My daughter has $200,000 each and every year in billed medical expenses. She is able bodied, but has a disease that might qualify her for SSI/Medicaid.
/She is currently working at Amazon, and before that Starbucks. Both of those companies have affordable health care plans with fantastic coverage - because they are large employers with a largely young healthy workforce. Her insurance at both of those companies is better than mine has been at jobs which pay more but require a college degree (or more).
Even with the fantastic plan, because of her extraordinary health expenses, she hits her out of pocket maximum each year by the end of January. Most people hit their out of pocket maximum once in a blue moon. But every year, working at a low-paying job, she has to cough up between $2,500 and $3,500 each and every year. In January.
Medicaid has a $0 out of pocket, and a $0 copay.
At barely-making-it wages - even with job associated health insurance, some are better off not working, taking the meager SSI/SSDI and avoiding thousands of dollars each and every year in medical expenses.
So even people who could conceivably work might choose Medicaid, not to abuse the system, but because they are forced into making fiscal choices by the lack of truly affordable health care for people with chronic illnesses.
As her mother, I made that choice for her when she was little. The state refused to recognize her parents' marriage. As my biological child, she was not eligible for health insurance from her legally-a-stranger other mother. I was staying home with her until she was 5, so I had zero income. At least initially, we could have afforded a separate health insurance plan for her by taking money out of savings - but that would have been fiscally irresponsible because the only reason she didn't have insurance through her parent's employment was the state's refusal to recognize our (by that time) 10 year marriage. When she was diagnosed with her first chronic illness, just before her 5th birthday, we had no choice - since it was back in the era before ACA - and the only plan which would accept her cost about $1500/month - $18,000 a year. Our family income at that time was about $30,000.
Living with a chronic illness can be incredibly costly - even if the condition is not, itself, disabling - if treated.
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