“I am so happy,” says Sizemore as she waits at the Grace Community Health Centre in Clay County, Kentucky, “I’ve not had insurance since I turned 19.” But Sizemore is also nervous. She is seriously overweight and was warned in her teens that she was likely to develop diabetes. Without health insurance she has not been able to afford tests or check-ups to see if she has indeed got the disease. Sizemore is one of 421,000 people in Kentucky who’ve signed up since the Patient Protection and Affordable Care Act, widely known as Obamacare, came into force last October. Like many, she now qualifies for Medicaid, the government programme that pays for health care for the poorest Americans. Under the new law, the federal government offers states money to expand Medicaid so that many more people on very low wages, like Liberty Sizemore, are covered. Benita Adams may be one of the people the Governor has in mind. The 62-year-old grandmother lives on the edge of the rolling Appalachian Mountains in eastern Kentucky. She owns her home but works two jobs as a dental assistant to make ends meet.

Adams has had no health insurance since her divorce 30 years ago. A recent heart operation left her with a $67,000 bill. Although the hospital waived around half of that, she still pays $50 a month to clear the rest. “I used to say, if I get hurt just let me be killed because I can’t afford to pay any more hospital bills,” she says. But Adams no longer has to worry. Under Obamacare, she qualifies for a private insurance plan with a hefty government subsidy that covers the monthly payments in full. “Everyone was mad over Obamacare but it’s just wonderful, it’s really helping people,” Adams says as she lists the medical appointments she has been to since getting insured. Liberty Sizemore, waiting for her blood test results at the Grace Community Health Centre, feels the same. “I was so worried,” she says. “But now I can get better because I have a doctor. I have a doctor and that’s a relief off my shoulders, more than you can know.”
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