Kate Clyatt, 28, works seasonally as a ranch hand in southwest Montana, and relies on the state’s Medicaid program for health coverage. “Ranching is just not a job with a lot of money in it,” Clyatt says. “I don’t know at what point I’m going to be able to get off of Medicaid.”

Kate Clyatt, 28, works seasonally as a ranch hand in southwest Montana, and relies on the state’s Medicaid program for health coverage. “Ranching is just not a job with a lot of money in it,” Clyatt says. “I don’t know at what point I’m going to be able to get off of Medicaid.”