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The Check’s in the Mail

An unexpected inheritance came too late to raise her mother from poverty, but not too late for the state of Tennessee to claim the money for itself. A first-person look at how Southern states stack the deck against their working poor.

Fifty-four thousand, five hundred eighty-one dollars, and twenty-five cents.

I stared at the check made out to Mama’s estate.

It was a huge amount of money, one bestowed on Mama by the death of her brother, a single, free-spirited architect from Little Rock who loved to ride his Harley all over the country but never found the time to write a will. Because he died without one, his half-million-dollar estate was divided among his ten siblings.

My finger traced the imprint of her name on the blue rectangle. The money would not go to Mama, because she had died while his estate was in probate. It wouldn’t go to me or Sissy, either. Instead, I was about to put the check into an envelope bound to an administrator hired by the state of Tennessee.

The money, they said, belonged to their Medicaid fund.

My mother was one of the 10 million-plus Americans the press calls the “working poor,” people who earn less than 200 percent of the federal poverty line. She had worked for years as a lunch lady and had retired from not one, but two school systems. But afterward, she had no assets except her monthly Social Security checks and a small burial policy. And she was suffering from schizoaffective disorder, plus vascular dementia.

In 2018, it had become clear Mama needed more help than my sister and I could provide, so we started the application process to insure her under Medicaid. We also went on the hunt for a long-term facility that took Medicaid. To our immense relief, we found a modest but decent place in the next county. Her care cost more than $75,000 a year—three times more than any salary she’d ever made. Every month, Mama’s entire Social Security check, minus $50 for incidentals, went to the nursing home. Medicaid covered the rest. Mama lived there, in a semi-private room decorated with family pictures and rocks she “borrowed” from the facility’s landscaping, until she died.

“You mean, the state of Tennessee would swear out a warrant for my arrest just because I think poor people shouldn’t be punished for needing nursing home care?”

She was still living in the that nursing home when my uncle died. When the news came that Mama would get a portion of his estate, my sister and I learned Tennessee state law required us to notify the state Medicaid fund, because the money she inherited might be enough to make her ineligible for Medicaid.

My uncle’s estate spent eight months in the probate process. Only after Mama’s passing did the big check arrive. And the state Medicaid fund said the money belonged to them. In a way, the timeline was a blessing in disguise. If Mama had still been alive when the check for her portion of the estate was written, the amount of the check definitely would have pushed her over the Medicaid asset limit, and she would have been kicked off Medicaid until we used up all her money to pay for the nursing home. Then, we would have had to reapply for Mama’s Medicaid while Sissy and I tried to scrape together the $7,000 a month we’d need until she was once again approved.

But I was hotly resentful that anyone who was poor enough to qualify for Medicaid in Tennessee would be forced to return money at all.

My Arkansan aunts, one steadfast, one spitfire, and on opposite ends of the political spectrum, pleaded with us to hire an attorney to look for loopholes. They both thought it an abomination my sister and I couldn’t keep the money. After all, Mama had left nothing to us because she had nothing left.

We took their suggestion and hired an attorney. And we quickly learned we couldn’t keep the money. We also learned we couldn’t reject Mama’s share of my uncle’s estate or give it to charity, either. Tennessee, despite already draining the pockets of the poorest in our state with the second highest sales tax in the nation and lavishing generous tax incentives on terrible corporate neighbors, wanted every penny of this unexpected bonanza.

“What would happen if we kept the money?” I’d asked the attorney. “Strictly a hypothetical question, of course.”

“If you knowingly cashed a check that belonged to Medicaid, you’d be committing fraud,” she’d replied. “You’d have to pay back the money, plus fines. Plus, you could get banned from ever getting Medicaid yourself, if you needed it. And it’s not out of the question you could be found criminally responsible, too.”

“You mean, the state of Tennessee would swear out a warrant for my arrest just because I think poor people shouldn’t be punished for needing nursing home care?”

“Well…yes,” she said uncomfortably.

“You can relax. I’ll send them the stupid money,” I told her. “I don’t want to end up in one of Tennessee’s for-profit prisons.”

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I knew about living in poverty. I had grown up in a series of housing projects, cramped apartments, and trailers. I knew the tangy taste of government cheese and the stinging indignity of watching Mama pirouette for utility-bill extensions so our power wouldn’t be cut off. We lived hand-to-mouth until I was in college.

