know what signs to look for to tell me to stop painting. Those signs are not intellectual.

Sure, all art instruction will talk about drawing skill, color theory, composition, etc. But I do not rely on an intellectual analysis to gauge a painting's success. I don't know any artists who do.

Yes, art instruction is necessary whether one teaches one's self or takes the express route and goes to art school. Understanding how art tools work is the same as knowing an airplane's controls so one can fly. Once in the cockpit, I know when a painting is working by the chill up my spine. By a ringing in my ears. The heart flutters. Everything in life feels possible. All is right with the world. And when a painting isn't working, I feel like a 500 lb. anvil crashing onto a tile floor. Experience has taught me not to overreact to a painting going wrong. I'll work it out even if I have to start over 100 times.

In the original portrait story (below), I refer to subsidized health coverage KayCee had in 2010. When I interviewed my subjects in the early days, I didn't know enough to know what to research. I never thought of myself as a researcher. I was being led by my subjects' stories. As the portrait stories pulled me deeper into the dark US healthcare chasm, my naiveté receded and the investigator in me took over. I had to know. Why exactly were so many suffering -- and some dying -- trying to get healthcare in this country?

Today I can fill out this portrait story a bit. New York state's Medicaid eligibility requirements were more generous and reasonable than most states in 2010. KayCee most likely qualified for New York's Medicaid program especially being pregnant. Most states' Medicaid programs were more generous for pregnant women


I was thrilled to be able to track down KayCee. Here is what she wrote.

"I now get my healthcare through my work. My partner, Owen and I, are both insured through my plan. (He has been a small business owner for many years, but closed his business to go back to school. He just finished his Associates program and works part-time as a contract worker. He has never been able to afford insurance through his business nor was he able to offer insurance to his employees). Our insurance is not good. High premium and high deductible. We pay close to $600 a month with my employer paying more than half of the monthly premium. I am constantly writing checks to doctors and feeling like what is even the point of insurance when I still pay so much. For example, I was having abdominal pain and my doctor prescribed an ultrasound. I paid $500 for the ultrasound and $250 to see the OBGYN to interpret the results of the ultrasound. There is such a disincentive to seeing a doctor!

My son is still insured through Child Health Plus and it is still amazing. We now pay the full monthly premium, about $280, but I feel great about it because I never ever see a bill. That is how insurance should work!"

Artist Note (3/2012)

I talked to KayCee with her husband and my husband present during the interview. My husband accompanied me for the long ride to meet the subject. The portrait does not capture this woman’s beauty. Instead I captured her struggle. After painting this portrait, I realized that I need to interview my subjects alone. I usually can make a deep personal connection if my interview is one-on-one. It is the connection I paint not the face. This is one of the few portraits where I did not feel a deep connection with the subject. Had I interviewed her alone, I feel I would have.

KayCee has a partner. I am curious, knowing what I know now, if they did not get married because being married might disqualify her for subsidized health insurance benefits? Of course this is pure speculation. I did not ask. I did not know enough at the time of the interview about how securing health benefits socially engineers our society. I have seen in other stories where people often get married or not to get or keep health insurance benefits.


The subject's baby. Oil on canvas, 24 ins. x 20 ins.

(Interview from 2010)

Pasture-Based Farmer Raising Grass-Fed Lamb & Cattle, age 34, Pregnant, Insured

KayCee works on her own farm in addition to doing part-time work at another farm. Working part-time at the second farm qualifies her for state-subsidized health insurance.

KayCee's insurance does not cover her midwife charges to deliver her baby. KayCee will pay $6500 for the midwife out of her total savings of $10,000. It is that important to control how, and by whom her baby is delivered. She is trying to get her insurance company to reimburse her.

KayCee hopes her modest income will make her newborn eligible for Medicaid. Medicaid is a public health insurance program. The states operate their own Medicaid programs with joint funding from the federal government


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