Mrs. Tuttle is a 42-year-old woman who was recently diagnosed with early-stage breast cancer. After feeling a lump, she went to a free clinic for evaluation. She became extremely upset when she was told it was cancerous and that she would need treatment, as she had recently lost her insurance.

She had been on Medicaid for several years, but the new year brought the implementation of Medicaid work requirements to maintain state Medicaid coverage, and Mrs. Tuttle is not currently employed. She had been a nurse but had to stop working when her father, who has dementia, was no longer able to live independently. She became her father’s full-time caregiver, with her long-term partner supporting her financially.

She was told that the cost of treatment without insurance could exceed one million dollars, which she cannot afford.