Eventually, Sissy and I clawed our way out, boosted by things like public education, marriage, and Obamacare. We worked hard to break the chains of generational dysfunction. We were determined to take only the best lessons from our scant childhood and learn the rest from the world at large.

Therapy saved my life. My therapist helped me create boundaries and manage the anger and anguish caused by lack that had raged in me since adolescence. It hurt like hell, but once the poison was removed, like any infected thing, the healing began.

Mama did okay, too, but she never seemed to want to catapult herself out of poverty completely. She deigned to let Sissy and I help her escape. She occasionally indulged our pleas of sensible retirement plans and holistic living, but bringing Mama into our headspace was like trying to pull her out of quicksand. She was distrustful of people different from her and wouldn’t change for anybody.

Still, she could have used that money. When I thought of how her life would have changed for the better had she never gotten sick and been able to cash the check herself, my chest ached with grief. She loved her brother and wouldn’t have traded his life for anything, but maybe I would’ve. I thought of the years Mama spent on her feet in cafeteria kitchens. I thought of how she suffered mini strokes caused by untreated high blood pressure. And by the time she could afford insurance, her health had been irrevocably injured by decades without it.

I had known and loved so many people in poverty. Were they not worth every penny we had in reserve? … A boy I sat next to on the school bus whose family didn’t have running water. A dear friend who could only afford to take her diabetes medicine every other day.

I would have traded all his wealth and my handful of it, too, just to restore her. I felt the same way about every sick and busted-down person in the supposedly great state of Tennessee. I had known and loved so many people in poverty. Were they not worth every penny we had in reserve? I wept for my daddy, who had worked overtime every week but still died with a mouthful of rotten teeth. A boy I sat next to on the school bus whose family didn’t have running water. A dear friend who could only afford to take her diabetes medicine every other day.

These stories swirled in my head as I angrily shoved the check into an envelope and taped it shut. The administrator had assured me Mama’s money would go back into the general Medicaid fund.

“So, it will help people,” he’d told me cheerfully. I did not tell him that, compared to the need in our state and the untouchable money Tennessee kept in savings, adding $54,581.25 to the pot would be like pouring a teakettle full of water on a raging house fire.

I tried to stay positive, to think in terms of my family’s incremental change. This check arrived too late for Mama, but based on our humble beginnings, it was truly remarkable no one else in my family needed it. Perhaps the money would eventually help a few more neighbors afford carpal tunnel surgery or antibiotics next time they were sick.

Incremental change suddenly felt like defeat. Despite what I’d told the attorney, I still had to resist the urge to crumple up the envelope in anger. Should I?

“I’d better not,” I said aloud. “Mama, I know you would want me to do the right thing.”

Keep the faith, she used to say. My faith is harder to find these days, especially since she’s gone. Sometimes, I see nothing but brokenness in my neighborhood, my city, my country, my world.

I walked out to my mailbox, opened it, and shoved the envelope to the back of the box as hard as I could.

“This isn’t the last you’ll hear from me,” I said loudly to the inside of my mailbox. I quieted quickly, realizing how disturbed I must sound. I hoped none of my neighbors were outside. Then again, I’d lived here for years. They knew I was a political junkie. They’d all heard me yell at something or other.

“Mama, please help me keep the faith…or least help me stay out of prison.”

I flipped up the red flag and slammed the box shut. Their damned check was in the mail.

Author Profile

Heather Ream is the author of Lunchladies Bought My Prom Dress: A Memoir. She is a Christ follower and the proud owner of a twangy Appalachian accent. She lives with her husband in Knoxville, Tennessee.

1 thought on “The Check’s in the Mail”

  1. I read this story and immediately thought, “Oh, but how I disagree.” My mother lived out her last few years in a nursing home. She was a WAVE during WWII and later worked to raise her three children as a single parent and buy a home. Mom put her children first, and though she managed to give them all she could, she never thought of herself first. When she sold her home while in her late 80s, she put aside $10,000 per child in CDs, keeping some in savings for her own needs. She fiercely defended the right to keep those CDs in tact, but ultimately she needed the money to pay nursing home expenses. At her death, she had only $3,000 to her name. I explained to her that it wasn’t the responsibility of the state Medicaid program to pay her bills while she still had savings; we had to use the money, for her. And we would not have wanted it any other way for she had instilled in her children to have dignity and to do what was right.

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