I grew up in New York City, a city with a vast public transportation system of subways underground and buses and taxis above. Most New Yorkers don’t even need to own a vehicle, and I had no need for a driver’s license. However, in the summer of 2011, I left New York City for Colorado and ended up in Highlands Ranch where my eldest sister lived. I knew leaving New York that I would have to adapt to a whole new way of life, especially in terms of transportation. In the suburbs, cars reign supreme and mass transportation is an afterthought.
My first job here was for a startup marketing firm in Stapleton. I took a combo of two buses and a light rail to get there by 8 AM, and my total commute each day was about six hours. The following year I moved closer to my job, cutting my commute to a 30-minute bike ride or a 15-minute drive—if I could drive. I tried to learn how to drive, but failed my first driver’s test, and my friends and family were reluctant to teach me, let alone loan me their vehicle for practice. So, I had to pay for driving lessons, and it cost me $500 that I didn’t really have to spare. Now, as a digital organizer for Center for Health Progress, I work on transportation issues every day.
Health is closely connected to transportation, because transportation affects our access to health care and helps us take care of our basic needs. In fact, nearly four million people don’t get medical care each year because of transportation issues. Transportation affects many aspects of a person’s life—from getting to work to getting food to getting health care. Add in income inequality, and the inequitable ways we distribute community resources, like grocery stores, hospitals, and public transportation access, and it’s easy to see how a lack of transportation can be a major barrier to good health.
Non-Emergency Medical Transportation, or NEMT, is a federally-mandated benefit of Medicaid. It is a service Medicaid provides for their enrollees to take patients to their appointments at doctor’s offices, dialysis clinics, and other health care facilities. Every day, I speak with people who are ill, and often living in poverty or have disabilities, who are faced with trying to figure out how to get to their appointments with little or no access to transportation. They might be able to pay Lyft to take them, but that would cost money they can’t afford. They might be able to take public transportation, but that would put their health at further risk, especially if their immune system is compromised, and it could cost them multiple hours of travel time. So, NEMT services are important.
Now, with COVID-19, many patients are canceling their NEMT rides. The riders fear catching COVID-19 from drivers, many of whom don’t have appropriate protective equipment, like masks and gloves, or from other passengers, who may have ridden in the van before them. They’re legitimate fears, and one patient’s story about getting ridiculed for requesting basic safety precautions left me particularly rattled. We’ve brought these stories to state leaders and are working to ensure the NEMT program can meet patient needs during this crisis and beyond.
Transportation continues to be a challenge in my life, so I relate to the people I talk to every day. I am learning over and over again that without access to transportation, good health is out of reach. We must protect the NEMT program and also fight for laws and policies that improve our entire transportation system—our lives depend on it in so many ways.