. >> reporter: jay costman in her doctor.ike most of his low-income patients at the john bell health center, his health care is medicaid. >> we treat all inner city, low income predominantly, either insured or unassured patients >> reporter: that means taxpayerser and states are left to foot the bill. across the nation states have thrown up road blocks. most states have added restrictions that delay or make it difficult for hepatitis c medicaid patients to get their treatment. her application was rejected four times. >> denied completely because it is not medically necessary because you do not need the hepatitis-- meet the hepatitis c criteria >> reporter: they won't pay for the mirror axle drug until her disease gets worse. the doctor has said you're sick enough >> yes >> reporter: the health say you're not >> they want me to get sicker. >> reporter: her experience is not uncommon. privacy insurers and medicaid reject patients who are not deemed sick enough. to a patient like this woman, it is a cruel and possibly life threa