The Worst Places To Be Sick And Poor

In Pictures: The 10 Worst States To Be Sick And Poor

Bernadette Sheridan, a doctor at Grace Family Medicine in Canarsie, Brooklyn, has stopped seeing patients covered only by Medicaid, the Federal-State partnership that pays for medical care for the poorest Americans.

Why? Sometimes Sheridan didn't get paid, and when she did, it took forever. New York takes 140 days to process most claims, compared with 41 for South Carolina, according to AthenaHealth (nasdaq: ATHN - news - people ), a company that helps doctors get paid. But the worst thing was that all the specialists to whom she wanted to refer patients had already stopped taking Medicaid. If a woman showed up with a lump in her breast, Sheridan had to just send the patient to a clinic or emergency room.

In Pictures: The 10 Worst States To Be Sick And Poor

What scares her most, she says, is that the many people with families who suffer from chronic illnesses are "only a pink slip away" from a hard-to-navigate system that she calls "a horror."

Medicaid is the primary medical insurance for 55 million Americans. Another 47 million are uninsured and finding ways to cover these people is expected to be a big point of focus for the administration of President-elect Barack Obama.

But what you get varies widely depending on where you are. Unlike Medicare, which takes care of senior citizens, Medicaid is a patchwork of 51 different state programs that get federal funds of between 50 cents and 77 cents for every taxpayer dollar they spend.

State budgets are often strapped, and priorities differ, so the quality of care, what patients need to do to get coverage and what the plans will pay for all vary wildly from state to state