Carmen Smith remembers the day about a year ago when she gained Medicaid coverage.
"It was like Christmas Day, it was like getting a gift from Santa Claus!" she says. "People don't realize how important and how special it is to have insurance to be able to go see a doctor on a regular basis when you have an illness like mine."
Smith, 44, has Type 2 diabetes. Before qualifying for Medicaid coverage, she was what policy experts call a "frequent flier." She had used the emergency room at MetroHealth, the public hospital in Cleveland, five times in one year.