Shanna Peele was born and raised in Asheville, North Carolina. She has spent 15 years teaching students with special needs, raising her own family, and helping her community adapt as her hometown near the Blue Ridge Mountains has grown—and grown more expensive. 

Peele loves education, but life as a teacher looks a little different than Peele imagined it would when she entered her profession. “We consider ourselves professional,” she said. “We’ve gone to school, and we have a degree, and so we think we shouldn’t have to reach out for assistance from the government. Our jobs should be enough.” 

Peele sees the gap between professional wages and the real cost of raising a family, as she finds herself caught in the same financial storms that batter so many working families: rising medical debt, income that doesn’t cover childcare costs and dual incomes that still struggle to meet the expenses of raising three children.

Hurricane Helene washed away the farm her husband managed, increasing the family’s financial anxiety. “It is hard to advance as a family, just to be able to take care of basic needs, on the salary of a teacher, even with my husband working full-time,” she said. “It’s hard to get a living-wage job.”

Teachers in North Carolina get raises via “steps,” a small bump in compensation for each year of service. When Peele reached her 13th year of teaching, her and her husband’s income finally topped the threshold of eligibility for Medicaid.

Until then, Medicaid meant that Peele could keep her family healthy while continuing to work, even through a high-risk pregnancy and childbirth.  Coverage allowed Peele to keep teaching without risking her family’s health or taking on medical debt that could have pushed them out of the workforce entirely.

Medicaid paid tens of thousands of dollars toward the birth of her children. “It’s that security in knowing that at least something’s going to be OK,” she said of coverage. “At least I’m going to be somewhat healthy. My baby is going to be healthy and taken care of.”

Peele worked as a stay-at-home parent for a time after her second child, when she realized that childcare costs would eat up the vast majority of her meager salary. “It’s just wild to think that you can’t afford to work,” she said.

For Peele, stepping out of paid work was the best way to keep the family financially afloat at a time when childcare costs nearly equaled her earnings. “We have to continue to make really hard decisions,” she said. 

Now, losing Medicaid coverage means a new world of navigating co-pays, negotiating to consolidate medical bills and significantly increased expenses for the family. “We’re absolutely in a more difficult position,” Peele said.

“There is a lot of debt, and a lot of management,” said Peele, describing days spent calling billing departments just to consolidate care into something the family can afford.

In rural communities children make up 36% of Medicaid enrollees, with expansion through Affordable Care Act (ACA) benefits vital to maintaining children’ s health. Two of Peele’s own children are diagnosed with autism, and one child has pathological demand avoidance.

“We’re calling mobile crisis multiple times a week for him,” Peele said. “He’s in need of a lot of therapy.” Co-pays for therapy alone will cost several hundred dollars per month for the family in 2026.

As a special education teacher, she also sees the importance of Medicaid in serving her students. “Medicaid is the fourth-largest funding stream for our schools,” Peele said. In her classroom, that funding shows up as speech therapists, occupational therapists, and consistent support for students who need it most. “I’m very worried that, if Medicaid goes away, our students with special needs are going to suffer the most,” Peele said.

Across North Carolina, Peele knows that thousands of other teachers like her are juggling family expenses, wondering how to pay for medical care or making ends meet with federal health care coverage. “It’s not widely talked about,” she said. “We’re not living luxurious lives over here. We’re just trying to cover basic rent and power, and maybe Netflix. It’s not what I thought life was going to be like when I became an adult,” she said – especially when she devoted herself to a professional career educating the next generation.