If your on Medicaid it's a given your "poor" as determined by Federal guidelines. I knew plenty poor folks in Hawaii, on Medicaid, SSI and various Government programs. I never asked them WHY they were poor. In some cases it was obvious, mental health, handicapp, that sort of thing. In other cases it was more difficult to tell, but as I got to know them it became more clear. Sometimes, it was just a head scratcher as to why, maybe they were frauds. I can't imagine walking up to someone and asking them, "Why are you poor?"
I recall two folks in particular, both Vets. One of them worked for me for awhile, did what he could, I paid him for what he was worth. He was just not able to hold a job, anger issues mostly, very sensitive to questions like, "Why are you poor?" That would have set him off!
The other fellow recently had a liver transplant in Portland. Sharp guy, used to own a restaurant, got sick, lost everything, dang near lost his life.